Healthy Start Initiative – Enhanced

HRSA launched the Healthy Start Initiative – Enhanced (HSE) in 2023 to improve health outcomes before, during, and after pregnancy and reduce the well-documented racial/ethnic differences in rates of infant death and adverse perinatal outcomes. HSE supports projects in diverse communities and populations (e.g., rural, urban, non-Hispanic Black, American Indian/Alaskan Native [AI/AN]) experiencing the greatest disparities in maternal and infant health outcomes. There are currently 10 HSE grantees.

HSE has two focus areas: 1) providing direct and enabling services (e.g., screening and referrals, case management and care coordination, health and parenting education, and linkage to clinical care to enrolled HSE participants; and 2) convening Community Consortia comprised of diverse multi-sector partners that advise and inform HSE activities and develop and implement plans to improve perinatal outcomes within the selected project area. HSE has an increased emphasis on addressing social determinants of health in order to improve disparities in maternal and infant health outcomes. The program also provides recipients with increased flexibility to customize interventions to meet the unique needs of their target population.

The goals of HSE are to: 1) Continue reducing infant mortality rates (IMR) in the U.S., and 2) Decrease disparities in infant mortality (IM) across racial/ethnic groups by achieving steeper declines for groups with the highest infant mortality rates (e.g., non-Hispanic Black and AI/AN infants). HSE projects are implemented in communities experiencing high rates of maternal and infant mortality and morbidity that do not already have access to Healthy Start services.