Arkansas Maternal Health BRIDGE Initiative
Summary
In 2025, Winrock International committed to scaling the Arkansas BRIDGE Initiative (Building Resources for Integrated Delivery of Global Maternal Empowerment) to improve maternal and infant health outcomes in rural Arkansas. This approach focuses on enhancing health system capacity to deliver maternal care in rural settings and reducing socio-cultural barriers to accessing maternal health supports. The initiative also fosters community attitudes supportive of maternal health to address multi-level, social-ecological factors and create a comprehensive ecosystem of support for mothers in Arkansas’s most vulnerable communities. Winrock will lead a three-year pilot of the initiative in five rural counties in Arkansas to increase accessibility, uptake, and utilization of the Maternal Life360 HOME maternal care program. They will also partner with local health systems to use evidence-based home visiting care models so that mothers can receive the prenatal and postpartum care they need along with other necessary community-based services such as housing, food, and transportation assistance.
Approach
Winrock International commits to enhancing maternal and infant outcomes in rural Arkansas by 1) enhancing health system capacity to deliver maternal care in rural settings, 2) reducing socio-cultural barriers to accessing maternal health supports, and 3) fostering community attitudes supportive of maternal health. Winrock’s community-centered approach to addressing critical challenges and expertise in capacity building and community engagement complement the medical and patient care expertise of health system partners. The Arkansas BRIDGE Initiative (Building Resources for Integrated Delivery of Global Maternal Empowerment) addresses multi-level, social-ecological factors to create a comprehensive ecosystem of support for mothers in Arkansas’s most vulnerable communities.
Access to and utilization of prenatal and postpartum care are significant factors in preventing maternal and infant mortality. To address the complex barriers to access and utilization, Winrock will 1) accelerate the establishment of Maternal Life360 HOME programs creating availability in unserved areas, 2) increase the accessibility of the program so that more mothers enroll, and 3) foster local supports for maternal health so that mothers are better supported in prenatal and postpartum care in the community and workplace. Health system partners will use evidence-based home visiting care models to increase maternal health knowledge and skills and navigate services so that mothers with high-risk pregnancies are better able to attend prenatal visits, detect and respond to pregnancy warning signs, and receive social support services such as housing, food, and transportation assistance.
Winrock will lead a three-year pilot of the Arkansas BRIDGE Initiative in five rural counties in each region of Arkansas with hospital systems and Federally Qualified Health Centers (FQHCs) as key implementing partners and state agencies and national home visiting programs as technical advisors. Learning from this pilot will then be expanded statewide so that Maternal Life360 HOME is available to all eligible mothers in Arkansas.
Action Plan
During the three-year pilot phase of the Arkansas BRIDGE Initiative, Winrock and partners commit to increasing the number of health systems operating evidence-based home visiting programs (HVPs) , increasing the number of women receiving prenatal and postpartum care through Maternal Life360 HOME programs, and improving health seeking behaviors of women enrolled in the program. Key activities and milestones will be completed to achieve these outcomes:
In Year 1, Winrock will increase the administrative capacity of health systems to establish home visiting programs (HVPs) , thereby becoming eligible to apply for Maternal Life360 HOME certification. Consulting services will be provided to health systems in five counties currently unserved by Maternal Life360 HOME programs to identify the best path for HVP development. Winrock will also support health systems in the application process for Maternal Life360 HOME certification with the goal of health systems receiving certification during Year 2.
Year 2, Winrock will develop a community engagement strategy for Maternal Life360 HOME programs to increase awareness of the program, establish community referring partners to increase enrollment, and establish “neutral space” visit alternatives for those who feel unsafe meeting in home settings. Home visiting technical advisors will support health systems in best practices in recruiting, hiring, and training Community Health Workers (CHWs) and nurses to initiate HVPs so that enrollment can begin once Maternal Life360 HOME certification is received.
Year 3, new certified Maternal Life360 HOME programs will enroll eligible mothers and provide home-visiting care according to the HVP scope of practice. Home visits include health screenings, health education, and developing and discussing personal goals and needs. During this time, Winrock will train local community-based organizations and workplaces on best practices to bring awareness to and be supportive of maternal health, whether that be for their own staff, clients, or the general public.
Background
Arkansas faces a critical maternal health crisis with the highest maternal mortality rate in the nation (43.5 deaths per 100,000 live births) and the third highest infant mortality rate (7.67 deaths per 1,000 live births) (CDC, 2018-2022) . These poor outcomes are driven by intersecting medical, social, and environmental determinants. Over 45% of Arkansas counties are defined as “maternity care deserts” with no birthing facilities or obstetric providers; women in these counties travel an average of 30-60 minutes to receive care (March of Dimes, 2023) . With 10-15 prenatal visits expected during a healthy pregnancy, long travel times and lack of reliable transportation are barriers to receiving prenatal care, a significant factor in preventing maternal and infant mortality. In Arkansas, 20% of women receive inadequate prenatal care compared to the national average of 15% (MoD, 2023) .
The State of Arkansas has made concerted efforts in the past year to address this maternal health crisis. A significant new feature planned for ARHOME, Arkansas’s Medicaid expansion program, is Maternal Life360 HOME, a program modeled after the federal community bridge organization concept to provide intensive support and care coordination. Maternal Life360 HOME provides home visitation for women with high-risk pregnancies including assistance addressing social determinants of health needs and enhancing life skills. To be eligible, health systems must participate in Medicaid, provide obstetric services, and operate an evidence-based home visiting program (HVP) , or partner with an organization that does. These eligibility requirements leave significant gaps in service areas, either because no obstetric services are present or there is no organization that operates an evidence-based HVP; smaller health systems with fewer administrative resources or existing outreach programs face barriers to creating HVPs. Nearly half of Arkansas counties are not in eligible service areas and only 3% of Arkansas women eligible to receive services are currently enrolled.
Progress Update
Partnership Opportunities
Winrock International seeks funding from philanthropic foundations, government agencies, and private-sector partners to launch the Arkansas BRIDGE Initiative pilot. Winrock seeks implementation partners, including health systems, evidence-based home visiting programs, healthcare payers, and maternal health-focused organizations, to coordinate and collaborate on efforts related to maternal health, either in Arkansas or other states. With intent to scale BRIDGE, Winrock welcomes healthcare policy allies and evaluation experts, particularly those with expertise in return on investment analyses for preventative health strategies, Medicaid expansion projects, and collective impact. Additionally, Winrock welcomes media and communications partners to amplify success stories and case studies as well as increase awareness of the challenges many mothers face in accessing prenatal and postpartum care in the U.S. This combination of resources and expertise is critical to scaling this holistic model for maternal healthcare delivery in maternal healthcare deserts across the U.S.