Local health departments (LHDs) have been on the front lines of the COVID-19 pandemic since the beginning, and throughout, they have remained a constant source of information and resources to keep communities safe and informed. LHDs have been pivotal in supporting the maternal and child health (MCH) populations as they navigated pregnancy and postpartum while in a pandemic.

NACCHO, in collaboration with the Center for Public Health Innovation at CI International (CPHI) and through funding from the Centers for Disease Control and Prevention (CDC) ‘s Division of Reproductive Health, conducted three focus groups with 28 MCH staff from LHDs across the nation to learn about their experiences supporting pregnant and postpartum people amid this global pandemic.

The goal of each focus group was to identify major lessons learned in mitigating the impact of COVID-19 on pregnant people, postpartum people, and children. The focused groups discussed a range of topics, including care services that LHD staff prioritized during the pandemic, how LHDs identified the priority needs of the MCH population during the pandemic, and a self-assessment on the quality of care their LHD provided MCH population during this time. Key themes identified through the focus groups include:

• Dedication to the community: Even when LHD staff were redeployed to the COVID-19 response, staff did everything they could to continue serving their MCH clients. Strategies identified to meet MCH client needs while also focusing on COVID work included working longer hours or nights, working with other agencies, and/or being innovative in their approaches to their MCH service delivery.
• New communication methods: In some LHDs, a breastfeeding program continued but was delivered using telehealth. Some noted that the program was difficult to administer. In contrast, others stated it was easier to encourage breastfeeding because the new parents were at home with their infants and did not have to overcome barriers like pumping at work, which can deter breastfeeding.

• Recognizing mental health concerns: The mental health needs specifically identified were substance use, child neglect, social isolation and postpartum depression, and depression in general.

There are many lessons from the LHDs’ response to COVID-19 that can be adapted for future public health threats and emergencies, including when public health programs lose funding or governmental agencies must make difficult decisions about program prioritization inclusive of population health and equity. While LHD staff identified their commitment to serving their MCH communities despite being deployed to the COVID-19 response, this commitment yielded longer work hours, increased physical and mental stress, and burnout. It is vital to support MCH providers in avoiding compassion fatigue and burnout, especially during a public health crisis.

The identified themes and lessons learned from the focus group discussions will inform NACCHO’s technical assistance and development of tools and resources to support LHDs in serving their MCH populations. Furthermore, the identified lessons learned here can inform a response to a pandemic or local public health crisis and any situation that calls for the reorganization of staff in a way that threatens MCH programming. Access the full report here.