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Opinion: The Maternal Child Health Department is closed: What now?

American mothers were dying at the highest rate in the developed world long before the COVID-19 pandemic began. In its wake, pregnant, birthing, and postpartum families navigate the ongoing effects of financial instability, social isolation, political unrest, childcare closings, and health outages. The burden has been relentless, especially for families living in urban areas like New Haven.

Chronic stress from poverty, racism and marginalization contributes to many maternal and infant health problems, leading to medical emergencies at birth and even death. Addressing maternal and child health crises is more important than ever. So, for many dedicated health professionals and advocates in New Haven, the recent and sudden closing of the Maternal Child Health Division of the city’s health department came as a total shock.

The decision to close the section was not made overnight. According to former and current employees, the division’s services have been slowly being phased out over the past five years. The division housed essential programs for families, including HUSKY health insurance, MANOS home visiting and more. Maria Damiani, the former division director, was a formidable leader who used her organizational wisdom and long-standing professional relationships to sustain the division. A former employee described Damiani driving to Hartford and knocking on the doors of lawmakers when she thought funding was in jeopardy. This is how the department maintained vital programs and served the New Haven community until 2017 when she sadly passed away.

After that, the position of Divisional Director was never posted or refilled. Without leadership and consistent funding, the programs operating under the umbrella of the Health Department were phased out. By 2020, home visiting was the only program left within the division. But Family Centered Services took over all home visiting responsibilities a few months ago, which meant the end of the Maternal Child Health Department altogether. All but one of the remaining division staff were fired.

Some local health workers and advocates argue that eliminating the split without a formal explanation sends the message that maternal child health doesn’t matter at a time when the city’s families are overwhelmed and vulnerable. In a recent letter to the health department from Black and Brown United in Action, the division was described as providing well-utilized, essential services in New Haven. They argued that eliminating programs that promote the health of Black and brown residents runs counter to state leadership’s commitment to address health equity and improve quality of life.

Others see the division’s closure as a necessary shift in New Haven’s maternal and child health service delivery. Public Health Director Maritza Bond led New Haven through the height of the pandemic when the department’s main initiatives included COVID-19 safety and immunization efforts. When asked about the future of maternal and child health in New Haven during a recent panel discussion at the Yale School of Medicine, Bond discussed the importance of partnerships between the Health Department and social services to improve maternal and child health. Currently, departmental staff link residents to care by referring them to any of seven local agencies that provide maternal and child health services.

Building partnerships to consolidate efforts may indeed be the appropriate evolution of maternal and child health service delivery in New Haven. However, this shift raises several questions:

With most division staff no longer employed by the department, are the professional relationships and knowledge gained during the division’s nearly 20-year history maintained?

Is cross-sector communication strong enough to meet service demand?

And most importantly, are New Haven residents aware of this change in service delivery?

Our city is home to many nonprofits and social service agencies that do incredible work on behalf of New Haven families. The Yale School of Public Health recently announced the inauguration of a Mother Child Health Promotion track, strengthening the institution’s commitment to equitable, evidence-based research and practice for maternal and child health. Maternal and child health in New Haven remains a priority. But without a designated maternal child health division, the health department, collaborating nonprofits, and community advocates must work together to ensure collective action for mothers and children.

Annie Winneg is a Master of Public Health student at the Yale School of Public Health.

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