Inadequacies and biases within the healthcare system contribute to significant challenges in maternal and child health, particularly for Black and brown women. Marginalized and disadvantaged groups face disproportionate challenges and barriers to accessing quality care including inadequate prenatal care, lack of culturally sensitive care, discrimination based on race, ethnicity, language, or immigration status. Maternal health outcomes vary significantly across different populations. Although maternal mortality in Louisville is on the decline for white women, Black women are still dying at a rate 2.5 times that of white women and Kentucky is one of the four worst states for maternal health based on mortality rate.

The Reconstruct Challenge: Maternal and Child Health is seeking to find and fund five innovative solutions that enhance cultural competence and diversity within the healthcare system, improve mental health support and resources for mothers, promote transparency, respect, for individual choices, and comprehensive explanations in healthcare, as well as alleviate economic insecurity and overcome barriers faced by pregnant individuals and caregivers. Some particular areas of interest include:

• Mental health support pre- and post-partum, including specialized resources and holistic options for mothers, both in facility and in-home

• Inadequate access to postpartum care and in-home support

• Insufficient cultural competency and diversity in healthcare staff and lack of cultural competence leading to a lack of belief in the patient at every stage and a lack of transparency in decision-making.

• Food insecurity and barriers to accessing resources like WIC, SNAP, and Medicaid benefits before, during, and after pregnancy.

• Economic insecurity, including challenges of working during pregnancy and immediately post-birth, transportation to appointments, etc.

• Fear of Child Protective Services (CPS) and lack of confidentiality leading to avoidance of seeking help and potential harm.

This Reconstruct Challenge was supported by funds made available by the Kentucky Department for Public Health’s Office of Health Equity from the Centers for Disease Control and Prevention, National Center for STLT Public Health Infrastructure and Workforce, under RFA-OT21-2103.