New Report from The Century Foundation: How the Federal Government Can Make Funding Accessible to Maternal Health Community-Based Organizations

Monday, July 10, 2023

New Report from The Century Foundation: How the Federal Government Can Make Funding Accessible to Maternal Health Community-Based Organizations

Executive Summary
Community-based organizations (CBOs) are uniquely positioned to excel in providing maternal health care. Not only do they tailor their services and outreach to meet the needs of the communities in which they are located, but their providers and staff are part of those communities themselves. Women and birthing people need comprehensive, continuous, and culturally cognizant care throughout their pregnancy experiences, including through the prenatal period, birth, and postpartum; the disparate rates of maternal mortality alone indicate these needs are largely not being met for Black and Indigenous populations in particular.

Many of the holistic, patient-centered models of care used by CBOs have demonstrated the ability to meet these needs and improve outcomes for birthing people, particularly those that are Black and Indigenous. Compared to large health systems and hospitals, though, they are operating on incredibly limited budgets. Maternal health CBOs must be better funded to continue their work, scale up programs, and improve outcomes in their communities. One of the most equitable, effective, and efficient ways for the federal government to address maternal health disparities is to ensure that CBOs have the resources they need to do their work to best advantage.

To illuminate the ways in which CBOs’ fine-tuned, demographic-specific services are administered, the potential impact of federal funding, and barriers to receiving those funds, TCF has conducted interviews with maternal health care CBOs. These in-depth, semi-structured interviews allowed CBOs to describe how their organizations improve maternal health equity and what they need from the federal government to continue and expand upon this work. Interviewees included staff and leaders from the six maternal health CBOs participating in an ongoing project with TCF. Interview findings revealed a number of barriers to applying for federal funding, including tangible obstacles such as the length of applications and turnaround time, as well as perceptions of the inaccessibility of federal funding that discouraged CBOs from applying. Interviewees offered a number of ideas for how the funding process could be made less burdensome and more worthwhile for CBOs, including more streamlined processes, unrestricted funding, and increased transparency.

Although CBOs are eligible applicants for many federal grant opportunities, these grants are often inaccessible given the burden of the application processes. See the recommendations offered in the following section to learn how federal agencies and other funders can set CBOs up for success in grant opportunities so that these organizations can do their best work for their communities, scale up their programs, and expand their reach.

This report offers four recommendations on how to ensure that CBOs have accessible, sufficient, and equitable funding options. Although the focus of our study has been on the funding process for federal grants, these recommendations can and should be implemented by other funders, including state and municipal governments and private foundations.

1. Streamline and simplify application processes, and provide adequate turnaround time from grant announcement to application close.

Time and time again, our CBO partners named the structure and length of the applications themselves as a major barrier to even beginning the process of pursuing federal funding. While it is heartening to see opportunities that name CBOs as eligible recipients, this is only a meaningful distinction if applications are manageable for grassroots organizations, especially those operating on limited budgets with few staff. Applications should be made shorter (both the notices of funding opportunities themselves and the required applicant materials), use straightforward language, and provide more time between grant forecasting or announcement and the closing date for applications.

2. Offer technical assistance tailored to the needs of community-based organizations, including by providing one-on-one sessions.

Federal agencies currently offer technical assistance (TA) to applicants in the form of webinars and written materials, as well as making individual contacts available for outreach. However, needs in this vein continue to go unmet, and CBOs expressed a desire for more training that is tailored to the specific needs of community-based organizations. This assistance should include troubleshooting and guidance for navigating online application platforms, which posed issues for several CBOs in our interviews. In addition to assistance with the application process, CBOs described a need for ongoing support throughout the grant management process; this would include assistance to ensure awareness of and compliance with federal regulations and requirements. CBO leaders also expressed interest in continued communication after unsuccessful grant applications about how to improve in future funding cycles...

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