Year One Lessons from Community-Led Approaches

In Fresno County, Black, Latino, and Indigenous families face some of the most persistent maternal and child health disparities in California. Community-based organizations can help fill those gaps by offering care that is culturally grounded, trusted, and responsive. In 2024, the David and Lucile Packard Foundation’s Children and Families Initiative invested in six community-based organizations working on innovative approaches to maternal and child health, including prenatal group care, doulas, workforce development, family support, and culturally grounded health information.

Engage R+D served as the evaluation and learning partner to this initiative, conducting a developmental evaluation designed to support real-time learning across a diverse portfolio of approaches. In the first year, our work included logic modeling support, lean data collection, primary data collection with participants, and facilitation of cross-grantee learning sessions. This report shares early insights on what promising community-centered approaches are taking shape, what implementation looks like in practice, and what the first year reveals for funders and systems leaders interested in advancing birth equity.