To what extent does our existing healthcare culture encourage or dissuade pregnant women from seeking early and continuing prenatal care? By changing the ethos of healthcare delivery systems in ways that increase consumer access, satisfaction, utilization, and outcomes, is it possible to erase disparities in the health of mothers and infants? Those were questions the National Friendly Access Project set out to answer.
In 2002, Genesee County was selected as one of twelve communities nationwide to submit proposals to the Lawton and Rhea Chiles Center for Healthy Mothers and Babies at the University of South Florida to become a “Friendly Access Community.” As the lead agent of the Project in Genesee County, the Coalition applied for a grant but initially did not receive funding from the Chiles Center. We did, however, obtain $300,000 from area foundations and organizations to launch the program locally. Acknowledging our independent efforts, the Chiles Center made our program a full demonstration project of the Friendly Access Project, with additional funding in subsequent years. Friendly Access became a collaboration project between the health services sector and community based organizations in Genesee County, and was a core project of the Prevention Research Center of Michigan at the University of Michigan’s School of Public Health.
Initial data collection and analysis of birth records revealed that while low-income women in our area (those covered by Medicaid or uninsured) had fewer complications or risks noted in their birth records, they experienced poor outcomes. An analysis with respect to race showed an even greater difference in the African-American population.
A further study of the mother’s ratings of the prenatal and perinatal healthcare system was conducted by interviewing 358 new mothers who gave birth at one of the three Flint area hospitals, and whose birth was covered by Medicaid or self-pay. Findings suggested many of the women did not receive early prenatal care, counseling in family planning, or assistance finding a pediatrician for their new baby.
In addition to study outcomes, throughout the project’s five years, participating healthcare providers, community leaders, and consumers attended training programs designed to gain a better understanding of what patients need, improve policies and procedures, and create a more efficient process for delivering quality care.
The lessons learned through our work with the Friendly Access Project laid the groundwork for future Coalition activities and the data gathered continues to inform leaders as they strive to reduce the infant mortality rate and eliminate the racial disparity that exists between European American babies and African American babies in Genesee County. The activities that follow have contributed to the wealth of work being done to improve health outcomes for mothers and babies in our community.