Children’s Service Society of Wisconsin led the Milwaukee Start Right project, with the goal to improve the health of Black families in Milwaukee County through evidence-based home visiting services for pregnant or parenting women. The program addressed health disparities facing participants by offering prenatal and postpartum education, developmental screening, parenting support and connections to medical, mental health and community resources.
The Challenge
People of color, particularly the Black community, are impacted by factors, policies and practices that limit access to care, impede effective treatment and contribute to worse maternal and child health outcomes than other racial and ethnic groups. In Milwaukee, these inequities are compounded by high poverty rates, with 29 percent of residents and more than 40 percent of children living below the poverty line, which is nearly double the national average. Maternal and child health indicators further underscore the urgency. Milwaukee County exceeds state averages in births to teen mothers, fetal deaths and infant mortality. Between 2019 and 2020, 24 percent of all infant deaths in Wisconsin were to mothers residing in the City of Milwaukee and 68 percent of those mothers were African American.
While home visiting programs have proven to be an effective strategy for improving maternal and child health, many in Milwaukee have strict eligibility requirements, serve only first-time mothers or end services shortly after birth, leaving significant gaps in care. The need for non-restrictive, evidence-based, culturally responsive home visiting services that meet families where they are is critical, especially for pregnant and parenting women of color with children up to one year of age who face additional barriers such as trauma, systemic distrust, limited access to resources and lack of informal support networks.
Project Goals
The Start Right Home Visiting program aimed to reduce disparities in maternal and child health by providing families with family-centered services. Program goals included:
Onboarding a new home visitor to serve more clients.
Recruiting and enrolling families into the program.
Providing high-quality home visiting services.
Providing prenatal and postpartum education and referrals to access medical care and mental health services for unmet needs.
Connecting clients with community resources.
Using the Adult Adolescent Parenting Inventory and Nurturing Parent curriculum to deliver parenting education.
Administering screening and assessment tools.
Providing books and activities to promote early literacy.
Providing in-home mental health consultation services.
Results
The Milwaukee Start Right program was able to continue offering evidence-based home visiting services in Milwaukee County, expanding its reach to serve more pregnant and parenting women of color and their families. In the second year of funding, the program served 23 families – nine carried over from the previous year and 14 were newly enrolled – alongside 11 families served through other funding sources, for a total of 34 families. Without WPP funding, only 11 families could have been served through alternate funding sources.
The program maintained 100 percent staff retention over the two-year funding period, ensuring uninterrupted and consistent support for families. Over the course of the grant, Start Right transitioned from the Nurturing Parenting curriculum to the Parents as Teachers (PAT) evidence-based curriculum, enhancing parent education through a structure framework that promotes child development, positive parenting behaviors, parent-child interaction and family well-being. The home visitor for this program provided individualized prenatal and postpartum education, developmental screening, mental health referrals, early literacy promotion and connections to a broad range of community resources.
The program also strengthened its community network by adding new partners such as Milwaukee Job Corps, Transition High School and St. Charles Youth and Family Services. Through these partnerships and the program, families receive tailored case management addressing both immediate needs and long-term goals, with services ranging from safe sleep education and advocacy in healthcare navigation to safety planning for mental health crises.
Looking to the Future
Although WPP funding has ended, the program continues with limited support from United Way, carrying forward the skills, resources and strengthened referral partnerships established during the grant period. These connections and curriculum changes will benefit future families served, even with reduced capacity.
