A Mercer University School of Medicine-led program has received an additional $5.5 million grant to continue its work improving health outcomes for expectant and new parents and their babies. Under the direction of professor Dr. Jennifer Barkin since fall 2022, South Georgia Healthy Start has already demonstrated a significant impact.
Over a five-year period, a 2.6% decline in the infant mortality rate was achieved in the program’s 10-county service area, according to the program’s 2023 Impact Report.
Healthy Start is a national initiative of the Health Resources and Services Administration with more than 100 programs across the country. Mercer School of Medicine and its Center for Rural Health and Health Disparities received an initial $5.5 million grant to establish the South Georgia program in 2019, and it serves the counties of Appling, Bulloch, Candler, Emanuel, Evans, Jefferson, Jenkins, Screven, Tattnall and Toombs.
“The goal is to reduce maternal mortality and morbidity and reduce infant morbidity by supporting these families with more health education, social support and material support,” said Dr. Barkin, professor and vice chair of community medicine and an internationally recognized expert in maternal mental health and postpartum functioning.
Morbidity refers to health issues that result from pregnancy or giving birth. Infant mortality refers to infant deaths during the first year of life, and maternal mortality refers to mothers who die during or after child birth.
South Georgia Healthy Start is run by a team of 12, including a nurse practitioner and six case managers who work directly with participants and administrative staff on Mercer’s Macon campus. A consortium of community members helps to guide the program.
The program promotes healthy perinatal behaviors as well as safe practices for caring for infants and toddlers. Among the services provided are education on topics such as breastfeeding and safe sleep habits; screenings for postpartum depression; coordination of medical care, including mental health care; and distribution of baby items, Dr. Barkin said. South Georgia Healthy Start also has a fatherhood program.
Gina Akins, South Georgia Healthy Start nurse practitioner since 2021, sees patients at 10 rural East Georgia Healthcare clinics, including South Georgia Healthy Start participants. Akins said many patients otherwise lack access to health care.
She provides regular prenatal services until the women reach 18 weeks in their pregnancy and then helps get them placed with an OB-GYN to continue their care. She also offers post-pregnancy services and advises some patients by phone.
“I have a unique opportunity to engage women and educate them,” Akins said. “As women, in taking care of our children, we often put on a superhero cape … and put ourselves last.”
Akins said early prenatal care and education are vital, as is self care. She teaches women about the early warning signs and symptoms of health issues that could arise during and after their pregnancy, so they will know to address them right away. She encounters many women who are struggling with depression and refers them to counseling and prescribes medication as needed.
There is no income restriction to participate in the program, but participants must live in one of the 10 designated counties. After being accepted into the program, participants are assigned a case manager who works with them until their child is 18 months old, Dr. Barkin said.
“We wrap our arms around the whole family, and we are able to support them with everything from medical services to counseling to communication,” said Senior Case Manager Carroll Banton, who has worked with the program since 2021. “We’re kind of like a support system to the families, a listening ear, a planner. We build that relationship with them.”
Banton has five children of her own and enjoys having the opportunity to support new parents by sharing her experiences and the program’s educational curriculum.
“People need to know that there’s somebody reliable that can speak with them,” Banton said. “I can hear in their voice that I’ve made a difference because they’re very comfortable speaking with me. When you have your heart in front, the participants realize that. We’re not just a program, but we really do care about them.”
Kasey Rogers is a former program participant who became a case manager for South Georgia Healthy Start in 2023. She said the guidance she received from her case manager during her pregnancy and as a new mother was beneficial.
“As a first-time mom, it was helpful having someone to ask questions to,” she said. “I was able to receive the education they provided and receive the baby items. It really helped me get an idea of what to expect.”
Rogers said it’s up to the participants how much support they want to receive through the program. They can reach out anytime as needed, but case managers also check in with them at least once a month, depending on the level of surveillance needed. Case management services are completely free to eligible participants.
“Our program is unique in that we not only provide clients with these services and education, but we also look at the bigger picture and connect them with resources to help them further. I really like helping families become aware of all of the resources out there that they can take advantage of,” Rogers said.
“We know that Georgia is one of the top states for infant mortality rates, and we have seen a decrease in (our service area rates) in the last few years. I’ve seen families that I work with directly benefit from these services, especially the counseling that we refer them to.”
Georgia’s overall infant mortality rate increased 13% in the year 2022, compared to 3% nationwide, according to the Centers for Disease Control and Prevention. By contrast, South Georgia Healthy Start’s service area reported no infant deaths — a drop of 2.6% — since the program began in 2019, Dr. Barkin said.
“That was so encouraging to me and very empowering, and it proves education and spending time with these moms makes the difference,” Akins said. “Statistically, I know we’re making a huge impact. Encouraging women to start early prenatal care and assist them with connecting with a local OB-GYN can make all the difference in the outcomes of those moms and babies in our communities.”
In 2023, South Georgia Healthy Start worked with 960 total participants. Eighty-three percent of the new moms initiated breastfeeding; 100% of adult participants were screened for depression and intimate partner violence; and 94% of babies attended well-child visits.
The program distributed 314 infant care essential kits with car seats, pack and plays, and breast pumps; 259 other infant or health care items; and 422 books and developmental toys to participants. Twenty-four community recruitment and health promotion events were hosted, during which 360 additional baby items were given away.
“We had a stellar year in terms of recruiting (participants). We overperformed in all the categories. We not only hit but surpassed them,” Dr. Barkin said. “Overall, the program I think has been pretty effective.”
Right now, participants work one-on-one with their case manager, but plans are in the works to add a group education component, she said.
“The idea is that when you’re going through that journey with your peers, you get more support and encouragement,” she said.
In the future, Dr. Barkin would also like for case managers to receive doula certification and training as lactation consultants and in perinatal mood and anxiety disorders, such as postpartum depression.
Click here to find out more about South Georgia Health Start, or call or text 478-973-1093.
