Improving Low-income MCH Through Economic Policies
Mothers in Arizona Moving Ahead (MAMA) is a pilot project focused on individual and systems-level changes that improve health outcomes and financial stability for mothers and children living in poverty. A joint project between the Pima County Health Department (PCHD) and the Pima County Community Services Employment and Training Department, MAMA enables low-income mothers to become partners, not just patients, and to identify the system changes needed in practice and policy to achieve greater equity and to provide more responsive care for people living in poverty. In a time of uncertain funding, this model is designed to be lean and replicable by harnessing strong community collaboration and a volunteer base.
With funding from PHNCI, Pima County aims to ensure that the MAMA model will build social capital across economic class as it engages and educates new sectors of the community for a deeper understanding of poverty, while increasing political will to undertake lasting community change.
MAMA starts with a 50-hour curriculum that investigates poverty and focuses on creating a new “future story” with self-determined goals. Presentations on health concerns identified by the moms are delivered by PCHD staff while health navigators, who are knowledgeable both with employment and training as well as health department resources, are available to the 40 active moms to problem solve and connect to county and community resources.
This is followed up with a monthly Circle of Care that focuses on goals, the action steps needed to achieve them, and the strategies to overcome the barriers that get in the way. Community volunteers, called allies, attend trainings to deepen their understanding of poverty and be equipped to listen, learn, and give support. The 35 current allies receive a newsletter and participate in quarterly meetings to learn about community resources, stay connected, and give critical feedback. Incorporating allies not only bridges economic class, often a significant divide in many communities, it also strengthens the community’s resolve to alleviate poverty and decreases the need for costly staff involvement, making the model more affordable and sustainable.
At PCHD, we know health equity has to be at the top of our agenda. And that means both revisiting our current programs with a new lens as well as innovating new approaches. MAMA is one of those innovative approaches that we believe can be transformative. The MAMA project allows us to have a new kind of relationship, a deeper and more investigative approach, with our community partners, as well as with the moms. As a single mom who experienced poverty, I wish a program like MAMA had been there for me. My commitment is to make sure what we learn alongside these moms translates into change, both in our department and in our community. , PCHD Director
County resources are organized to assist with specific issues, like the Public Defender’s office providing expertise for the third of the moms facing legal concerns. Moms take on leadership roles in the community and with the program, with three now serving as co-facilitators of the class.
MAMA works through community partners already serving mothers in poverty and interested in trying a new approach. The initial six partners vary from the Community Food Bank interested in “shortening the line” strategies, to the Tucson Urban League with a 50-year history of serving families in Tucson’s highest poverty areas, to two residential substance abuse recovery programs for women. In the next phase, six partners will participate, including three from the initial group. Partners wanted to try new groups including Spanish dominant mothers, mothers on Temporary Assistance to Needy Families, a group for fathers, and veterans. Most important, in the next stage PCHD will roll up its sleeves and begin the work of identifying systemic barriers to access and potential improvements with help from stakeholders: health professionals, allies, community partners, and MAMA participants. This Health Equity Redesign component is integrating three approaches that build on the trust, self-efficacy, conceptual framework, and analytical tools developed earlier in the program. Lessons learned will be shared at a culminating event in October and the MAMA model will be available for other communities.
Alisa Aponte, a graduate from the Food Bank, is an example of a MAMA leader. Since starting with MAMA, Alisa has graduated the Food Bank’s culinary arts program and is working on her behavioral health certificate, achieving her dream of becoming the first in her family to attend college. She is also a co-facilitator for MAMA.
I tell everybody about MAMA, anybody who will listen. It has changed my life completely. , MAMA Leader