Six Delaware Community-Based Organizations Receive Mini-Grants to Reduce Infant and Maternal Mortality

DOVER — To reduce disparate birth outcomes and save the lives of both infants and their mothers, the Division of Public Health (DPH) and the Delaware Healthy Mother and Infant Consortium (DHMIC) awarded mini-grants to six community organizations. The local grant recipients were announced today, Dec. 10, during the DHMIC’s quarterly meeting in Dover.

The state’s first mini-grants to reduce infant and maternal mortality aim to narrow the wide variance in birth outcomes between black women and white women by building state and local capacity and testing small-scale innovative strategies. The awards are evidence-based, as DPH’s Healthy Women Healthy Babies program identified communities, or “zones,” whose residents are at high risk for poor birth outcomes. Grant recipients will provide targeted services within the zones to women of childbearing age (15-44 years), children, and their families. Awardees will support community-led place-based initiatives and shift the impact of social determinants of health that are tied to the root causes of infant mortality: poverty, racism, health access, food insecurity, housing, and having a good job and a good education, all of which affect mothers and children.

“Members of the DHMIC are delighted to see resources being spent in the communities where women with disparate birth outcomes reside,” said Susan Noyes, DHMIC Co-Chair. “With our shift in priorities to address the social determinants of health, we believe we are on the right track in Delaware to improve birth outcomes.”

“Infant mortality is a leading health indicator to measure how healthy Delaware is,” said Lieutenant Governor Bethany Hall-Long. “By investing resources in communities to ensure women receive necessary supports before, during and after their pregnancy, we not only promote and protect the health of mothers and babies, but also ensure a stronger, healthier Delaware.”

More than twice as many black infants in Delaware die before their first birthday than white infants, according to DPH Vital Statistics data. For the period 2014-2018, Delaware’s black infant mortality rate is 12.2 deaths per 1,000 live births and the white infant mortality rate is 4.5 deaths per 1,000 live births. In 2017, the U.S. black infant mortality rate was 10.97 per 1,000 live births and the white infant mortality rate was 4.67 per 1,000 live births.

“While we have seen a 22% reduction in our infant mortality rates from 2000-2018, babies born to black women are still 2.7 times more likely to die than babies born to white women,” said DPH Director Dr. Karyl Rattay. “Using data, we identified geographic areas in Delaware with high infant mortality rates and are focusing our attention to offering needed services in these defined ZIP codes to address this unconscionable disparity.”

Racial disparities in birth outcomes extend to mothers. In the U.S., black women die from pregnancy-related complications three to four times as often as white women, according to the U.S. Centers for Disease Control and Prevention’s Division of Reproductive Health. In Delaware, severe maternal morbidity rose by 37 percent between 2010 and 2014, according to the Delaware Child Death Review Commission’s Maternal Mortality Review Report, which reviewed cases from 2011 to 2017. Risk factors for pregnancy-related complications include obesity, pre-eclampsia, high blood pressure, and substance use disorder, all of which are on the rise among Delaware women of reproductive age.

“I know firsthand of the challenges that women of color face during pregnancy, having endured complications during both my pregnancies. We must address the social determinants that affect maternal health outcomes, which is why it was critical that the community itself was part of the selection process for these grants,” said Rep. Melissa Minor-Brown, D-New Castle South, who distributed the award certificates to grantees at the meeting. “We have high expectations for this work to promote systems changes for Delawareans to achieve optimum health and well-being across the course of their lives.”

Grant funds totaling $327,925 were awarded to the community organizations for a one-year period. DPH and DHMIC will review the projects annually and have the option of renewing them for up to four additional years.

Available funds were equitably distributed, based on the estimated number of women of reproductive age (ages 15-44) living in each Healthy Women Healthy Babies Zone, which were identified as “high need” based on several data points/indicators, including: percent of teen births; mother’s high school education; percent of births to black mothers; percent using cigarettes during pregnancy; percent of families on Medicaid; percent of women with no prenatal care; percent of mothers with pre-pregnancy diabetes; percent of mothers with gestational diabetes; percent of mothers with pre-pregnancy hypertension; percent of mothers with gestational hypertension; percent of mothers with previous preterm birth; percent of mothers who were obese; percent of mothers with a preterm birth; percent of mothers with a low birth weight baby; and percent of mothers with neonatal deaths (<28 days).

The Delaware-based awardees are:

Delaware Adolescent Program Inc. (DAPI)
DAPI will serve teen mothers and their partners who live in high-risk zones throughout the state. DAPI will provide ongoing mentoring services and supports for social and emotional well-being, and support in navigating the health and social services system, including maternal and child health care services, housing programs, financial management, and economic empowerment. DAPI will also encourage college and career readiness based on each individual’s self-identified goals, identify and address adverse childhood experiences, and offer stress reduction and maternal health courses and co-parenting workshops. DAPI will provide services at each of its service sites, located in each county, as well as directly in the community and in collaboration with a variety of community-based partners.

Reach Riverside Development Corporation (REACH)
Multi-generational maternal and child health program
At its Kingswood Community Center located in the Riverside community in Northeast Wilmington, REACH will serve women of childbearing age and their families, targeting women who live in ZIP codes 19801 and 19802. To reduce toxic stress to women of childbearing age, REACH will create a multi-generational maternal and child health program with three components. First, a peer-to-peer program will provide mindful and empathetic services pre-, during, and post-pregnancy. The program will focus on stress and adverse childhood experiences training; examine the role of adverse experiences from a multigenerational lens; and address strategies to prevent transference of these experiences through the generation to children in particular. REACH plans to train at least 40 women during the period of the grant. Second, the organization will provide care management with referral and resource services, as well as case management via a community family and support service liaison. The liaison’s focus will be financial empowerment, self-sufficiency, and housing. Third, REACH will provide workshops to increase fatherhood/partner engagement, using strategies for inclusion and parenting dynamics that support mothers and their children.

Rose Hill Community Center
Women’s Wellness Program
The Rose Hill Community Center’s Women’s Wellness Program will offer women of childbearing age in the 19720 and 19801 ZIP codes the opportunity to take fitness, nutrition, and self-improvement classes at no cost. Fitness classes will include yoga, Zumba, and cardio kickboxing. One-on-one appointments with an on-site nurse will be available. Self-improvement classes will discuss ways to handle stress, positive self-image, combatting negative attitudes, conflict management, effective communication, parenting 101, couponing, social media, professionalism, discipline versus punishment, financial literacy, community resources, stress management, and goal setting. Free childcare will be available during classes. Participants will have access to an on-site mental health consultant who is a National Certified Counselor and Licensed Professional Counselor of Mental Health. Fitness activities and other services will be tailored to pregnant women and other participants with specific needs through meetings with a nurse and Women’s Wellness Program staff.

Delaware Coalition Against Domestic Violence (DCADV)
Community Health Worker Collaborative Project
DCADV will continue providing support and expand integration of its services with health services in New Castle County through its Community Health Worker Collaborative Project, which seeks to integrate domestic violence and health services to improve the health and safety of victims and survivors. The program will serve black and Hispanic/Latina women who are pregnant, parenting a child under the age of 5 years old, and/or of reproductive age, who are living in Wilmington, Claymont, Newark, and New Castle (ZIP Codes 19703, 19809, 19802, 19801, 19805, 19804, 19702 and 19720). The program will manage and expand service delivery to the HWHB target population; administer flexible Health Access Funds to support the safety and health of the participants; and train health care providers on best practices for domestic violence assessment and response, interviews, focus groups and/or surveys for individuals at the two New Castle County domestic violence shelters. It will work with direct service providers in the maternal and child health care and victim services fields to learn challenges and explore possible solutions.

Delaware Multicultural and Civic Organization (DEMCO, Inc.)
DEMCO will provide academic and life skills supports and job training education to young women of childbearing age, including those who are pregnant and parenting, who are living in Dover ZIP codes 19901 and 19904. Each woman served will be matched with a mentor to provide social and emotional support. The program will progress through a series of educational workshops to develop hard and soft skills to better prepare them for gainful employment and a career in the IT field. The program also includes support for fathers/partners, including effective fathers/partner parenting lessons, and an opportunity to engage in job shadowing and internship placement.

Hispanic American Association of Delaware
Mamas felices hijos felices (Happy Mothers, Happy Children)
The Hispanic American Association of Delaware will provide pregnancy and postpartum support in Spanish to women ages 15-44 who live in ZIP code 19720 in New Castle County. A support group called Mamas felices, hijos felices (Happy Mothers, Happy Children) will be located at Garfield Park, which is within walking distance for a high number of Latino families. Mamas felices, hijos felices will create wellness, resilience, hope, and connection for women adjusting to parenthood and experiencing pregnancy and postpartum emotional ups and downs. The support group will also address racism and language barriers by providing bilingual services. It will hire a dedicated community liaison to offer referrals to insurance and other needed services; reduce cultural mental health stigma in the Latino population; and provide support to families with recent migration and acculturative stress. The organization will also create a family network event to involve the whole family (especially fathers) and to connect the community to pregnancy and postpartum mental health resources.

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About the Delaware Healthy Mother and Infant Consortium:
In 2005, the Delaware Infant Mortality Task Force’s final report put forth a three-year plan with 20 recommendations to reduce the high infant mortality rate in Delaware. The plan called for the creation of the Delaware Healthy Mother and Infant Consortium (DHMIC) to help ensure that stated directives were put into place. The directives include coordinating efforts to address disparities related to the health of infants and women of childbearing age; and facilitating collaborative partnerships among public health agencies, hospitals, health care practitioners, and all other interested agencies and organizations to carry out recommended infant mortality improvement strategies.

Delaware’s Department of Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, drink almost no sugary beverages.

DPH Director Participates in March of Dimes Congressional Briefing on Infant and Maternal Health

Washington D.C. – Division of Public Health (DPH) Director Dr. Karyl Rattay participated in a Congressional briefing for members of the U.S. Senate and U.S. House of Representatives on Capitol Hill today, November 7, 2019, regarding maternal and infant health as part of a panel discussion hosted by March of Dimes. The briefing, “Making the Grade on Maternal and Child Health: 2019 March of Dimes Report Card,” addressed efforts across the country to prevent preterm birth and improve infant and maternal health. According to the 2019 March of Dimes Report Card released Monday, Delaware received a grade of “C+” based in part on its 2018 preterm birth rate of 9.6% of live births, which is lower than the national rate of 10.02%, and a decrease from the state’s rate of 10.2% the year before. March of Dimes’ preterm birth rate goal is 8.1% by 2020.

Dr. Rattay’s presentation focused on the state’s efforts to address birth equity through addressing social determinants of health, the Delaware Contraceptive Access Now (Delaware CAN) initiative, the importance of collaboration and partnerships, and the importance of sustained federal funding.

“I am honored to be asked to share information about the incredible work that is occurring in Delaware to improve health outcomes for mothers and babies,” said Dr. Rattay, who was invited to participate by March of Dimes and the Association of State and Territorial Health Officials (ASTHO). “In spite of the significant progress we have made, it remains true that too many babies in Delaware do not live to see their first birthday. Premature birth and its complications are the largest contributor to infant mortality in the U.S. Preventing preterm births is vital for healthier babies and mothers.”

Dr. Rattay discussed Delaware’s historically high infant mortality rate and the significant racial disparities that exist. While the state experienced a 22% reduction in infant mortality between 2000 and 2017, Delaware’s infant mortality rate of 7.3 deaths per 1,000 live births in 2013-2017 is still significantly higher than the national rate of 5.9 deaths per 1,000 live births in 2013-2017.

The leading cause of infant mortality is premature birth, and such births have both short-term and long-term negative impacts, and disproportionately impact women of color. Black infants in Delaware are more than twice as likely as white infants to die before their first birthday. Factors such as obesity, diabetes, hypertension, chronic disease, smoking, stress, race and racism, genetics, infection, and maternal age, along with multiple social determinants, all contribute to premature death and infant mortality.

In Delaware, black women have an infant mortality rate of 12.5 deaths per 1,000, which is approximately two and a half times that of white women, for which the infant mortality rate is 5.1 deaths per 1,000 live births.

“We can do better and are committed to doing so,” said Dr. Rattay. “The available research is clear that the path to more significant and sustained improvement in the statewide rate and eliminating the persistent racial disparity lies in addressing the social determinants of health.” Social determinants of health are the 90% of what affects a patient’s health that have nothing to do with clinical care, such as housing, transportation, employment, public safety, income, substance use, or how close they live to a grocery store, park or health care provider. “Everyone has the right to live in a society that values health equity – one in which everyone has an equal opportunity to make decisions that allow them to live a long, healthy life, regardless of income and education levels, race, or ethnicity.”

Dr. Rattay also focused on unintended pregnancy in Delaware and the success of the Delaware CAN initiative. Extensive data show that unplanned pregnancies have been linked to increased health problems in women and their infants, lower educational attainment, higher poverty rates, and increased health care and societal costs. In 2010, 57% of Delaware’s 11,000 births were unintended, which was one of the highest in the nation.

Through the Delaware CAN Initiative, a public-private partnership in collaboration with Upstream USA, the state has worked since 2014 to ensure all women of reproductive age in Delaware, regardless of insurance or ability to pay, have same-day access to the full range of contraceptive methods at low or no cost. The initiative has included policy changes, trainings and technical assistance to clinical sites, and the development of a statewide public awareness campaign, “Be Your Own Baby.”

Child Trends, a research organization focused on improving the lives of children and youth, performed an evaluation and issued a report using available contraceptive data from 2014 to 2017 in Delaware among Delaware Title X family planning clients ages 20-39. The observed movement from moderately effective contraception to highly effective long-acting reversible contraception paired with a small decrease in no method, was linked to a simulated 24% decrease in the unintended pregnancy rate among this population. As financial support through the partnership ends, DPH has developed a sustainability plan to leverage both federal Title X and state funding to support best practices in contraceptive counseling and the integration of existing DPH programs to support uninsured women.

Dr. Rattay also pointed out the state’s work in improving birth outcomes for Delaware families would not be possible without the collaboration of various stakeholders and partners, such as the Delaware Healthy Mother and Infant Consortium (DHMIC), Delaware Perinatal Quality Collaborative, and the Delaware Maternal Mortality Review program.

The DHMIC has recently undertaken an aggressive initiative to examine the social determinants of health by taking a Life Course approach to both understanding and addressing the disparities that have led to the rise in black maternal and infant mortality in Delaware.

“Addressing this problem requires us all to think beyond the doctor’s office or a prenatal visit. We must work to reach women in their communities and focus on the conditions in which they live, work and play,” said Dr. Rattay. “These determinants can have a significant impact not only on women’s access to care, but also increase their risk for preterm birth.”

The briefing was moderated by Dr. Rahul Gupta, Senior Vice President and Chief Medical and Health Officer, March of Dimes (MoD). Welcoming remarks were provided by MoD President and CEO Stacey D. Stewart, and other panelists included: Tiffany Spina – Parent Advocate, Manassas, VA; Dr. Zsakeba Henderson – Medical Officer, Maternal and Infant Health Branch, Division of Reproductive Health, Centers for Disease Control and Prevention; and Dr. Andrew Bremer – Acting Chief, Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Development, National Institutes of Health.

Photo courtesy of the Association of State and Territorial Health Officials (ASTHO). 


A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit

The Delaware Department of Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.