What happens before and during a mother's pregnancy largely determines whether her child will thrive. If the mother is African-American, her chance of losing a baby before its first birthday doubles. The risk of infant mortality climbs if she used drugs and alcohol or is homeless. When it comes to which children born in America survive and thrive, race, poverty and education are a strong undercurrent.
Nowhere is this more true than in the South. States like Mississippi, Louisiana and Alabama have the highest infant mortality rates in the nation. But not far behind are states like Indiana, West Virginia, Michigan and Maine.
The good news is that some foundations have been highly active on this issue for years, and the national infant mortality rate has fallen. The most well-known leader here is the Kellogg Foundation, which does substantial grantmaking for health equity on behalf of mothers and their newborns, as we report often. But there are important local funders on the case, too, like the Healthcare Georgia Foundation, which addresses infant mortality through a rural healthcare approach, and directs funding for better access to prenatal care.
In Missouri, the state's leading health foundation has an initiative that looks promising. The Missouri Foundation for Health is making collective impact funding available to nonprofits and service providers in the southeastern corner of the state. The six-county region has infant mortality rates twice as high as the rest of the state. For babies born to black mothers, it's 14 percent; for white mothers, 9 percent. Missouri's Bootheel region, as its called, loses nearly 10 babies per 1,000 births.
Collective impact is an approach we write about often an IP. In a nutshell, the idea is that the best way to solve complex problems is by engaging multiple stakeholders who work in a coordinated fashion, bringing differing strategies and resources to bear. This is especially important on public health challenges.
The Missouri Foundation for Health is funding in the Bootheel's rural communities and is interested in mobilizing new ideas and energy around Bootheel Babies and Families network. Because the factors affecting infant deaths are complex, this campaign is open minded about who receives this funding and how they'll attack the underlying issues of infant deaths and women's health. In rural Missouri, for example, many people live 50 miles from a prenatal clinic.
Program Director Kathleen Holmes with the Missouri Foundation for Health says, "There's a place at the table for everyone who wants to participate." Collective impact requires patience, because it's built on networking, but Holmes says even startups without tax-exempt status are welcome.
The collective impact model "doesn't differentiate between big and small (service providers)," she explains to me.
The promise, here, lies in going well beyond a traditional public health campaign. Public service announcements do educate women and mothers-to-be that medical and social-service assistance is available to them. The trouble is that some can't get to a clinic for a prenatal visit because they don't own a car or can't find a ride. A church group with a van or a bus could fill this service gap because it has the necessary resources.
As we've noted before, collective impact efforts work best when an anchor organization coordinates the activities of everyone involved. This requires skills and diplomacy to serve the participating agencies and agencies, and to help different players make the transition from acting alone to acting in unison. Funders can play an important role in getting people to collaborate. In this case, Bootheel Babies and Families is serving as the anchor organization. It's funded and supported by the Missouri Foundation for Health, in coordination with the Bootheel Network for Health Improvement and the Missouri Bootheel Regional Consortium.
Collaborative grants are open to partnerships serving women, families and infants in the counties of Stoddard, New Madrid, Mississippi, Scott, Pemiscot, and Dunklin. This initiative in Missouri has taken baby steps, looking to recruit innovative thinkers who approach health issues from a fresh perspective. Patience is a necessity for funders in collective impact because this type of complex societal problem—healthier women and fewer infant deaths—can't be fixed quickly.
"It doesn't happen right away; you find that collective muscle over time by working together," Holmes says.
Related: Big Money vs. Premature Births