Acosta-Pérez Edna, Díaz Cristina, Gómez-Reyes Atisha, Vega Samaris, Noboa Ramos Carlamarie, Justinianes-Pérez Rosario, Ferran Glamarie, Carnivali-García Jessica, Grau Fabiola J, Sardiñas Lili M, Campos Maribel, Sánchez Cesareo Marizaida
Grupo Nexos, Inc., Guaynabo 00966-2715, Puerto Rico.
Urban Strategies, LLC, Arlington, VA 22209, USA.
Int J Environ Res Public Health. 2025 Jul 31;22(8):1204. doi: 10.3390/ijerph22081204.
Maternal and newborn health disparities remain a challenge in Puerto Rico, especially in underserved communities. Puerto Rico, sponsored by the U.S. Department of Health and Human Services' Healthy Start Initiative (HRSA), addresses these gaps through an integrated Networks of Care model known as Puerto Rico is a maternal, paternal, and child health program aimed at improving the health and well-being of pregnant women, mothers, fathers, newborns, and children in Puerto Rico, particularly those from disadvantaged communities.
This paper presents the Puerto Rico program's model to integrate a network of healthcare providers and services across hospitals, community organizations, and families. This model aims to improve maternal and newborn/child health outcomes by focusing on the importance of integrated, hospital-community-based care networks.
Participants experienced significant improvements in key birth outcomes: low birth weight prevalence declined by 27.2% compared to the community baseline, premature birth rates decreased by 30.9%, and infant mortality dropped by 75%, reaching 0% by 2021 and remaining there through 2023. These results were complemented by increases in maternal mental health screening, paternal involvement, and breastfeeding practices.
The model demonstrates a scalable, culturally responsive strategy to improve maternal, newborn, and child health outcomes. It offers critical insights for implementation in other high-need contexts.
孕产妇和新生儿健康差距在波多黎各仍然是一项挑战，尤其是在服务不足的社区。由美国卫生与公众服务部的健康开端倡议（卫生资源与服务管理局）资助的波多黎各通过一种名为“关爱网络”的综合模式来解决这些差距，该模式是一项旨在改善波多黎各孕妇、母亲、父亲、新生儿和儿童，特别是来自弱势社区的这些人群的健康和福祉的母婴及儿童健康项目。
本文介绍了波多黎各项目整合医院、社区组织和家庭的医疗服务提供者及服务网络的模式。该模式旨在通过关注基于医院 - 社区的综合护理网络的重要性来改善孕产妇和新生儿/儿童的健康结局。
参与者在关键出生结局方面有显著改善：与社区基线相比，低出生体重患病率下降了27.2%，早产率下降了30.9%，婴儿死亡率下降了75%，到2021年降至0%并在2023年一直保持这一水平。这些结果还伴随着孕产妇心理健康筛查、父亲参与度和母乳喂养率的提高。
该模式展示了一种可扩展的、具有文化适应性的策略，以改善孕产妇、新生儿和儿童的健康结局。它为在其他高需求环境中的实施提供了关键见解。
