The Problem. Health problems in newborns—jaundice, sepsis and heart defects—do not show up until 72 hours after birth. Babies of poor, developmentally disabled, teen, drug-addicted or disadvantaged mothers often do not get the basic care they need at home to begin life, and they sometimes die needlessly from such problems. A visit by a nurse at home could detect medical problems and teach new mothers needed skills—only these mothers are uninsured and Medicaid does not cover such preventive services.
Grantee Background. Sharon Rohrbach grew up poor. "I would go to bed to get warm," she remembers. "Snow came in under the door. I shared one room with my parents and a space heater."
Part of a large extended St. Louis family descended from a Cherokee grandmother and an Irish grandfather, she was the first of their 41 grandchildren to graduate from high school.
As a teen volunteer, Rohrbach recalls one Christmas she delivered food baskets to the needy. She was shocked when she encountered a woman helping her pregnant teenage daughter count contractions: “It sort of planted a seed,” she says.
After marrying, working as a medical secretary and starting her own medical transcription company, at age 29, with three small children, nursing became her calling. She completed a two-year nursing program in seven years and became a critical care nurse for newborns, a job she held for 16 years.
Rohrbach started noticing she was being called down to the emergency room more often. "They didn't have the right size IVs or blood pressure cuffs to take care of new babies," she explains, “and I started to see babies dying in the emergency room."
The babies were 2 to 10 days old; born healthy and sent home from the hospital because health insurance companies had cut the length of hospital coverage to one day from three.
As a nurse, says Rohrbach, “it's a very disturbing thing to watch a new mother holding a dying newborn, and knowing that if you had been in that home, you could have identified the symptoms earlier and this baby would not be dying.”
Results. That vision was the genesis of Nurses for Newborns, which Rohrbach founded in 1989 as a for-profit service to send nurses into homes of middle-class new mothers to examine their babies and make sure no problems were developing. She hired nurses on a contingency basis and waited for the phone to ring. It did not.
After taking a community college course for women entrepreneurs, Rohrbach wrote a business plan that won an award from the National Association of Women Business Owners. The media attention that followed enabled her to get a grant to fund her work. Then in 1992, she started the Nurses for Newborns Foundation. By 1999, Nurses for Newborns was serving St. Louis and 24 surrounding counties, with more than 7,000 nurse visits to the homes of almost 1,200 clients. Others across the nation were using her business plan to form similar organizations to address the problem of needless newborn deaths.
In 2000, Rohrbach received a Robert Wood Johnson Foundation Community Health Leader award. After a St. Louis Post-Dispatch feature article about her award, Rohrbach appeared on Oprah Winfrey's television show, and Nurses for Newborns received $100,000 as a member of Oprah's Angels Network.
The leadership program's annual retreats provided an opportunity for Rohrbach to mingle with other grassroots health leaders. She also visited the programs of two other recipients. From Rev. Micheal Elliott, president of Union Mission in Savannah, Ga., she acquired improved community advocacy skills and learned how to work better with her board. From Martha Ryan, executive director of the Homeless Prenatal Program in San Francisco, she learned how to hire formerly homeless prenatal clients.
“I've since been able to get over a million dollars in [federal] Healthy Start funding over four years,” Rohrbach reports, “and hired three of our own patients who've never had a job before to be community outreach mothers, to go along with our nursing staff.”
Most recently, Rohrbach received a 2007 Purpose Prize from Civic Ventures. The $100,000 award honors people over age 60 who are taking on society's biggest challenges. Her organization's nursing visits now bring health care and education, as well as formula, diapers and clothing, to mostly single mothers in 29 Missouri counties and 30 counties in Tennessee.
RWJF Perspective. The Robert Wood Johnson Foundation Community Health Leader was initiated by RWJF in 1991 to recognize the extraordinary contributions of community leaders who are instrumental in improving the health and health care of in their local communities. The program honors unsung and inspirational individuals who work with the most disenfranchised populations. The formal recognition by the Foundation often launches these leaders and their programs to greater levels of influence and extends their reach to serve more vulnerable populations.
RWJF provides a financial award to the individual and their organization as well as critical guidance in strategic planning, board development, marketing and communications. Equally important, RWJF connects the community health leaders with one another to enable programs to build upon the wisdom and experience of previous leaders.
"Against all odds, our community health leaders continue to remind us of the difference that one person can make and we are exceedingly proud of their endeavors," says Judith Stavisky, MPH, MEd, RWJF senior program officer.