Community-Driven Solutions for Whole-Family Health in North Carolina

Centering Lived Experiences to Advance Maternal and Child Health Equity

For the past two years, we have proudly housed the Maternal and Child Health Equity Action Network (MCHEAN). Centering community voices throughout the process, the MCHEAN co-created action plans to meaningfully improve our state’s maternal and child health outcomes. Read more about the MCHEAN and learn about the next steps for this essential work.

Laying the Groundwork: Listening, Learning, & Landscape Analysis

In 2022, as a foundation for the MCHEAN, FHLI conducted a landscape analysis of maternal and child health efforts. Based on the research, the team compiled a report, “Progress and Opportunities: Maternal and Child Health Equity in North Carolina,” detailing existing maternal and child health efforts, alongside interviews and surveys of mothers, health educators, doulas, midwives, and other health professionals.

Subsequent stages of the work involved creating and facilitating the MCHEAN beginning in 2023. Through a series of convenings, the MCHEAN engaged in meaningful, nuanced conversations with diverse participants, including health providers, community organizations, advocacy groups, government agencies, policymakers, researchers, educators, and those with lived experiences.

Building the Network: A Collaborative Approach to Health Equity

Around two-thirds of all the MCHEAN participants had professional experience in maternal and child health. Many also shared firsthand experiences with systemic inequities. Thanks to this range of perspectives, the discussions examined the root causes of complex and pressing challenges, especially the impact of systemic racism, social drivers of health, and other structural barriers.

After two years, thanks to the thoughtful leadership of our lead facilitator Danielle Little, MEd, Maternal and Child Health Consultant, and co-facilitators Melinda Ramage, FNP-BC, CARN-AP, Director of North Carolina Perinatal Substance Use Disorder Network, and Alexandra Simpson, MPH, Maternal and Child Health Equity Consultant, the MCHEAN efforts have culminated in a report, “Rising from Challenges to Change: A Cross-Sector Action Plan for Maternal and Child Health Equity in North Carolina.”

Elevating Community Voices in Maternal & Child Health

The MCHEAN applied FHLI’s Community Voice (CV) Model to co-create solutions to challenges impacting families across our state. The model is a values-based community engagement framework for co-creating solutions to public health challenges. This community-centered approach applies intentional tools and systems-led philosophies shaped by the voices of community members.

A key method used in the CV Model is human-centered design (HCD), an evidence-based, collaborative approach focusing on empathy, co-creation, and lived experiences. In public health, HCD offers a robust framework for tackling systemic issues and fostering lasting change.

HCD and community co-design processes aim to empower marginalized voices through deep listening and advocating for policies shaped by community input. These approaches provide fresh insights into complex issues, incorporate diverse stakeholder perspectives, and maintain a strong human focus.

From Insight to Action: Four Community-Led Strategies for Change

The report includes four community-created action plans focusing on evidence-based, culturally sensitive, and equitable solutions to drive the next steps for the MCHEAN.

1: Provide Direct Perinatal Health Education to the Public

Insufficient perinatal education presents challenges and opportunities for enhancing maternal and child health. The first action plan aims to cultivate a widespread, informed dialogue on maternal health, promote a sense of shared responsibility, and mobilize communities toward sustainable solutions.

It focuses on distributing targeted, strategic public service announcements (PSAs) to raise awareness about the crisis and its underlying causes, drawing on community-driven initiatives such as the “Every Baby Guilford Campaign.” This action plan aims to replicate their model and adapt it to the broader context of maternal health equity, including:

Developing a PSA campaign for community spaces through various channels.
Collaborating with health professionals, community leaders, and advocates to ensure the campaign message is accurate and relevant.
Tailoring messaging to resonate with diverse cultural, ethnic, and socio-economic groups.

The action plan outlines each stage within this overarching objective, including content creation, partnership engagement, community outreach, and monitoring and evaluation.

2: Develop a Shared Understanding of the Standard of Care for Patients and Providers

The second action plan aims to cultivate a common understanding of standards of care between patients and providers, fostering a respectful relationship that prioritizes communication, education, and access to appropriate care.

To ensure patients feel respected, informed, and empowered, and providers engage in a collaborative, two-way relationship, the action plan outlines the following steps:

Enhancing patient-provider relationships through education and training, including establishing and managing patient expectations about access to appropriate care.
Integrating behavioral health with medical care, developing protocols to identify and address behavioral health concerns, and advocating for policies that promote integration.
Establishing a statewide maternal care hospital designation, revitalizing and reimagining previous maternal and child health programs that have ended.

This action plan adopts a multifaceted approach, incorporating strategies to improve interpersonal relationships between patients and providers, statewide initiatives, and policy changes.

3: Engage Co-parents and Support Persons Through Education and Wellness Interventions

This action plan aims to engage co-parents and support persons in maternal health by providing education on maternal health literacy and recognizing signs of distress and potential health threats. It focuses on:

PSA campaigns and educational initiatives for co-parents and support persons that use inclusive communication strategies to reflect diverse family structures and relationships.
Wellness programs, healthy living resources, counseling services, and support groups tailored to the unique needs of co-parents and support persons.
Effective communication between providers and co-parents to ensure that relevant information is shared and understood.

These interventions aimed at the well-being of fathers, co-parents, and support persons acknowledge that their physical and mental wellness directly influences the health and well-being of the mother and child, an often-overlooked reality.

4: Patient Advocacy and Education for Empowered Maternal Health

The fourth action plan focuses on empowering women and pregnant individuals by providing comprehensive education and advocacy training to foster trust in their bodies and equip them with the knowledge and communication skills needed to effectively engage with health providers.

It focuses on early education and tools for intentional dialogue during health visits, including:

Developing patient-centered educational materials and workshops focused on reproductive health, family planning, and pregnancy considerations for individuals of all ages.
Implementing educational campaigns to raise awareness about reproductive health challenges and materials specifically tailored for individuals over 40.
Creating a checklist to ensure all patients’ questions are answered, training providers to recognize and respond to patient advocacy, and implementing feedback mechanisms.

This action plan aims to create a health landscape where patients are informed, confident, and actively engaged in their maternal health through early education and intentional dialogue.

Addressing Rural Health Gaps in Maternal & Child Care

North Carolina has the second-largest rural population in the nation. Addressing the unique challenges that rural communities face is essential to improving the health of mothers, children, and families statewide.

Incorporating rural needs into every stage of our action plans is key. Tailored strategies can help ensure that all families, regardless of location, can access the care they need. These strategies include:

Expanding outreach programs to connect families with available health resources and services.
Fostering collaboration between local leaders and communities to close information gaps and improve access to care, especially in areas impacted by hospital closures.
Boosting support and investment in infrastructure, telehealth, and funding to relieve pressure on overburdened hospitals.

Looking Ahead: Our Commitment to Whole-Family Health

At FHLI, we’re dedicated to advancing whole-family health across North Carolina—building a healthier state where everyone can access the care they need.

Earlier this year, FHLI welcomed Austyn Holleman, MSW, MPH, LCSW, as the new Director of Community Voice to the team. As a mental health therapist and community-based doula, she brings invaluable experience to our community-centered efforts to create healthier systems for all North Carolinians.

We’re thrilled to announce that Austyn is working alongside MCHEAN’s co-facilitators and network participants to outline the next phases of this essential work. If you’re interested in learning more and getting involved, please complete this brief form, and we will be in touch!