Comienzo Saludable Puerto Rico: A Community-Based Network of Care to Improve Maternal, Newborn, and Child Health Outcomes

Edna Acosta-Pérez (), Cristina Díaz, Atisha Gómez-Reyes, Samaris Vega, Carlamarie Noboa Ramos, Rosario Justinianes-Pérez, Glamarie Ferran, Jessica Carnivali-García, Fabiola J. Grau, Lili M. Sardiñas, Maribel Campos and Marizaida Sánchez Cesareo
Additional contact information
Edna Acosta-Pérez: Grupo Nexos, Inc., Guaynabo 00966-2715, Puerto Rico
Cristina Díaz: Urban Strategies, LLC, Arlington, VA 22209, USA
Atisha Gómez-Reyes: Grupo Nexos, Inc., Guaynabo 00966-2715, Puerto Rico
Samaris Vega: Grupo Nexos, Inc., Guaynabo 00966-2715, Puerto Rico
Carlamarie Noboa Ramos: Grupo Nexos, Inc., Guaynabo 00966-2715, Puerto Rico
Rosario Justinianes-Pérez: Grupo Nexos, Inc., Guaynabo 00966-2715, Puerto Rico
Glamarie Ferran: Urban Strategies, LLC, Arlington, VA 22209, USA
Jessica Carnivali-García: Grupo Nexos, Inc., Guaynabo 00966-2715, Puerto Rico
Fabiola J. Grau: Grupo Nexos, Inc., Guaynabo 00966-2715, Puerto Rico
Lili M. Sardiñas: Grupo Nexos, Inc., Guaynabo 00966-2715, Puerto Rico
Maribel Campos: Emerge PBC, Guaynabo 00966-2715, Puerto Rico
Marizaida Sánchez Cesareo: Grupo Nexos, Inc., Guaynabo 00966-2715, Puerto Rico

IJERPH, 2025, vol. 22, issue 8, 1-20

Abstract: Background: Maternal and newborn health disparities remain a challenge in Puerto Rico, especially in underserved communities. Comienzo Saludable 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 Cuidado Compartido. Comienzo Saludable 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. Methods: This paper presents the Comienzo Saludable Puerto Rico program’s Cuidado Compartido 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. Results: 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. Conclusions: The Cuidado Compartido 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.

Keywords: maternal health; newborn/child health; networks of care; community-based care; Puerto Rico; health differences; integrated care; infant mortality (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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