Pathways to integrate maternal-child health and nutrition interventions to transform equity and human potential

Maternal and child health is critical to achieving the Healthy People 2030 Goals. Investing in integrated nurturing care interventions from preconception through childhood and adolescence defines one’s developmental trajectory with benefits that accumulate across the life course and promote the health of generations to come. The 2019 global pandemic disrupted essential nurturing care services such as prenatal, perinatal, and pediatric services. As a result, over a million preventable child and maternal deaths globally are estimated to have occurred due to extreme poverty and food insecurity (i.e., lack of consistent access to enough healthful food for an active, healthy life due to limited financial resources). Amid the pandemic, food insecurity in the US tripled among households with children (~19.5%), disproportionately burdening low-income families and those in vulnerable communities. Food insecurity is strongly linked with social determinants of health and adverse maternal-child health and nutrition outcomes. Integrating effective food security interventions within nurturing care services post pandemic is an achievable strategy to promote the health of economically vulnerable populations. The West Las Vegas Promise Neighborhood (WLVPN) is an intervention addressing social determinants to improve population health in economically vulnerable communities in the Southwest US. The WLVPN has been implemented by over 50 multi-sector partners in key life domains (health, education, employment, housing, and civic participation) and is coordinated by Nevada Partners, Inc., with whom we have a solid and long-term collaboration. While the WLVPN social intervention is a unique opportunity and platform to address maternal-child mortality and food insecurity in the community’s vulnerable population, it lacks a focus on maternal-child health and nutrition. Therefore, our partnership with Nevada Partners, Inc. is well-placed for carrying out the maternal-child component within WLVPN and advancing implementation and health promotion research. Using a community-based participatory approach we will co-create with the community an intervention to integrate maternal-child health and nutrition consisting of a bundle of effective food security interventions retrieved from the literature (e.g., universal screening, community referral, monitoring system, and nutrition-focused counseling strategies) and then adapted and integrated into the nurturing care services within WLVPN communities. A Hybrid Type III quasi-experimental within-site trial will be designed to 1) develop and implement a community-engaged system-level intervention to integrate maternal-child health and nutrition and 2) assess the effectiveness of this intervention in decreasing levels of food insecurity and/or improve health outcomes of pregnant women and their young children under the age of 3, which will nurture their potential, enabling them to thrive. This project is designed to inform how the best multi-sectoral maternal-child health and food security interventions can be integrated to transform maternal-child health and nutrition in economically vulnerable communities.