G-1878

Prenatal care/Indigenous Women

Description

Financing

Documents

Photos

History Logs

Project Description

Region: North America

Country: USA

Location: Mn, Sd, Ne, Mt, Nd

Total Budget: $183,991

Area of Focus: Maternal and child health


GG1980712: Group Prenatal Care Training for Indigenous Women

PROJECT SUMMARY

Five health centers serving indigenous women in North Dakota, South Dakota, Minnesota, Nebraska, and Montana are requesting our help to develop group prenatal care in order to reduce infant mortality and negative outcomes among the pregnant women in their communities. Indigenous communities face the highest rates of preterm birth and infant mortality in the Midwest, and have the highest rates of negative outcomes among mothers.

Group prenatal care is an evidence-based intervention that can reduce preterm birth-the number one cause of infant mortality-and improve many outcomes for the pregnant mothers, such as increasing breast-feeding initiation, reducing smoking, etc. Group prenatal care is consistent with native culture, similar to 'talking circles'.

This Global Grant will provide training in group prenatal care to all five communities in 2019. Each site will receive start-up funding for two years, data and technical support, and an opportunity to meet together at the start and end of the grant to facilitate problem solving and collaboration.

Goals: ultimately, the project will reduce preterm birth (thus, reduce infant mortality). Health outcomes for pregnant mothers will also be improved. Trust in the medical community and personal empowerment over health will increase prenatal care attendance, which is strongly related to improved health for babies and pregnant women.

PROJECT PARNTERS

INDIGENOUS HEALTH CENTERS

1. St. Vincent Health Center, Billings, MT 59101 Phone: 406-237-7000, https://www.sclhealth.org/locations/st-vincent-healthcare/about/

2. White Earth Home Health Agency/White Earth Service Unit for Indian Health Services (IHS), White Earth Service Unit, Indian Health Service, Ogema, MN 56569 https://www.ihs.gov/bemidji/healthcarefacilities/whiteearth/

3. Santee Sioux Health Center, 110 S. Visiting Eagle ST. Niobrara NE 68760 http://santeesiouxnation.net/santee-health-center.html

4. Elbowoods Memorial Health Center and Three Affiliated Tribes/MHA Nation MHA Nation | Three Affiliated Tribes, 404 Frontage Road New Town, ND 58763 http://www.elbowoodshealth.com

5. Rosebud Health Rosebud Comprehensive Care Facility, Hwy 18 Soldier Creek Road Rosebud, SD 57570 https://www.ihs.gov/greatplains/healthcarefacilities/rosebud/

These centers conducted formal and informal community assessments and assessed their ability to successfully begin and sustain the program. The five sites have started conducing monthly phone calls together to discuss potential challenges they may face in implementing Group Prenatal Care. They have already submitted letters of support from their Health Centers, Indian Health Services (if required), and their tribal councils.

MARCH OF DIMES

March of Dimes will provide training in group prenatal care and is willing to offer support in kind for this project. March of Dimes emphasizes health equity and thus is willing to provide staff time to developing the partnerships required for successful completion of this grant. They also have a long history of partnership with Rotary, beginning in the early days of polio eradication.

UNIVERSITY OF NORTH DAKOTA

This grant will support one public health graduate student who is from an indigenous community and who hopes to continue working with native communities using their Public Health Master's degree. Their participation in this project will leverage the project results to connect with additional native communities in the Midwest, scale up the project nationally, and ensure that results are gathered, processed, and disseminated in a culturally-appropriate and professional manner. The partnership with the University of North Dakota graduate program will bridge gaps between the native communities and the broader health and academic communities and will work closely with March of Dimes local and national staff to ensure this project has national implications.

INDIGENOUS GROUP PRENATAL CARE EXPERT

A native facilitator will be selected by an interview with the FMAM Rotary Club from a pool of applicants. The person would ideally be from an indigenous community in the Midwest, be highly interested in group prenatal care development in native communities, have wide experience developing programs in native communities, and have experience in a clinical setting. One appropriate candidate has already volunteered, from the participating Montana health center. March of Dimes has offered to provide training with national Group Prenatal Care March of Dimes staff for this individual to become an expert.

ROTARIANS

HOST ROTARY CLUB: Fargo-Moorhead AM, Fargo, ND, USA, District 5580

INTERNATIONAL ROTARY CLUB SPONSOR: Rotary Club of Thunder Bay (Fort William), Thunder Bay, ON, Canada, District 5580

Rotary Clubs will be responsible for:

1. administrative tasks, including extensive workload arranging regular monthly billing/reimbursement components for the many sites and partners involved.

2. identifying and providing guidance and support for appropriate graduate student and native group prenatal care expert. The host Rotarians will work with the university and with health centers to identify individuals, arrange supervision plans, and get paperwork in place with the university and health center to create a billing mechanism.

3. participating and preparing the training at the start of the grant and the follow-up session at the end of the grant. Tasks will include: printing of banners, pamphlets, training booklets and materials for the training; arranging the training site including location/meals/hotel blocks/IT support; participate during training session and follow-up session.

ASSESSMENT OF NEED

Each of the five sites conducted community assessments, per requirements of the Rotary International Global Grant process. In summary, the assessments revealed:

1. a need for increased cultural and spiritual connections for pregnant moms,

2. the communities' belief that they would benefit from having more social support and holding group sessions for pregnant women.

3. a lack of trust in medical providers, which group prenatal care overcome by bridging the gap between the formal health system and the trusted professionals and paraprofessionals working in the community.

Note: Individual community assessments are available upon request and will be submitted with Global Grant application.

SUSTAINABILITY

Initial training costs and start-up funds are the primary barrier for communities who wish to implement group prenatal care. Further, when group prenatal care is first implemented at a health centers, technical support is often needed for the program to overcome challenges and gain momentum. After this initial start-up period when training, additional funds and technical support are needed, prenatal care-including group prenatal care-is a covered Medicaid benefit.

Therefore, this grant will help sites overcome the major barrier to implementing group prenatal care: technical support, training and start-up funding. After this two-year period, the sites will be able to sustain the cost of group prenatal care after the two-year grant period.

BUDGET AND FINANCIAL SUPPORT NEEDS

The total budget for this project is approximately $184,000 and includes the following components:

1. Training: All health centers will be trained in group prenatal care techniques in a 2-3 day session, provided by March of Dimes. Transportation, room, and board will be provided to attend the training.

2. Individual site support: each site has submitted individual budgets for start-up supplies, such as blood pressure cuffs and other medical supplies, a stipend for elders or other guest speakers to bless the session and/or provide specialized discussions on substance use or other topics of interest, cultural crafts to connect the women with their culture, healthy snacks for the participants, and booklets or other materials for the participants. All sites will receive technical support and data support from March of Dimes, an indigenous group prenatal care expert, and a graduate student at the University of North Dakota.

3. Collaboration/partnership opportunity: At the end of the grant period, providers will meet again to discuss grant results and plans for follow up.

Primary Host Partner

District: 5580

Rotary Club of: Fargo-Moorhead AM

Primary Contact: Herb Schmidt

Email: hjs2107@gmail.com

Primary International Partner

District: 5580

Rotary Club of: Thunder Bay (Fort William)

Primary Contact: Robert Hookham

Email: robert.hookham51@gmail.com

Project Status

Paid
This project is "Paid". This means the funds have been received and the project is being implemented.

Project listed for the 2018-19 Rotary Year.

The TRF Grant application number is #1980712.

Proposed Financing

Existing Contributions Towards This Project

Date

Cash

DDF

Total

Thunder Bay (Port Arthur) (5580)

4-Jan-19

$250

$500

$750

District 5610 DDF

4-Jan-19

-

$5,610

$5,610

Del Mar (5340)

10-Jan-19

$5,000

$5,000

$10,000

Pelican Rapids (5580)

11-Jan-19

$1,000

$2,000

$3,000

Williston (5580)

11-Jan-19

$250

$500

$750

Thunder Bay (Fort William) (5580)

11-Jan-19

$3,000

$6,000

$9,000

Bismarck Far West (5580)

11-Jan-19

$500

$1,000

$1,500

Prior Lake (5960)

11-Jan-19

$1,000

$0

$1,000

Sun Lakes (5495)

12-Jan-19

$1,500

$0

$1,500

Nipigon (5580)

12-Jan-19

$2,000

$4,000

$6,000

Grand Rapids (5580)

15-Jan-19

$2,500

$5,000

$7,500

West St. Paul & Mendota Heights (5960)

19-Jan-19

$1,000

$0

$1,000

Brainerd (5580)

19-Jan-19

$1,865

$3,731

$5,596

Meenambakkam (3232)

30-Jan-19

$1,000

$0

$1,000

Fargo-Moorhead AM (5580)

30-Jan-19

$7,684

$15,368

$23,052

Fargo Moorhead PM (5580)

30-Jan-19

$1,300

$2,600

$3,900

Moorhead (5580)

30-Jan-19

$1,300

$2,600

$3,900

Fargo-West (5580)

30-Jan-19

$1,300

$2,600

$3,900

Fargo (5580)

30-Jan-19

$1,300

$2,600

$3,900

Wabasha (5960)

30-Jan-19

$100

$0

$100

District 5890 DDF

30-Jan-19

-

$5,000

$5,000

Amount Requested from The Rotary Foundation

$16,924

$64,109

$81,033

Additional Contribution (not matched by The Rotary Foundation)

$5,000

Total

$183,991

DDF contributions in grey are pending approval of the corresponding district committee.

Note: as of July 1, 2015 there is a 5% additional support fee for cash contributions. This fee does not appear in the financials above because it does not apply if the funds are sent directly to the project account (without going through TRF, and therefore without Paul Harris credit). Clubs sending their cash contribution to TRF must be aware they will have to send an additional 5%.

Project Supporting Documents

Project Photos

History Log Entries

31-Dec-18

System Entry

System Entry: Creation of project page.

3-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $1,000 by Alicia Helion Belay of the Rotary Club of Pelican Rapids, District 5580.

3-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $500 by Alicia Helion Belay of the Rotary Club of Bismarck Far West, District 5580.

3-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $250 by Alicia Helion Belay of the Rotary Club of Williston, District 5580.

3-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $2,000 by Alicia Helion Belay of the Rotary Club of Nipigon, District 5580.

4-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $250 by Alicia Helion Belay of the Rotary Club of Thunder Bay (Lakehead), District 5580.

4-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $3,000 by Alicia Helion Belay of the Rotary Club of Thunder Bay (Fort William), District 5580.

4-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $250 by Alicia Helion Belay of the Rotary Club of Thunder Bay (Port Arthur), District 5580.

4-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $1,500 by Alicia Helion Belay of the Rotary Club of Sun Lakes, District 5495.

4-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $5,610 DDF by dave lorenz of District 5610.

10-Jan-19

System Entry

System Entry: Pledge of $5,000 with $5,000 DDF by Karin Davies of the Rotary Club of Del Mar, District 5340.

11-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $1,000 with $2,000 DDF by David Gottenborg of the Rotary Club of Pelican Rapids, District 5580.

11-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $250 with $500 DDF by Marsha Schmidt of the Rotary Club of Williston, District 5580.

11-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $3,000 with $6,000 DDF by Bob Hookham of the Rotary Club of Thunder Bay (Fort William), District 5580.

11-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $500 with $1,000 DDF by Greg Carlson of the Rotary Club of Bismarck Far West, District 5580.

11-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $1,000 by Mary Haugen of the Rotary Club of Prior Lake, District 5960.

12-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $1,500 by Stan Kaufman of the Rotary Club of Sun Lakes, District 5495.

12-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $2,000 with $4,000 DDF by Linda Nicol of the Rotary Club of Nipigon, District 5580.

15-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $2,500 with $5,000 DDF by Brandon Otway of the Rotary Club of Grand Rapids, District 5580.

15-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $2,500 with $5,000 DDF by Brandon Otway of the Rotary Club of Grand Rapids, District 5580.

15-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $2,500 with $5,000 DDF by Brandon Otway of the Rotary Club of Grand Rapids, District 5580.

19-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $1,000 by Bridget McCauley Nason of the Rotary Club of West St. Paul & Mendota Heights, District 5960.

19-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $1,500 with $3,000 DDF by Rick Bricker of the Rotary Club of Brainerd, District 5580.

30-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $1,000 by PP Dr.B. Dakshayani PhD of the Rotary Club of Meenambakkam, District 3232.

30-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $1,300 with $2,600 DDF by Alicia Helion Belay of the Rotary Club of Fargo-Moorhead AM, District 5580.

30-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $1,300 with $2,600 DDF by Deb Maertens of the Rotary Club of Fargo Moorhead PM, District 5580.

30-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $1,300 with $2,600 DDF by John Andreason of the Rotary Club of Moorhead, District 5580.

30-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $1,300 with $2,600 DDF by Melvin Whitney of the Rotary Club of Fargo-West, District 5580.

30-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $1,300 with $2,600 DDF by Heather Ranck of the Rotary Club of Fargo, District 5580.

30-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $100 by Sharon Burke of the Rotary Club of Wabasha, District 5960.

30-Jan-19

by Alicia (Helion) Belay

System Entry: Pledge of $5,000 DDF by Carmen Cuneo of District 5890.

31-Jan-19

by Alicia (Helion) Belay

System Entry: Project is now "Fully Pledged".

10-Apr-19

by Alicia (Helion) Belay

System Entry: Application Sent to The Rotary Foundation through Member Access.

11-Apr-19

by Stan Kaufman

System Entry: Application approved by The Rotary Foundation.

11-Apr-19

by Philippe Lamoise

System Entry: Project status reverted to Application Sent.

23-May-19

by Philippe Lamoise

Contribution of $5,000 from the Del Mar Rotary Club sent to TRF through the Matching Grants Website DAF.

23-May-19

by Philippe Lamoise

System Entry: Application approved by The Rotary Foundation.

16-Aug-19

by Alicia (Helion) Belay

System Entry: Payment has been issued by The Rotary Foundation.

3-Mar-20

by Alicia (Helion) Belay

Hello all,

Wanted to give a quick status update on our Group Prenatal Care for Indigenous Women Global Grant.

Recently, we presented our project in Albuquerque NM, at the Annual International Meeting on Indigenous Women's Health. We were invited to present both a poster and a breakout session. Leaders from three of the participating sites joined me in the Albuquerque and presented their site's unique strategy for implementing group prenatal care.

At this point, one site has begun group care, one will start this next week, and two are scheduled to begin in April. It has been harder than we expected to get the groups rolling and it wouldn't be possible without the financial and technical support that has been provided in this grant.

Thank you for making this possible!

16-Oct-20

by Alicia (Helion) Belay

COVID has made it a challenging time to launch group prenatal care. One of the five sites is running group care, but sites, all on tribal lands, have been unable to have groups meet because of COVID.

In September, our project had a review from a Rotary International Cadre, which is mandatory for all Global Grants of this size. Though we have not received a final report, the meeting with her was very positive and we were pleased to learn that Rotary will be flexible with our project to allow adaptation given the circumstances.

We are currently working with the sites to identify how to move forward. We are exploring virtual options and other creative partnerships to move the project forward.

Thank you for your support and your good wishes for project success despite COVID.

16-May-21

by Alicia (Helion) Belay

Hello all, the matchinggrants.org website keeps sending automatic notices to us all asking for an update, so I'll update you! We are currently working to identify telehealth strategies to implement and alternative models to implement the project. Unfortunately, due to COVID, this project has not moved forward as hoped (albeit one site is doing amazingly well). We are working on identifying collaborators, such as WIC programs within the tribes, that may have capacity to implement the project. I am meeting with one site this week that has innovative ideas for implementation of the project. We are working to hire an indigenous liaison through the Indigenous Health PHD program at UND. We have an annual report due to RI coming up soon. Thank you all!

26-Sep-21

by Alicia (Helion) Belay

Quick project update: despite COVID, we have had some successes lately. Santee Sioux Health Center (NE) is launching in October. St. Vincents (MT) has continued to have success with group care. White Earth Home Visiting launched last month, but are now on hold due to the COVID uptick. Rosebud Health Center (SD) has asked if they can wait to begin until January, because COVID is too severe. Elbowoods Clinic, MHA Nation (ND) has decided they do not have capacity because of COVID but we will work with the Health Start Program instead. We have been working with the ND Department of Health Tribal Liaisons for new avenues and we have hired an a PHD student in the Indigenous Health Program at UND to support our project. Thank you all for your support and patience as we continue to push forward!

28-Apr-22

by Alicia (Helion) Belay

Significant progress has been made in the project!

MHA Nation held its first event in April. Participants received maternity supplies and pamphlets/flyers of community services/programs for pregnant women and prenatal education.

The Santee Sioux site had their first prenatal care class in January. In March, they had another cradleboard making class in which a healthy meal was served.

Spirit Lake is a NEW site! They have developed a Prenatal Advocate position. A Birthing Rights document was developed.

St. Vincents Hospital in Billings has had 100 people in their program, 10% Indigenous. They plan to expand to the Northern Cheyenne Reservation sometime in 2022.

White Earth Home Visiting program has had several community events, and are currently planning another event.

7-Dec-22

by Alicia (Helion) Belay

Despite significant challenges and changes in direction, this project continues to be very successful. The prenatal care advocate program in Spirit Lake has been very successful and a follow-on Postpartum group is being developed. The Little Moccasins program at the Santee Sioux Health Center completed a successful prenatal group in November; women presented the cradle boards that they made during their groups to the public. The Three Affiliated Tribes site has held virtual groups for pregnant women and their families and has had strong participation. St. Vincent's Hospital in Montana continues their group prenatal care program, reaching Indigenous and non-indigenous women. Two sites have not continued, due to challenges with staffing that were exacerbated by COVID.

7-Apr-23

by Alicia (Helion) Belay

Last week, a presentation was made to the Spirit Lake Health Director regarding the Prenatal Advocate program. Due to the incredible success, the Director is considering adding the program to their ongoing budget. This would be a great win, as it would make this new, innovative program sustainable through their internal budget. In addition, programs in Nebraska (Santee Sioux Health Center) and Montana (St. Vincents Hospital) continue their success. Sacred Pipe in Mandan, North Dakota, has begun their group prenatal care program in 2023. A group care program and prenatal advocate program are under review again at Three Affiliated Tribes, after their first attempt to start the program was thwarted by COVID. The interim report for this project will be submitted in the next few weeks.

16-Oct-23

by Alicia (Helion) Belay

In the last 6 months, one of our 2019 original sites completed final reporting (Santee Sioux program in Nebraska). Another original site launched group care on their own, after using Rotary funding for pilot work and to become trained (Elbowoods Clinic, Three Affiliated Tribes in ND). A new site, Sacred Pipe, which serves urban native people in Mandan ND, is planning to launch group prenatal care and is working through logistics. Lastly, a budget change was approved by TRF to work with the American Indian Public Health Resource Center (AIPHRC) at North Dakota State University to train 3 sites around the state in an evidence based program called Family Spirit to improve pregnancy/postpartum for native people. Family Spirit will be used with group prenatal care and home visiting.

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