Maternal & Infant Health

Challenge

The U.S. has worse birth outcomes than most other developed countries. Additionally, the Centers for Disease Control and Prevention data show that the Carolinas have a number of outcomes that rank below the national average. 

Our Objective

Our vision is that all women in the Carolinas will be healthy during pregnancy and the postpartum period, and that newborns remain healthy during the critical first year of life.

Through our grantmaking, we seek to reduce disparities and improve outcomes such as the percentage of low-birthweight deliveries and pre-term births, infant and maternal morbidity rates, and timely and accessible prenatal and postpartum care. We seek to advance our understanding of ​“what works” to build the evidence base for effective program models.

What We Fund

The Carolinas Maternal and Infant Health Initiative 

The Duke Endowment’s primary funding strategy to support improving maternal and infant health in the Carolinas is through the Carolinas Maternal and Infant Health Initiative. This initiative is supporting the expansion of the H.E.A.R. (Healing, Equity, Advocacy, and Respect) 4 Mamas and Babies (H4MAB) program. 

H4MAB is an evidence-informed, text- and phone-based screening and referral program developed at the Medical University of South Carolina (MUSC) to identify medical, behavioral health and social needs early in pregnancy and throughout the postpartum year. 

The model proactively connects participants to timely and trusted services and has demonstrated significant improvements in the detection and treatment of mental health conditions (e.g., an improvement in maternal depression and anxiety rates), substance use disorders, chronic health conditions, intimate partner violence, and unmet social determinants of health needs. 

H4MAB has also helped reduce disparities in access to care. Its technology-enabled approach enhances early identification of maternal and infant health needs by providing patient-centered responses from care teams.

The Endowment has allocated more than $13 million to advance the initiative. The multiyear investment will support five health systems as they plan and implement H4MAB. The participating health systems are Cape Fear Valley Health System, ECU Health, Atrium-Wake Forest Baptist Health System, Prisma Health, and Spartanburg Regional Healthcare System. Funding is also supporting a Technical Assistance and Training Center, led by MUSC in collaboration with UNC-Chapel Hill. The Center will provide training, technology, cross-site evaluation, data resources, and ongoing technical assistance to strengthen implementation. It will also partner with state agencies, Medicaid programs, and private payers to explore long-term reimbursement pathways, contributing to the program’s sustainability.

Advancing Innovation in Maternal and Infant Health  

Maternal and infant health is a broad field, and The Duke Endowment anticipates continued learning through the funding of innovative programs and approaches that can inform and complement the Carolinas MIH Initiative. While we are not currently accepting additional applications from health systems to join the first cohort of participating sites, we do anticipate releasing a request for applications for a second cohort pending outcomes from the initial pilot sites. In the meantime, we continue to consider funding requests that support improving maternal and infant health outcomes in the Carolinas. These requests may be submitted through the pre-application process while the pre-application cycle is open via our online application portal.