To describe the development of a collaborative partnership to improve birth outcomes in Harris County, Texas.


State and city-level maternal and infant health data were re-analyzed and presented to stakeholders at the zip-code level to generate a renewed response to health issues in these populations, particularly infant mortality. Public and private sector stakeholders convened to form the Impacting Maternal and Prenatal Care Together (IMPACT) Collaborative, identifying four priority areas that required collaborative action.


Priority area action groups are currently working on strategies to improve maternal and infant health outcomes. Collaborative strategies include: raising patient and provider awareness, campaign partnerships, advocating for legislative change, and implementing community based programs. As a collaborative, IMPACT received funding to implement an evidence-based health education intervention for women at risk of having poor birth outcomes.


Through the leveraging of resources, expertise, and leadership, collaborative partnerships are capable of formulating innovative ideas, developing sustainable solutions, and generating change at multiple levels.

Key Take Away Points

  • Collaboration is necessary for the improvement of public health issues and allows for the development of recommendations to improve access to care, reduce health disparities, support health policies, and advocate for vulnerable populations.

  • Geographic information systems (GIS) mapping of data at the community level can be used to gain attention and inspire individuals and organizations to take action to overcome community-level health issues such as adverse birth outcomes.

  • Collaboratives with strong organizational structure, a clear mission, and an action-oriented approach can attract a variety of stakeholders that are willing to compile resources and be active participants to improve the health of a community.

Author Biography

Jamie Freeny, MPH is a Senior Health Educator and Special Projects Coordinator in the Community Outreach Services Department of the Harris Health System. She coordinates the Faith-Based Health & Wellness Ministries Network and the Women With IMPACT Program, a program under the IMPACT (Impacting Maternal and Prenatal Care Together) Collaborative of Greater Houston. She serves as the Parliamentarian for the African American Health Coalition and is an appointed member of the National Children’s Study Regional Community Engagement Advisory Committee.

Angie Cummings, DrPH, MSPH, MEd is an Adjunct Assistant Professor in the Division of Management, Policy, and Community Health at The University of Texas School of Public Health. She is also a Research Specialist for the Texas Health and Human Services Commission.

Margo Hilliard Alford, MD, MPH, is the Senior Vice President of Community Health & Wellness for the Harris Health System. Dr. Hilliard Alford previously served as the Director of ambulatory clinics for the City of Houston’s Department of Health and Human Services, administrator of Jefferson Davis Hospital and after it closed, the Lyndon B. Johnson General Hospital, where she served for 17 years. More recently, Dr. Hilliard Alford was instrumental in creating the IMPACT Collaborative for the purpose of improving birth outcomes in Harris County.

June Hanke RN, MSN, MPH is a Strategic Analyst and Planner and provides GIS analysis and mapping for the Harris Health System Community Health and Wellness Department. Her MSN was perinatal nurse practitioner and MPH focused on international maternal health and health policy. Recently, Ms Hanke worked to have legislation passed to have a maternal mortality morbidity review taskforce in place in Texas.

Linda Lloyd, PhD, MSW, MBA is the Associate Dean for Public Health Practice and Associate Professor of Community Health in the Division of Management, Policy, and Community Health at The University of Texas School of Public Health (UTSPH). She chairs the UTSPH Practice Council, serves as the principal investigator for the Texas Public Health Training Center, the director of the Center for Emergency Preparedness at UTSPH, and oversees the practicum program for MPH and DrPH students.

Deborah Boswell is the Director of Community Outreach Services at the Harris Health System. Ms. Boswell is positioned to implement evidence based health promotion interventions in the community to reduce health disparities and increase access to healthcare. Ms. Boswell has held her current position since 1999.