How Partnerships Between Organizations Can Transform a Community for the Better

A couple of years ago, in the heart of Spartanburg, South Carolina, a new mom was home with her 3-week-old baby, completely unaware that she was entering an acute medical crisis. The main symptom this mom noticed — we’ll call her Samantha — was that she was tired, which is more than expected after growing a new life and giving birth. But Samantha’s situation was much more concerning.

Spartanburg had just made a major investment in an initiative called Hello Family — focused on making sure every child born in the community has what they need to arrive at the schoolhouse door healthy, thriving, and ready to learn. One of the investments provides every mom with a home visit from a nurse in the weeks after giving birth.

When Samantha’s nurse arrived, she quickly noticed that Samantha was experiencing more medical distress than she realized. The nurse called an ambulance, which rushed her to the ER, and they quickly admitted her to the ICU. Thankfully, 24 hours later, she made a full recovery. Because of that new investment by the City of Spartanburg, the community had a brand-new baby who would get to grow up with her mom by her side.

That’s not the only win from the Hello Family Initiative: A recent independent evaluation showed substantial community-wide effects on every birth outcome evaluated, including NICU admissions, rates of healthy birthweights, and full-term births. Reducing low birthweight and preterm births is especially exciting because those two factors combine to represent the second strongest driver of infant mortality in the state of South Carolina. Seeing these effects across the whole community demonstrates the impact of this safety net of services for all young families, not only those directly involved in the program.

So why has Hello Family been so effective and what can other leaders learn from its model?

Crucially, Hello Family has been a partnership between many organizations and the Spartanburg community itself, which grew out of the need to address specific challenges for young families. As part of this partnership, a wide variety of supports are offered: community doulas, nurse home visiting, early learning quality boosts, parenting education support, and more.

To effectively evaluate community needs for systems-change projects like Hello Family, the key is to start with attentive listening. Engaging directly with the community allows for a deeper understanding of their priorities. Additionally, insights from service providers, who often have direct connections and knowledge of community needs, are invaluable. This doesn’t supplant community input but enhances it. Research plays a critical role as well, guiding us toward what works and away from well-intentioned solutions that may be ineffective or have negative consequences. Moreover, examining innovations from other communities tackling similar issues provides a rich source of learning and potential adaptation. This methodical approach aligns with common community practices like gap analyses and strategic planning.

How was this multi-faceted initiative able to make such a difference in this community? One tool supporting these types of results has been Hello Family’s innovative Pay for Success (PFS) financing — also called outcomes financing. As stated in our project overview, “A PFS project is a public-private partnership that drives better results for communities by aligning government spending with positive, measurable outcomes.” It changes how government typically conducts business by shifting away from contracts that largely reimburse costs or pay a fee for services delivered, to outcomes-based contracts where the government only pays as service providers achieve pre-defined outcomes in the community. The “outcome payments” earned by the project may be measured by an independent third party.

Of course, systems change work doesn’t require PFS funding — that is just a tool for helping overcome certain challenges. In our experience, though, a proactive and collaborative approach is much more fruitful than seeking out grants to fit a pre-existing plan. The Hello Family model was successful because it purposely aligned with the goals of multiple stakeholders. For instance, the support for young pregnant mothers through community doulas not only met the city’s objectives but also addressed the priorities of the state Health Department, Medicaid, local hospitals, family foundations, and insurers. By including these partners in the planning process, we could articulate the value of the initiative to their goals, leading to multifaceted support. This synergy allows for a more sustainable and resilient funding strategy.

At its heart, Hello Family is about changing systems. It challenges the status quo, emphasizing the importance of the relationships between partners in the support systems, rather than just the efficiency of individual components. This holistic approach has been crucial in achieving remarkable outcomes, from dramatically increasing healthy birthweight and reducing infant emergency room visits to increasing family protective factors and improving access to quality early learning.

So often, communities struggle to solve the big problems — not because of a lack of heart — but because the solutions are often hard to identify or to execute, leading to a feeling of hopelessness. What we see from Spartanburg’s effort, though, often makes me think of Red’s quote from Shawshank Redemption: “Geology is the study of pressure and time. That’s all it takes really, pressure, and time.” If you’re open to creative problem-solving (pressure), and working patiently with a broad set of partners (time), it’s possible to transform communities in dramatically positive ways for our youngest children.

As we share this story, we do so in the hope that other communities will find it as inspiring as we have. Please reach out if you’d like to learn more about Hello Family Spartanburg or about the Institute for Child Success. Finally, we want to recognize and thank the dozens of partners who made this work possible (there’s not enough room to list them all here, and we don’t have sufficient vocabulary to give any of them justice).