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17
Sun, Dec

Maternity Care Coalition: Meeting the Needs of Changing Communities

What Works & What Doesn't
Typography

Maternity Care Coalition (MCC), a community-based organization serving pregnant and newly parenting families, has been on the front lines of identifying and meeting community needs since 1980. From the emergence of HIV/AIDS and the crack epidemic in the 80s to more current challenges such as the rise in opioid use and changing patterns of immigration, MCC has been on the ground helping our community understand the impact of these issues on families with young children. As “first responders,” MCC has had to work quickly to meet families’ critical needs, often before adequate resources or infrastructure is available. Addressing the needs of our region’s growing immigrant population is a particular case in point. Through its organizational commitment to serving the most vulnerable, the resourcefulness of staff, collaboration with partner agencies and a strengths-based approach to service, MCC has become a trusted resource for immigrant women and their families in the Philadelphia region. 

Last summer, a woman was killed in a hit-and-run accident while standing on the sidewalk in South Philadelphia with her husband and two-year-old child. She was an Indonesian immigrant and a MCC client. Tragedies of this magnitude in the MCC community are fortunately rare; nevertheless, MCC was poised to respond to the immediate crisis and help the family develop both an immediate and long-term plan.

The woman was a client at MCC’s South Philadelphia Early Head Start (EHS) center. Upon hearing about the tragedy, the staff sprang into action. They began by using emergency funds to purchase and deliver groceries, diapers, and supplies for the family. The child’s father worked long hours for minimal pay and couldn’t afford reliable and consistent childcare. To accommodate the family’s new circumstances, the two-year-old child was transitioned from the home-based EHS program -- in which families receive services in their home on a weekly basis -- into the center-based program, which includes childcare. MCC staff supported the father as he began the difficult process of taking on his wife’s responsibilities, which included managing the household and the family’s finances. The Dad faced significant challenges during this process as he spoke limited English, was not accustomed to being the primary caregiver for his two children, and was working through the grief of losing his wife. MCC provided holistic support for the family during this difficult time including helping the father recover the PIN number for their SNAP card and shifting their benefits from the mother’s name to the father’s -- a transition that was additionally complicated by the family’s mixed immigration status. MCC’s Clinical Director worked to connect the family to mental health services in their own language, and helped EHS staff identify age-appropriate coping strategies for the two-year-old.

MCC’s response to this tragedy illustrates how and why the organization has become a trusted and vital resource for immigrants in the Philadelphia region. Across four counties, MCC provides services to extremely diverse immigrant communities. While, MCC does not track clients’ immigration status, in 2016, 25 percent of MCC clients who reported their country of origin were foreign-born. With high concentrations of clients from Central America, the Caribbean, Southeast Asia, and North and West Africa, MCC clients speak more than 40 languages. As MCC expands its footprint in Bucks County through its recent merger with Child, Home and Community, this list will continue to grow.

The capacity to serve such a wide range of immigrant communities is deeply rooted in MCC’s service model and organizational approach. MCC’s service model begins with the needs of the mother and her family and is rooted in a strengths-based approach. This model, combined with targeted and strategic staff recruitment, a refined and intensive workforce development program, and a demonstrated organizational commitment to innovation, is at the core of MCC’s success.

MCC was founded 37 years ago, with the mission to improve maternal and child health and wellbeing through the collaborative efforts of individuals, families, providers, and communities. MCC recognizes that everyone, regardless of their circumstances, brings their own strengths, which can be built upon. Similarly, MCC has developed a set of core values that guide its work across the organization. These core values include empowerment, integrity, inclusion, achievement, and innovation. MCC has institutionalized its mission, vision, core values, and approach and they inform all aspects of MCC’s work including the recruitment, training, and performance evaluation of all staff. Collectively these pieces make up the MCC model: a strengths-based approach that centralizes the need of the mother (and her family) and is ultimately predicated on the quality of the relationship between the mother and her Advocate (case manager/community health worker).

The efficacy of MCC’s model is based largely on the capacity of its Advocates to build strong relationships with their clients and is the primary reason MCC has become a trusted resource in immigrant communities. The strength and quality of the client-advocate relationship is particularly crucial in this context because many new immigrants face extraordinary challenges in accessing benefits and services due to language barriers, cultural and social isolation, fear, and the complexity and lack of coordination between social service systems. MCC conducts outreach though community events and by forming and maintaining relationships with entities such as hospitals, churches, and other social service organizations, but clients overwhelmingly seek MCC services as a result of receiving a referral from a friend or family member.

Week of the Young Child Celebration at Maternity Care Coalition
Photo Credit: Hannah Daly  

MCC’s approach to providing services for immigrant women is a prime example of how MCC operationalizes its commitment to providing quality services and improving client outcomes. With an organizational commitment to both inclusion and innovation, MCC is well positioned to serve both existing and emerging immigrant populations. These approaches include partnering with other community-based organizations serving immigrants, recruiting staff with relevant language skills, and establishing language access policies. 

First, when entering a new community, MCC prioritizes establishing relationships with other community-based organizations serving similar populations. In some cases, this means creating a formal partnership to establish a referral system to meet the community need. In other circumstances, it is a more informal process as MCC connects with hospitals, health clinics, and faith-based organizations to ensure pregnant and parenting women are aware of MCC’s programs and services. These partnerships and relationships are critical in immigrant communities, as many new immigrants are not yet connected to the full range of health and social services available. Next, MCC seeks to recruit advocates from the communities it serves; within established immigrant communities, this strategy can eliminate language barriers and provide a strong foundation for the client-advocate relationship. In some cases, former clients become MCC employees. 

Within emerging immigrant communities, it is not always possible to match clients with Advocates who speak their language or to find a local agency that can meet their needs. In such situations, MCC Advocates have been very resourceful in finding ways to communicate with clients, including using demonstrations to convey critical concepts and resources found through research. Although this is not a best practice and MCC continues to work towards establishing longer-term language access policies for these situations, it is a real-life example of meeting immediate needs on the front lines to ensure that vulnerable populations can access the support they need.

As a result of their efforts, MCC’s Advocates have developed an impressive reputation in the immigrant communities they serve and MCC’s outcomes among its immigrant clients are on par with overall agency outcomes. Simply put, MCC’s reputation, bolstered by a strategic commitment to establishing programs in the most underserved communities in Southeastern Pennsylvania, is MCC’s primary outreach mechanism. MCC serves as a resource and a point of connection to critical benefits and services for pregnant and newly parenting mothers. Depending on the program, a new mother may be eligible to receive services during pregnancy until her child is three years old. MCC’s Advocates connect with their clients at a particularly critical moment in their lives and build on that relationship over weeks, months, and years with an emphasis on empowering their clients and promoting self-determination.

MCC’s work in immigrant communities informs the organization’s advocacy efforts and results in impactful systems-level change. Recently MCC Advocates noted anomalies in where their immigrant clients were electing to give birth. They brought their concerns to the attention of MCC’s policy team. MCC conducted a survey of clients and discovered that some immigrant women were given misinformation about their payment options for prenatal care and labor and delivery. Feeling discriminated against and fearful, some immigrant women were not receiving consistent prenatal care and were traveling to hospitals outside their community to give birth. MCC’s Executive Director and Director of Public Policy met with the hospital’s administration and presented the findings of the survey. As a result, the hospital’s administration is exploring opportunities for collaboration with MCC in the future to improve its services for immigrants.

As MCC’s immigrant client base continues to grow, the challenges associated with providing quality services to diverse immigrant communities persist. The lack of cost-efficient interpretation services and technologies creates difficulties for clients and MCC staff. Identifying qualified staff that can serve new immigrant groups is often difficult. Utilizing telephonic or in-person interpretation services is very costly for a service model where staff meet as often as 60 to 90 minutes per week with families over a three-year period. Building support from public and private funders and finding innovative solutions to these challenges are high priorities as MCC looks to its future as an organization serving fast growing immigrant communities.

Early Head Start Socialization for children and caregivers at Maternity Care Coalition
Credit: MCC Staff

One year later and the toddler who lost his mother in the accident is preparing to transition out of MCC’s Early Head Start program and into a Head Start program. The family’s Advocate helped locate and secure a space for the child in a Head Start Center that is connected to before- and after-school care to help decrease the logistical burden on the now single father. In speaking about the experience, the child’s Advocate and teacher reflect on both the challenges and rewards of their work. Despite the challenges that include difficulties accessing quality services, the staff noted what a joy it is when former clients return to the center to share how their children have grown and flourished. The staff at MCC eagerly look forward to the day when the young toddler who lost his mother will return for a visit as a thriving and happy school-aged child.