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Project Name: Healthy Start Initiative-Eliminating Racial/Ethnic Disparities (H49)
Applicant Title: Urban Strategies, L.L.C.
Abstract Text: The Puerto Rico Healthy Start Initiative: Central South Corridor (Comienzo Saludable-Centro Sur) represents a renovation of an enhanced and robust scaling-up of services aimed to impact a minimum of 700 participants each year. This encompassing participant group comprises pregnant, preconception women, inter-conception women, fathers/partners, as well as infants and children from birth to 18 months of age. The core of HS-Central South Corridor lies in its provision of case management, care coordination, direct and enabling services for up to 450 participants and a minimum of 250 individuals in group health education annually. Based on evidence-based criteria including need, feasibility, and capacity, seven municipalities have been chosen as the geographic target area: Aibonito, Cayey, Coamo, Guayama, Jayuya, Juana Díaz, Ponce and Santa Isabel. These municipalities collectively exhibit an Infant Mortality Rate (IMR) of 8.4, accounting for a total of 134 infant deaths, an LBW rate of 10.5%, and a Preterm Birth (PTB) rate of 12.0% (PRDOH, 2023). Among the eight municipalities, Coamo, Jayuya, and Santa Isabel are eligible for Rural Health Grants and are classified as rural areas according to the Rural Health Grants Eligibility Analyzer. The target population under consideration faces significant socioeconomic challenges, high percentage of families living below the poverty level, low median household incomes, and high levels of unemployment rate. Access to obstetric care is a significant concern, with only six hospitals with fully equipped maternity wards, and only 6 gynecologists in the area. This information underscores potential challenges in the accessibility and quality of prenatal services in the area. Therefore, our CS-Centro Sur target population will consist of the municipalities of Aibonito, Coamo, Guayama, Jayuya, and Santa Isabel with the most worrisome maternal and child indicators of our target area as evidenced by the PR-Vital Statistics. To the best of our knowledge, the project area proposed does not overlap with the project area of a recipient funded through an HRSA-19-049 grant. Our primary goal is to continually reduce infant mortality rates, disparities in infant mortality, and perinatal health outcomes in high-risk areas of Puerto Rico, United States. This approach comprises five key components. Firstly, it includes direct and enabling services such as case management, care coordination, and health and parenting education, ensuring access to quality healthcare, and promoting positive health outcomes. Secondly, a Community Action Network Consortium to foster collaboration and address community needs. Thirdly, technical, and capacity-building support will be provided to staff, healthcare providers, community organizations, and individuals involved in the program. Fourthly, sustainability and dissemination plans will be prioritized to ensure long-term impact and share knowledge with other organizations. Finally, a robust Monitoring & Evaluation system will track progress, identify areas for improvement, and ensure the effectiveness and sustainability of interventions. By continuing the implementation of this comprehensive approach, we aim to address various social determinants of health, promote evidence-based strategies, and strive for significant improvements in perinatal outcomes and infant health. With this array of services, we can empower and enhance the well-being of families in the project area. Our approach includes selecting adjacent municipalities to establish an impactful "impact corridor" and leveraging previous interventions and community services to improve perinatal health and eliminate health disparities. Through this visionary initiative, we aim to seamlessly integrate resources and amplify their impact, ultimately achieving improved health outcomes for the target population.