Reaching Across the Divide: Integrating Equitable Community-Based Qualitative Methods and Trusted Engagement Strategies Into Arizona's Statewide Maternal and Child Community Assessment.

Abstract

Maternal mortality in the U.S. remains a pressing public health issue, with African American and Indigenous populations experiencing significantly higher rates. In Arizona, maternal mortality reached 30.0 deaths per 100,000 births in 2023, well above the national average. To address persistent maternal and child health (MCH) inequities, the Arizona Department of Health Services, in collaboration with a university and other strategic partners, conducted the 2025 Arizona Statewide Title V Maternal and Child Health Needs Assessment using community-engaged research (CeNR) approaches. Qualitative methods, including the River of Life (ROL) and Community Forums (CF), were employed to elevate diverse community voices, particularly from underserved rural, border, and minoritized populations. Key priorities identified included improving access to mental health care, addressing childcare shortages, expanding transportation and healthcare access, and strengthening culturally and linguistically appropriate services. The ROL approach revealed 8 social drivers of health, while CFs highlighted actionable solutions rooted in lived experience. Findings underscore the need for upstream policy investments and community-informed strategies to reduce maternal health disparities and improve statewide MCH outcomes. This participatory process demonstrates the value of engaging historically marginalized communities in shaping programs and policies that directly impact their health and well-being.