‘Having someone there when no one else was around’: Positive Participant Experiences with the Maternal Infant Health Program
With funding provided through Governor Whitmer’s Healthy Moms, Healthy Babies initiative, YPL evaluates the effectiveness of a pilot program to allow MIHP provider agencies to bill for additional services and care coordination for families with high levels of need for basic services.
Key findings
- Families who participate in the Maternal Infant Health Program (MIHP) have reported that the program is beneficial and that they had positive experiences with MIHP.
- A majority of participants had excellent or very good relationships with their home visitor and felt the program fully met their needs.
- Communication strategies that emphasize these positive experiences may help shift the perception of the program to encourage eligible families to participate.
Introduction & Background
The Maternal Infant Health Program (MIHP) aims to reduce maternal and infant mortality and morbidity, promote healthy pregnancies, positive birth outcomes, and healthy infant growth and development. Home visits typically begin in pregnancy and continue in the postpartum period, and during the baby’s first year of life. MIHP is for Medicaid-eligible pregnant individuals and infants under one year old and is Michigan’s largest evidence-based statewide home visiting program. Those who enroll in MIHP before their third trimester and fully participate (i.e. at least three home visits), have a have a 23% lower risk of low birth weight and a 26% lower risk of preterm birth.[i] As these are the primary drivers of infant mortality, MIHP can make a substantial contribution to improving infant and maternal health.
Programs like MIHP are vital to addressing long standing inequities in maternal health both nationally and within Michigan, as nearly half of all maternal deaths in the state are preventable.[ii] Furthermore, Black women in Michigan are three times more likely to die from pregnancy-related causes than white women.[iii] Michigan lags nationally for infant mortality, with Black, American Indian, and Hispanic babies dying at the highest rates. [iv]
Even though Medicaid-eligible pregnant people are automatically eligible for MIHP, the program is chronically underutilized. One potential concern about low participation is that it may suggest people are not satisfied with the program or that the program is not meeting their needs. However, participant data collected by the University of Michigan Youth Policy Lab (YPL) over several years and across a variety of contexts suggests otherwise.
In our long partnership with the Michigan Department of Health and Human Services (MDHHS), YPL has conducted several surveys of MIHP participants. In 2019-2020, YPL surveyed 478 MIHP participants in Southeast Michigan (Macomb, Oakland, and Wayne counties) to learn about their experiences with the program. As part of Governor Whitmer’s Healthy Moms Healthy Babies (HMHB) Initiative, YPL also surveyed 1,706 MIHP participants across the state in a 2022-2023 pilot study evaluating the effectiveness of enhanced services. Across these surveys, we found that people who participated in MIHP were overwhelmingly satisfied with the program, felt the program met their needs, and felt they had a good relationship with their home visitor. These findings, collected from families across the state and at different times, suggest that low participation is not driven by low satisfaction.
[i] Roman, L., Raffo, J. E., Zhu, Q., & Meghea, C. I. (2014). A statewide Medicaid enhanced prenatal care program: impact on birth outcomes. JAMA Pediatrics, 168(3), 220-227.doi:10.1001/jamapediatrics.2013.4347
[ii] Michigan Maternal Mortality Surveillance Program. (2018). Maternal deaths in Michigan. Available at: https://www.michigan.gov/documents/mdhhs/MMMS_2011-2015_Fact_Sheet_FINA…
[iii] Michigan Department of Health and Human Services. (n.d.). Healthy Moms Healthy Babies. https://www.michigan.gov/-/media/Project/Websites/Whitmer/Documents/Mis…
[iv] Michigan Department of Health and Human Services. (n.d.). Healthy Moms Healthy Babies. https://www.michigan.gov/-/media/Project/Websites/Whitmer/Documents/Mis…
