Challenge:

Thirty years ago, The Guilford County Coalition on Infant Mortality was formed with the  mission to reduce infant death and disability through community education and involvement. In doing so, they hoped to increase public awareness of infant mortality, which measures the rate at which a child born alive dies before his/her first birthday.  

However, healthy birth outcomes for women in Guilford County continue to be concerning, especially when taking racial inequalities into account. In 2019, Guilford County’s infant mortality rate was 9.3 per 1,000 births, a 9% increase from 2018. This rate is nearly 37% higher than North Carolina’s rate of 6.8 and 66% higher than the national rate of 5.6. According to 2019 birth data from Guilford County, 66% of infant deaths were African Americans from all socioeconomic levels, making the infant mortality rate for African American infants 2 to 6 times higher than the rate for White and Hispanic infants. In Guilford County in 2019, the infant mortality rate for Black babies was 14.6, while the rate was 6.6 for White babies and 2.3 for Hispanic babies. The County’s pre-term birth rate also has persistent racial disparities with Black mothers having the highest pre-term birth rate at  13.3, compared to White women (9.7), and Hispanic women (8.2).

In Guilford County, the main causes of infant mortality are prematurity, low birth weight, birth defects, and SIDS. 

Overview:

Root Cause is working with The Guilford County Coalition on Infant Mortality to develop a five-year strategic plan grounded in our Collective Action framework. 

The Coalition identified its need for a Collective Action strategic plan that envisions bold goals, develops collective action strategies, is radically inclusive, and redesigns the Coalition in order to address the stark health disparities in birth outcomes and infant mortality in Guilford County, North Carolina. 

Potential challenges we may face over the course of this project will include pushing against a political landscape that holds a  colorblind approach and ensuring that partners have shared accountability for the outcomes of their contributions to carry out the work of the Coalition. Additionally, the Coalition will need to be thoughtful in organizing methods  to secure continuous funding for partners to allocate resources and time to build and maintain tools, processes, and systems.

During the research and planning phase, Root Cause guided The Guilford County Coalition on Infant Mortality in building a robust case for why their work is critical, essential, and urgent. This was accomplished by reviewing  existing materials about the Coalition’s purpose and from other similar Coalitions, understanding local, state , and national discussions on infant mortality and maternal morbidity  and identifying gaps in prenatal and perinatal services through stakeholder analysis. Root Cause led strategy convening sessions that  brought stakeholders together to understand the problem and unique barriers in Guilford County, gain community input and support for the future mission, vision, and activities for the Coalition, and ensure broad-based community support for the success of future activities. 

The Root Cause Theory of Change framework will be utilized to help stakeholders think about how they can address the racial inequities and health disparities in birth outcomes in Guilford County. This framework will serve as a foundation for discussion to plan activities and make strategic commitments to reduce infant mortality disparities over the next five years. In breakout groups, stakeholders will work with the Coalition to determine the activities that need to be carried out for each of the Coalition’s strategies, qualitative and quantitative goals for its expected outputs and outcomes, and how to collect the data. The Collective Action framework will be utilized to outline how stakeholders will continue to partner with the Coalition to carry out activities and accomplish goals. Root Cause will also help the Coalition set up a template for future data sharing and evaluation.