In the Face of COVID-19, Baltimore Healthy Start Builds Resiliency

The COVID-19 pandemic has disrupted daily life across the country, with schools and childcare closed, routine medical care delayed, public transportation limited, and millions of jobs lost. These disruptions have disproportionately affected vulnerable low-income communities where families already face significant threats to their health and well-being, including housing and food insecurity and less access to medical care.

In response, Baltimore Healthy Start, Inc., a federally funded program focused on eliminating disparities in perinatal health, has launched a multi-pronged approach to support the families they serve—many of whom live in poverty and struggle to meet their basic needs. From virtual home visits to delivering emergency supplies, Baltimore Healthy Start is persevering despite the barriers affecting the health and well-being of at-risk families during the pandemic. 

“A lot of our families already live in food deserts and have transportation issues, and now they are more isolated than ever,” explains Baltimore Healthy Start Executive Director Lashelle Stewart, MBA. “And if health issues were a problem before, imagine how they are now when they’re being exacerbated by stress?”

“Everything that was already an issue and already put people at a deficit is being amplified because of this crisis. That’s why we’re doing everything we can to provide our families with even more support right now.”

Baltimore Healthy Start is one of 101 Healthy Start sites nationwide that provide maternal and child health services in communities disproportionately impacted by poor birth outcomes. As the National Technical Assistance and Support Center, NICHQ works with all Healthy Start sites to accelerate and coordinate their efforts as they collaborate to pursue national change.

“COVID-19 has magnetized the critical importance of Healthy Start,” says NICHQ Senior Project Director Kenn Harris. “Even amid this crisis, Healthy Start sites are building resiliency in their communities so that they can come out even stronger on the other side of this. That’s what Healthy Start is all about: it strengthens communities and improves health outcomes for families.

“Baltimore’s work really shows what it means to be ‘Healthy Start Strong’.”

Virtual home-visits combat isolation

In mid-March, Baltimore Healthy Start switched to a remote service delivery model that aligned with social distancing recommendations. Instead of meeting clients in their homes, Community Health Workers now conduct virtual “home-visits” where they call or video conference with their clients. The check-ins provide an opportunity to discuss any health concerns, walk clients through medical procedures like checking their blood pressure, assess social determinants of health, and engage families in supportive, open conversations about life during the pandemic.

These virtual home visits are especially important for relieving stress and anxiety brought on by isolation, says Stewart. “We know a lot of pregnant women who are living alone, or single parents who haven’t talked to another adult in days. These calls are a really important opportunity to have communication with another human being… someone who can relate to what you’re going through. So, while a lot of this work is about specific health needs, right now it’s also just about connecting and being human.”

Reaching families through digital resources

Driven to stay connected with families, Baltimore Healthy Start is using digital solutions to inspire community. In mid-April, they introduced a virtual version of their breastfeeding education course; and next month, they plan to start hosting fatherhood groups virtually, where dads can come together and learn about the vital role they play during pregnancy and after birth. Baltimore Healthy Start is also working on rolling out an online version of Belly Buddies™, their 8-week course focused on helping more mothers achieve full-term pregnancies. The course brings together pregnant women with similar due dates to receive prenatal care information, share their experiences, and engage in stress reduction activities like yoga, knitting, and massage therapy.

“Belly Buddies provides a support system and creates a sense of community for women going through pregnancy, and that’s just really important during this crisis when everything is constantly changing and moms are feeling so much extra stress,” says Stewart. “That’s why we’re trying really hard to roll this group out soon.”

Along with online courses, Baltimore Healthy Start is using digital communication tools to share unique and timely resources with the families they serve. Each week, they release a virtual educational segment—a short video on vital health topics, such as mental health resources and the signs of postpartum complications. The videos and other relevant resources are shared across Baltimore Healthy Start’s various social media platforms and emailed directly to families.

Emergency response team delivers essentials

Even before COVID-19, families with less money often struggled to find reliable transportation and access basic necessities, like food, diapers, and Pack’n Plays. Now because of limited public transportation, those barriers have become even more pronounced. Realizing that families were at risk, Baltimore Healthy Start created an emergency response team to deliver much-needed items to families in the communities they serve.

Families call the office and share what they need (e.g., diapers, baby wipes, feminine hygiene products, and food). Volunteers collect items from the Baltimore Healthy Start Store, a small store stocked with essentials, and their supply inventory and food pantry. Then, volunteers drop the items at each family’s door, call the family to notify them of the delivery, and wait outside in the car until the family comes and collects the package. To reduce exposure, all volunteers wear recommended protective gear, including N95 face masks and gloves.

Reproductive health services can’t wait

Each woman enrolled in Baltimore Healthy Start has an individualized reproductive life plan—a set of personal goals to help her decide when and if she wants to have a new baby. These plans are one of the benchmarks of the national Healthy Start program and are being worked on by all 101 Healthy Start sites. However, COVID-19 lockdowns have left many women struggling to make appointments with their providers and access contraception.

Reproductive health needs don’t pause for a pandemic though. That’s why the Baltimore Healthy Start nurse is providing needed in-home services while wearing recommended protective gear: she’s administering a birth control shot, Depo-Provera, and ordering prescriptions for other birth control options for women who can’t connect with their providers.

Sustainable solutions start with healthy staff

Baltimore Healthy Start staff and volunteers have gone above and beyond to support the families they serve. This support comes at a cost though, says Stewart. “They’re doing so much, while dealing with many of the same barriers and the stress and anxiety brought on by the pandemic. We’re making mental health a priority; we provided an all staff training on burnout and the importance of self-care, and we’re making sure everyone can connect with virtual mental health services.”

Baltimore’s comprehensive and immediate response to COVID-19 illustrates the incredible capacity of Healthy Start sites. In the midst of a national crisis, they use the collective power of their communities to remain strong. 

Interesting in learning how other communities are responding to COVID-19? Read how a county in Ohio has rallied together to address the rising disparities from COVID-19.