A pregnant African-American woman with her doula or birth support coach. The future mother, who … (+)
A recent Commonwealth Fund report highlights once again how far behind we are globally in tackling maternal health disparities. We have been discussing and studying these disparities since over 20 years old. Despite a plethora of start-ups specializing in maternal health, these long-standing disparities remain. So when I hear about a new startup in the maternal health space, I am skeptical and cynical, not believing that one of them can change this narrative.
I recently heard about a maternal health startup, Cayaba carewhose mission is to ensure access to comprehensive maternal health support. At first glance, reading about the organization didn’t lessen my skepticism about the long-term value of maternal health startups. However, I was curious because Cayaba Care has a black CEO, Dr Adaeze Enekwechihealth systems researcher with extensive experience in the healthcare sector, who is also a mother with her own stories about treatment during childbirth. I asked him what sets the organization apart from what seems like a glut of maternal health startups doing similar things. “Our power lies in partnerships with moms, their doctors and the healthcare system as a whole. Because of this, we can see where the system is failing for the mom and step in to help close the gap,” she said. she declared.
I still wasn’t convinced because her answer sounded like what most startups might say, so I pressed further, wanting her to explain Why their approach matters. Enekwechi says it’s about the team approach and relationships the company builds with doctors and other healthcare providers. “We’re not just app-based. For us, it’s a hands-on game,” she said.
Dr. Enekwechi differentiates his organization from others first by recruiting for empathy. She says communities have human capital, which is an overlooked resource, and so they partner with trusted community organizations to find team members and screen them for empathy – to find the right fit. person.
Attributing differentiation to empathy is tricky because it is a soft but instinctive skill that is easily dismissed as a proxy for results and difficult to master. For Enekwechi, empathy includes a shared understanding of culture, background, and family dynamics. Finding a suitable team member for the organization sometimes takes three months, but Enekwechi believes it’s worth it. In a startup environment, the pressure to hire quickly can be enormous. Hiring mistakes and staff mismatches cost a lot of time and money. She believes that the methodical approach the company takes to finding the right person for the Cayaba Care team improves long-term results, as fear is one of the main drivers of poor results. She says many of their members are afraid and fearful of what the health care system “will do to them” because they have heard from others who have had bad experiences, such as being ignored and fired when they were seeking care.
Dr. Enekwechi says the second differentiator is their emphasis on building relationships with doctors and care teams. Traditionally, pregnancy support services have been disconnected from clinical services, leaving patients to fend for themselves using a leaflet, the Internet or a list of numbers to call for help. In contrast, Cayaba Care fills this gap in information and support, creating peace of mind for the mother. Additionally, rather than acquiring physical spaces, they are looking to set up shop in provider offices, thereby building trust and collaboration with healthcare teams. Enekwechi offered an instructive example for healthcare teams on SDOH Screening. She says some people may feel too proud or ashamed to admit their food insecurity to a doctor, but these vulnerabilities are easily shared with the right navigator. Thus, the browser can also serve as a communication bridge to help ensure the accuracy of information provided to healthcare teams.
After my conversation with Dr. Enekwechi, I was intrigued but remained skeptical. I wanted to hear directly from people who had received services from Cayaba Care. I spoke to three women, all black and recently postpartum. They all agreed that Cayaba Care made their pregnancy journey easier. Two of them had previous pregnancies with different complications, and both felt that Cayaba Care made a difference in how they progressed throughout their pregnancies.
Jasmine, a 35-year-old mother who had just given birth to her third child, said: “During my other pregnancies I had to do everything myself, so I loved being able to call them 24/7 and someone I trusted would respond “She developed high blood pressure during her pregnancy and the team supported her with information about the impact of blood pressure on her pregnancy. it is necessary to search and when to seek help. This is an essential real-time support since one of the Most common contributors to preventable morbidity during pregnancy These are diseases linked to heart disease such as hypertension. She also said: “Sometimes it’s helpful to know you have support, even if you just have a question and it’s not an emergency. »
Rasheeda G. recently gave birth to twins and also congratulated the Cayaba Care team. She felt the difference between Cayaba Care and her previous pregnancy was that the person responsible for supporting her was also a black mother with a similar background. She immediately felt comfortable with her, as if a friend was taking care of her. “You know there are certain things you don’t want to ask the doctor or talk to him about because he might not understand you or judge you. I can tell him anything,” he said. she declared. Rasheeda also noted that her navigator taught her how to advocate for herself and said, “Black women’s concerns are not taken seriously. » During a previous pregnancy, Rasheeda had raised concerns about her history of anemia, but no action was taken until her third trimester, when she became symptomatic. She says that when a Cayaba team member accompanied her on her visits, she believes her concerns were taken more seriously and plans to use her new self-advocacy skills for any future engagements in health care matters.
When I spoke to Rasheeda, her examples shed some light on why we’re not reducing disparities in maternal health. Her experiences with Cayaba Care were not about something clinical and quantitative but about connection, something qualitative. These qualitative differences are likely overlooked when assessing the causes of morbidity and mortality. For example, the leading causes of preventable maternal morbidity are mental health problems, cardiovascular problems and infections. We categorize these items but have no context to understand what led to these diagnostic codes. Could a complication or death be avoided by calling on a trusted person? How can we assess whether or not people need this type of support?
Our approach to maternal health in the United States is largely clinical and quantitative, focusing primarily on protocols, clinical measures, and clinical predictors such as blood pressure measurement or complete blood count. These things are important, but Rasheeda described the feeling of being cared for, trusted and trusted by a Cayaba Care team member. We do not measure these things or intervene actively and consistently during pregnancy. In fact, we have no framework for applying this systemically to healthcare teams in the United States.
On reflection, I am much less skeptical of Cayaba Care’s ability to reduce maternal disparities among those they reach. They already have early signs that their approach will save money. The human approach they employ incorporates deep listening and connection with a trusted source of support, which is of great value to patients and the healthcare system. Dr Enekwechi also says: “The health system is too constrained to help people. We can help close the gap, but we must remember that the most important condition for stepping up our work is a strong dose of humility and assuming you don’t know. “
If every organization embraces this humility and openness to the human elements of maternal care delivery, we will likely be much more successful in addressing maternal health disparities.
Although this approach is not immediately scalable, it is certainly replicable nationally, provides concrete recommendations for health policymakers, and highlights the path forward to achieving health equity kindergarten. This will require organizations to emulate Cayaba Care’s efforts to slow down, listen, build trust and tailor support to each person’s needs. Perhaps in 20 years we will finally see dramatic changes in our shamefully embarrassing maternal health outcomes.