Maternal and Child Health

education and support for healthy eating, nutrition, and health behaviors, and addressing social determinants of health. ChristianaCare and long-term community partner, Urban Acres Produce, are increasing patients’ access to fresh produce through their partnership and development of the Produce Delivery Program (PDP), launched in May 2020. The PDP utilizes a delivery system to offer patients the opportunity to receive fresh fruits and vegetables every week without having to leave their homes. Patients who live in New Castle County, are on Medicaid or Medicaid eligible, and have diabetes, hypertension and/or need food assistance receive a $10 wholesale bag of fruits and vegetable, $20 bag for patients with a household of 5 or more, for 3 to 6 months. With each of these programs, we will evaluate success based on patient satisfaction and outcomes and make program modifications as needed. In the coming years we expect our evaluation framework to identify what works to improve patients’ chronic conditions and guide us in adapting and refining these programs to serve more individuals, with available resources.

Maternal and Child Health

ChristianaCare is addressing maternal and child health on multiple fronts. As stated above, ChristianaCare’s Annual Operating Plan for fiscal year 2023 committed to building systems and processes to identify and reduce disparities in quality measures and health outcomes with a focus on chronic disease, cancer, and maternal/infant health outcomes. Over the next several years, we will report on the identification of those disparities and how we expect to address them. On April 27, 2020, ChristianaCare opened its Center for Women’s & Children’s Health located at its Newark Campus. This new center was designed to support the optimal health of women and children. One of the most significant features is its state-of-the-art neonatal intensive care unit which has private rooms with sleep-in space for families. It is one of the only hospitals in the United States to provide “couplet care” in the NICU to keep the mother and the baby together even if they both require medical care. As one of the highest volume delivering hospitals in the region with more than 6,000 babies a year, this attention to the health of both the mother and baby is essential to improving maternal and child health outcomes. ChristianaCare has been the recipient of a grant from the Delaware Division of Public Health (DPH) to support its Health Ambassador Program since 2012. The Health Ambassador Program is a community-based intervention to promote health before, during, and after pregnancy. Its objective is to connect pregnant women and families to health care, social services, and education to increase their health and well-being with a focus on the high risk zip codes (19801, 19802, 19804, 19805, 19806, 19809, and 19703) within Wilmington that have the lowest maternal and child health indicators in the state. The Health Ambassador program expanded in

fiscal year 2021 to include a Health Ambassador who will focus on mothers with substance use disorder.

The Health Ambassadors have been effective at providing mothers and caregivers with resources and education. In fiscal year 2021, the Health Ambassadors’ total outreach was 3,916 unique community members. Of those, 82% needed direct assistance and the Health Ambassadors were able to meet the needs of all 3,202 mothers. ChristianaCare will continue to seek grant funding to provide this community support to those most at risk for poor maternal and child health outcomes.

In 2019, Women’s Health Community Health Workers (CHWs) began assisting patients on the inpatient delivery floors and in outpatient practices at ChristianaCare’s Wilmington and Newark campuses. In the past fiscal year, additional CHWs were added to serve patients in the NICU and OB Triage. These CHWs support the patients during and after pregnancy. For outpatients, the intervention is a 6 – 9 month program with intensive case management. The inpatient intervention is a 3-month program postpartum with intensive case management. The CHWs assess and address the patients’ social determinants of health, identify and support achievement of patients’ personal goals, increase post-partum followup visits, improve the use of long-term contraception, and reduce 42-day readmissions post-delivery discharge. Patients who meet the following criteria are eligible: • Medicaid or Medicaid eligible • Lives in one of the following zip codes: 19701, 19702, 19711, 19713, 19720, 19801, 19802, 19804, 19805, 19977 • AND meets at least 1 of the following criteria: o A history of poor birth outcomes (e.g., low birth weight delivery, premature birth, infant death, fetal death/stillbirth) o A chronic disease (e.g., diabetes, high blood pressure) o Late entry into prenatal care o No prenatal care o Risk for birth defects – exposure or family history o Mental illness o BMI at or above 30 Along with our state-of-the-art Center for Women & Children’s Health and programs such as the Health Ambassadors and Women’s Health CHWs to directly address the health of pregnant and postpartum mothers and children, ChristianaCare also believes that addressing social determinants of health will improve women and