Rural Maternity and Obstetrics Management Strategies Program - Project Title: Georgia Maternal and Infant Health Access, Protection and Support (GMAPS) Goals: This project implements innovative and novel approaches to establish a sustainable, formal OB health services network and improve maternal and infant health outcomes in rural and underserved populations in Georgia. Funds Requested: $1M requested per project year. Network Composition: Our network includes an academic research institute, 1 Level III obstetric hospital, 1 rural hospital, 2 FQHCs, 2 AHECs, the state Medicaid office, 1 maternal behavioral health organization, and 2 community-based organizations. Target Service Area: 13 HRSA-designated rural counties: Burke, Elbert, Greene, Jackson, Jefferson, Lincoln, McDuffie, Morgan, Oglethorpe, Walton (census tracts 13297110300, 13297110400, 13297110700), Warren, Washington, and Wilkes Counties. A majority of these are high OB service need areas, either in a maternity care desert or with low access to maternity care. Target Population: Women in our rural counties are 40% racial/ethnic minorities and 17% uninsured. Among all GA births in 2023, 11.8% were preterm, 10% had low birth weight, 17% received inadequate prenatal care, 27% of birthing people had hypertension, and 33% of birth people had diabetes. Non-Hispanic Black women in GA are nearly 3 times at risk of pregnancy-related maternal mortality. Capacity to Serve Rural Underserved Populations: Augusta University in partnership with Wellstar/MCG and the Medical College of Georgia is the region’s only academic health center and is the only delivery hospital in our network. Our clinical partners have experience with rural outreach through tele-stroke, tele-mental health, and telehealth emergency services, together these efforts have reduced unnecessary ED referrals by 80%. A newly funded USDA grant to support tele-obstetric emergency support has also recently been awarded to the university. Our current pregnancy and delivery network relies on a hub and spoke model – individual care is provided locally, and referrals for high-risk care and delivery are made to the Augusta Regional Perinatal Center at Wellstar/MCG. We have historic and current working relationships with our network partners, including AU clinic sites in the rural hospital, educational opportunities, and preceptorships with medical and nursing students. Project Activities: Utilizing the Life Course Development framework, this proposal impacts rural women during pregnancy, postpartum, and the transition to primary care. Our goals are to: 1) Identify and implement evidence-based and sustainable delivery models to provide maternal and obstetrics care in rural hospitals and communities to reduce risks associated with maternal mortality, specifically exploring dyad care, group prenatal care, mobile care, and maternal self-monitoring of health risks.; 2) Enhance and preserve access to maternal and obstetric services in rural hospitals, including by developing an approach to aggregate, coordinate, and sustain the delivery of and access to preconception, prenatal, pregnancy, labor and delivery, and postpartum services; 3) Provide perinatal health support training for professionals in health care settings that do not have specialty maternal care. 4) Assess and address community specific disparities in infant and maternal health outcomes, including among rural underserved populations. Our approach ensures each woman receives the right care, in the right setting, at the right time. Expected Outcomes: 1) Increase the number of women receiving adequate prenatal and postpartum care; 2) Increase patient and provider self-efficacy, health knowledge and improved perceived trust of providers; 3) Increase rates of early intervention for co-morbidities and facilitate primary care transition; and 4) Decrease maternal mortality rates. Funding Priorities: GMAPS qualifies for the following funding priorities: • Established network history • Top 10 states with the highest average MCTA scores
