"Ekip Manman": Group Prenatal Care Adapted for Pregnant Haitian Immigrants in Boston, Massachusetts

Perinatal health disparities disproportionately impact immigrant populations. Recent federal policy changes in the United States increase health risks for Haitian immigrants in the United States. Group prenatal care improves outcomes among vulnerable groups. Perinatal health professionals at a Boston health center adapted the CenteringPregnancy^© model to meet the perinatal needs of Haitian immigrants. This article describes the process of adapting CenteringPregnancy^© for Haitian immigrant populations.

This quality improvement project used the Model for Improvement framework to guide adaptation of the CenteringPregnancy^© model. A non-exhaustive literature review of the CenteringPregnancy^© model and thematic analysis of stakeholder interviews with perinatal care team members at the health center (n = 7) and midwives from partner sites (n = 3) informed the adaptation process. Interviews aimed to better understand adverse social determinants of health, the importance of mental health, and the challenges patients face navigating the paradigms of the Haitian and American health care systems. The Salutogenic Framework was used to identify best practices for effective group care that improve comprehensibility, manageability, and meaningfulness for Haitian immigrants.

Five adaptations to the CenteringPregnancy^© model emerged from stakeholder interviews: (1) prioritizing mental health, (2) integrating immigration expertise, (3) addressing differing medical paradigms between Haiti and the United States, (4) building early bridges to pediatric care, and (5) reducing social isolation. Educational materials were also developed in Haitian Creole.

Factors for successful implementation included institutional buy-in, integration of a perinatal care coordinator, adjunct routine obstetric care for high-risk pregnancies, scalable electronic medical record systems, and ongoing care coordination across the care team.

"Ekip Manman," the adapted group care model, advances maternal health equity for Haitian immigrants in Boston. This adaptation can inform culturally tailored perinatal programs for other immigrant communities in Boston and beyond-and can contribute to perinatal health equity efforts throughout the United States.