Centering Equity and Fostering Stakeholder Collaboration and Trust—Pillars of the Maternal Health Innovation Program in Maryland

• Published in: Health equity 2024-06, Vol.8 (1), p.46-418
• Main Authors: Creanga, Andreea A, Kramer, Briana, Wolfson, Carrie, Mary, Meighan, Stierman, Elizabeth M, Clifford, Sarah, Ezennia, Ada, Rhule, Jane, Martin, Nina, Vance-Reed, Maxine, Bruce, Teneele, DiPietro, Bonnie, Burgess, Adriane, Warren, Nicole, Lawson, Shari N, Meyerholz, Sarah, Bower, Kelly
• Format: Article
• Language: English
• Subjects: evaluation; health equity; maternal health; Original Research; program implementation; stakeholders
• ISSN: 2473-1242; 2473-1242
• DOI: 10.1089/heq.2023.0127

Objective: To describe two main pillars of the Maryland Maternal Health Innovation Program (MDMOM): (1) centering equity and (2) fostering broad stakeholder collaboration and trust. Methods: We summarized MDMOM’s key activities and used severe maternal morbidity (SMM) surveillance and program monitoring data to quantify MDMOM’s work on the two pillars. We developed measures of hospital engagement with MDMOM (participation in quality improvement [QI] activities, participation in check-in meetings, staff involvement) and with other partners (participation in QI activities, representation in state-level groups). We examined Bonferroni-adjusted correlations between these hospital engagement measures and with key hospital characteristics: level of maternity care, annual delivery volume, and SMM rate. Results: Over 100 national and state organizations and individual stakeholders contributed to our building the MDMOM program and implementing key activities centering equity: hospital-based SMM surveillance in 20 of Maryland’s 32 hospitals; almost 5,000 trainings offered to perinatal health care providers; two telemedicine/telehealth interventions; training of home visitors and community-based organization staff. Birthing hospitals represent MDMOM’s main implementation partners. The strength of their participation in MDMOM QI activities is positively correlated to their participation in check-in meetings and with the degree of involvement by physicians in such activities. Higher engagement in MDMOM QI activities is also positively correlated to hospitals’ participation in other state-level maternal health initiatives or groups. Conclusion: Our experience with the MDMOM program demonstrates that an equity focus and broad stakeholder collaboration building strong relationships and providing implementation support can lead to high levels of engagement in innovative maternal health interventions.