PDF: Report August 2010
During her second pregnancy, Hermelinda Vicente didn't see a doctor until about three months before she was due to deliver, in part because she didn't realize the importance of prenatal care.
"I went to the doctor from the start when I was expecting my first daughter, and my friends would tell me what was the point, that they had never been and everything was fine," the Guatemala native said in Spanish.
Now that she's expecting her third child, she said she's taking better care of herself thanks to the Promotores de Salud program of La Paz Chattanooga.
Over the last two years the Promotores de Salud, or community health workers, have served 145 pregnant Hispanics, surpassing the two-year goal of 125. The goal for the three-year program is 225 pregnant Hispanics.
Promotores de Salud, funded with a grant for $207,000 from Tennessee's Bureau of TennCare, helps Hispanic women deliver healthier babies.
The program refers women to area doctors and offers classes about subjects ranging from prenatal care to how to install a baby's car seat.
Most women who participate in the program are from Guatemala, low income and have little to no education, according to the evaluation.
PROMOTORES DE SALUDTwo-year evaluation:* The program has served 145 pregnant Hispanic women, surpassing the second-year's goal of 125.* 229 participated in prenatal and preconception health education classes.* 90 women delivered their babies; two were low birth-weight births.* More than three-quarters, or 111, are from Guatemala.* Most are low income, with three-fourths earning less than $10,000 annually.* Close to 94 percent had only some schooling or no education at all.Source: Evaluation Report: La Paz de Dios Promotores de Salud Program/Hamilton County Infant Mortality Reduction InitiativeHISPANIC BIRTH OUTCOMES2000-03 vs. 2004-07* Total births increased from 868 to 1,592.* The infant mortality rate fell from 10.4 per 1,000 to 9.4 per 1,000.* Low birth-weight births fell from 11.2 percent to 8.4 percent.Source: Tennessee Department of Health
Next to blacks, Hispanic women have the highest infant mortality rate - 9.4 deaths per 1,000 births - and the highest increase of births in the 2000-03 and 2004-07 periods.
"What we've found is that usually the women never took prenatal vitamins and a lot were not informed on the dietary restrictions, like to limit caffeine," said Stacy Johnson, program director at La Paz.
So far, 90 women who participated in the program have given birth and only two babies were low birth weight, but all were carried to full term, she said.
The program saves about $600,000 in health care costs, according to Ed Canler, chairman of the Promotores de Salud Committee.
Babies born too small can require time in a neonatal intensive care unit at a cost ranging from $1,000 to $2,500 per day, and the median cost to deliver a low birth-weight baby is almost $50,000, according to the Tennessee Department of Health.
Eunice Mendoza, one of two promotoras, said one problem she's discovered has been the lack of information.
"We try to focus a lot on education," she said. "And what we've seen is that they eventually start helping each other and that's our goal, for them to give back to the community."
There's evidence that shows peer counseling and education is an effective way to change behaviors regardless of the community, said Tammy Burke, director of clinical services for the Chattanooga-Hamilton County Health Department.
"It all boils down to a trust issue, particularly with people who have not acclimated to the U.S. medical culture," she said.
Vicente said the group classes are what she enjoys most.
"You get to hear what others have to say or what type of questions they have," she said after a car seat safety class Monday. "You form friendships and feel more comfortable talking with others."
Contact Perla Trevizo at ptrevizo@timesfreepress.com or 423-757-6578. Follow her on Twitter at twitter.com/Perla_Trevizo.