“Imagining Ideal Solutions: Parents Share Their Vision for Family Support Systems”

In 2024, the Packard Foundation launched its Children and Families initiative, commissioning a comprehensive landscape assessment of maternal and child health systems in three California counties: Alameda, Fresno, and Monterey. The primary objective of this assessment was to scrutinize the structural organization and interconnectedness of publicly funded health and social services, as well as to pinpoint opportunities for enhancing the system of care designed for families with young children.

VIVA Social Impact Partners undertook this assessment, conducting interviews with key decision-makers such as Directors from Public Health and Social Services Departments, as well as representatives from Child Care Resource and Referral agencies across the three counties. These discussions illuminated the insights and recommendations of system leaders, who expressed a keen interest in delivering better services and improving maternal and child health outcomes. Suggestions included increasing training and development opportunities for staff and augmenting the capacities of community-based organizations—strategies that could lead to substantial progress in service delivery.

However, it became evident through the assessment that the most impactful solutions will be those that are developed with the families they aim to serve at the forefront. To gain a deeper understanding of the challenges families face when navigating these systems, the VIVA team sought to engage parents directly. They posed a salient question: “If you could wave a magic wand to change one thing to make this process easier or better for families like yours, what would it be?”

The assessment highlighted glaring disparities in access to maternal and child health services, particularly for Black, Indigenous, and Latino communities, which face extraordinary challenges. By centering their work on the experiences of these families, VIVA Social Impact Partners aims to drive comprehensive improvements in the health system that will ultimately benefit all families.

One poignant example from the assessment involved an Alameda County mother whose journey illustrates both the promise and pitfalls of navigating public health systems. After becoming pregnant at age 24, she experienced a mix of excitement and anxiety, particularly concerning her ability to afford medical care through her Medi-Cal coverage. While she found support through a home visiting program that provided ongoing check-ins, nutritional guidance, and valuable reassurance, her path to accessing services was fraught with obstacles.

The mother recounted struggles with the Medi-Cal enrollment process, including repeated unanswered phone calls and frustrating in-person visits. A significant setback occurred when her coverage was terminated for six months due to lost paperwork, resulting in missed prenatal appointments and unexpected out-of-pocket expenses. Only through persistence and the intervention of a manager was she able to restore her coverage.

Despite the eventual reliability of Medi-Cal and her home visiting program, the mother has faced ongoing challenges in accessing additional resources. Notably, an online application for child care assistance—submitted over a month prior to her conversation with VIVA—yielded no follow-up response, leaving her reliant on her mother-in-law for child care while she attempts to work and pursue an education.

The landscape assessment serves as a critical tool for understanding the systemic barriers faced by families in accessing essential services and highlights the urgent need for reform in maternal and child health systems in California. By leveraging insights from both system leaders and the families they serve, stakeholders can work collaboratively to build a more effective and inclusive network of care, thus addressing the pressing health disparities affecting vulnerable communities.