This year’s Black Maternal Mental Health Week carries the theme “Rooted in Legacy: Honoring Our Stories, Healing and Thriving Together for Generational Impact.” It is a call to celebrate the organizations, practitioners, and community leaders who have long supported Black mothers through pregnancy and postpartum, often filling gaps left by formal systems of care. 

These organizations know something that the maternal mental health field increasingly recognizes: healing happens in relationships. It happens through trusted peers, culturally rooted practices, community networks, doulas, faith leaders, support groups, and organizations that understand and adapt their support to the lived experiences of the communities they serve.^1,2 

Yet many of these community-rooted models face a paradox. The very qualities that make them trusted and responsive—local adaptation, cultural tailoring, and deep community relationships—can make them difficult to evaluate using the evidentiary standards that often determine funding decisions. As a result, some of the promising approaches to supporting Black maternal mental health struggle to access the philanthropic and public funding needed to grow and sustain their impact. 

As a field, we should ask whether current definitions of evidence are helping us identify what works or unintentionally limiting whose work counts. 

When “evidence-based” becomes a barrier 

Across philanthropy and government, there is understandable interest in funding evidence-based interventions. Rigorous evaluation helps ensure resources are directed toward programs that improve outcomes, and randomized controlled trials (RCTs) remain an indispensable tool for establishing causal impact. Many state Medicaid programs, including new federal maternal health models, condition reimbursement for services like doula and community health worker support on evidence-based status. 

But RCTs are not the only way to generate meaningful evidence, and they are not equally accessible to every organization. Community-based organizations (CBOs) often operate with limited evaluation budgets, lean staffing, and data systems designed primarily for service delivery rather than research. Conducting a large-scale experimental evaluation may simply be out of reach. Even when funding for evaluation is available, the time, technical expertise, and infrastructure required can be prohibitive.  

A second challenge, which is especially relevant in maternal mental health, is that community-rooted programs are intentionally designed to adapt: their approaches evolve in response to local culture, community priorities, participant feedback, and changing needs, and this flexibility is often central to their success. Traditional efficacy studies, however, are typically designed around implementation fidelity: if a program demonstrated impact under a particular set of conditions, future implementation should closely resemble the evaluated model. But for community-rooted approaches, their strength often lies in maintaining core principles while allowing communities to shape the delivery. This creates an uncomfortable tension: the very adaptations that build trust and relevance may make a program less amenable to traditional evaluation and less likely to be recognized as “evidence-based” under conventional funding criteria. 

What’s more, the tools used to measure maternal mental health outcomes carry their own limitations. Many standard screening instruments—including the Edinburgh Postnatal Depression Scale—were developed and validated primarily among non-Hispanic white women, yet the symptoms they prioritize and the language they use may not fully reflect how Black and Hispanic birthing people experience or describe maternal mental health challenges. Promising efforts are beginning to address these gaps. At the Policy Center for Maternal Mental Health’s 2026 Forum (MMH Forum), researchers from Virginia Commonwealth University highlighted the EPDS-US, an adaptation of the Edinburgh scale that uses clearer, more accessible language and reframes screening as the start of a person-centered conversation rather than a checklist. Other researchers are expanding what is measured altogether. For example, the recently validated Prepartum Form for Evaluating Race-Related Psychological Stressors (PP-FERRPS) captures race-related stressors experienced by Black pregnant women that traditional depression screening tools may miss.  

Why this matters for Black maternal mental health 

This conversation has particular urgency for Black maternal mental health. Black mothers continue to face significant disparities in maternal health outcomes while also navigating longstanding inequities in access to culturally responsive mental health care. Compared with white women, Black women are about twice as likely to experience maternal mental health conditions, and about half as likely to receive treatment³. Experiences of racism, stigma, bias, and historical mistrust of healthcare institutions influence whether women seek care, remain engaged, and feel supported throughout pregnancy and postpartum. 

Community-rooted organizations are often uniquely positioned to bridge these gaps. Because they are embedded within the communities they serve, they build trust over time and provide support that extends beyond clinical care to include social connection, advocacy, care navigation, and holistic well-being. At the MMH Forum, several organizations illustrated this approach in practice. The Perinatal Health Equity Initiative described how years of community partnership have enabled programs like Sisters Who Breastfeed to foster lasting peer networks among Black mothers, while its Mamas in Bloom program pairs nurse oversight with community health workers who help families navigate systems where they are too often unheard. Our Roots, a California-based peer coaching organization, similarly emphasized that healing extends beyond symptom reduction, combining peer support with navigation, advocacy, and community connection. These models demonstrate that if we want better maternal mental health outcomes, we must invest not only in clinical services, but also in the community infrastructure that makes those services accessible, trusted, and effective. 

While many community-based organizations have compelling stories, strong community relationships, and years of practice-based learning, what they often lack is the type of evidence that funding systems are designed to reward. If our evidence standards systematically privilege organizations with research infrastructure over organizations with deep community trust, we risk overlooking innovations that could strengthen maternal mental health ecosystems, particularly for populations who have historically been underserved. 

A role for catalytic philanthropy 

This is where philanthropy has an opportunity to lead. Rather than asking community organizations to fit into existing evidence frameworks, funders can help evolve those frameworks to better match the realities of community-based, culturally-relevant innovation. 

That could mean investing in evaluation capacity alongside program delivery. It could mean supporting developmental or participatory evaluation approaches that generate actionable learning while respecting local adaptation. And it could mean recognizing that causal attribution is not the only standard of rigor: theory-based evaluation and contribution analysis can test whether and how a program contributed to change even without a control group, while process evaluations, implementation science, qualitative outcomes, community-defined measures of success, practice-based evidence, and evidence syntheses round out a fuller picture of what’s working, for whom, and why. Washington, D.C.’s Mamatoto Village offers one example: an evaluation of its Mothers Rising home visiting program found improved birth outcomes among Medicaid-eligible Black mothers, evidence that helped inform the District’s 2024 legislation extending insurance reimbursement for home visiting services.  

Perhaps most importantly, philanthropy can create space for organizations to learn and improve without requiring every promising model to first clear the same evidentiary hurdle. Funder collaboratives are also moving in this direction: the Maternal Mental Health Equity Fund, a collaborative of thirteen national, regional, and state funders, invests directly in community-rooted organizations serving Black and brown communities, including several of the examples above, and pairs that support with funding to build data and evaluation capacity. 

This is not an argument against rigor. It is an argument for a more fit-for-purpose evidence ecosystem. Different decisions require different kinds of evidence. A national policy recommendation may warrant one level of proof, while a decision about whether to expand a promising community-based model may call for another. Building an evidence ecosystem that values both scientific rigor and community relevance will require expanding our standards. 

An invitation to think and measure differently  

We do not believe there is a single answer. Instead, there is an opportunity for the maternal mental health field to ask new questions together. 

What would a more inclusive evidence ecosystem look like? How might funding practices better recognize community-rooted innovation while maintaining accountability for outcomes? What can maternal mental health learn from adjacent fields, such as substance use and behavioral health, that have embraced practice-based evidence, participatory research, or adaptive evaluation models? And how can philanthropy help create pathways for community organizations to demonstrate impact without asking them to become research institutions? 

During Black Maternal Mental Health Week, we are reminded that lasting change depends not only on developing new interventions, but also on recognizing and investing in the wisdom and leadership that already exist within communities. If we want to improve maternal mental health outcomes for Black families, we should ensure that our definitions of evidence are broad enough to recognize the approaches communities already know are worth trusting.

The post Supporting Community-Rooted Solutions in Black Maternal Mental Health appeared first on Camber Collective.

2024 saw a growth in innovation to improve the health of women, highlighting the potential for transformative change — but the path to lasting impact will require sustained collaboration, increased funding, and unwavering commitment to center women’s voices in every decision

Read the Full Report

In early 2023, the Gates Foundation and the National Institutes of Health’s Office of Research on Women’s Health partnered with Camber Collective to establish the Innovation Equity Forum (IEF)—a global coalition of women’s health experts, innovators, and advocates. The IEF was launched to identify and prioritize critical opportunities to advance women’s health innovation worldwide. Its flagship initiative, the Women’s Health Innovation Opportunity Map, serves as a strategic blueprint to accelerate innovations that reduce women’s morbidity and mortality. 

A year after the Opportunity Map’s launch, Camber was re-engaged to produce a progress report tracking advancements in women’s health innovation over the past year. The report aims to promote accountability, assess how effectively partners are targeting under-resourced and high-priority areas, and provide insights to guide stakeholder decision-making within the context of the Opportunity Map. It focuses on three key areas: the broader women’s health research and development (R&D) ecosystem, Opportunity Map topics, and organizational success stories. 

Over the past year, women’s health innovation has gained momentum, fueled by increased advocacy, new partnerships, and growing funding commitments. Substantial progress has been made in six of the 50 high-impact opportunities identified in the 2023 Opportunity Map: Innovation hubs expanded in both HICs and LMICs to accelerate solutions to improve women’s health. Burden of disease and cost estimates improved through sex- and gender-intentional data practices, alongside ROI data that bolstered the case for investment. Breakthroughs in vaccines, diagnostics, and preventive measures addressed several communicable diseases, including STIs, RSV, and GBS, and the inclusion of pregnant and lactating individuals in tuberculosis clinical trials marked a pivotal step toward equity in research. Progress in female-specific conditions included new drug approvals for uterine fibroids and PCOS, while advancements in maternal health research delivered tools to improve outcomes for mothers and infants. In non-communicable diseases, a deeper understanding of sex- and gender-specific differences in cardiometabolic conditions has paved the way for more precise prevention, diagnosis, and treatment strategies.

More modest progress was made across 33 additional opportunities, reflecting important but incremental advancements in women’s health innovation. Medical institutions in some regions began incorporating gender considerations into training curricula. Advances in sex- and gender-intentional research gained traction in some regions, and regulatory actors increased their application of sex- and gender-intentional policies and frameworks. Encouraging developments also emerged in vaginal microbiome research, contraceptive technology, fertility optimization, menopause, autoimmune diseases, neurological disorders, and mental health. The remaining 11 opportunities stalled or experienced setbacks.

These advancements underscore the bold vision of the IEF’s 250+ members, but persistent barriers in the systems enabling innovation continue to hold back more significant progress in improving women’s health. Notably, a lack of accountability for the systematic collection, analysis, and reporting of sex- and gender-specific data limits understanding of the true burden of women’s health issues and the impact of interventions, impeding evidence-based decision-making. Gaps in ecosystem indicators prevent visibility into the breadth of the women’s health R&D pipeline, particularly for conditions beyond sexual and reproductive health. Pathways to market remain a critical obstacle, particularly in LMICs, where barriers to accessing innovations are most pronounced. Compounding these challenges are deep-rooted societal and structural inequities that have historically limited women’s participation and advancement in R&D careers. These inequities contribute to the ongoing attrition of women from the research field, stalling progress toward a more inclusive and representative research ecosystem. Finally, while promising funding commitments and partnerships have emerged, efforts remain fragmented.

To accelerate progress for women’s health innovation across conditions, the report highlights four immediate action areas: 

• Close epidemiological and accountability data gaps, including data on social and structural determinants and conditions beyond sexual and reproductive health to ensure innovations better address the diverse health needs of all women [Opp. 1.2, 1.3, 5.2]. 
• Create new market pathways and de-risk investment for women’s health innovation [Opp. 3.5, 4.3, 4.5]. 
• Enhance the participation and funding of diverse populations across the R&D continuum to ensure that women’s needs and voices guide national and global research agendas [Opp. 5.1, 5.4, 6.3]. 
• Activate the IEF as an action and accountability engine to translate opportunity areas to action and accelerate harmonized advocacy that unlocks new partnerships for women’s health innovation [Opp. 4.5, 10]. 

By centering equity in innovation, the global women’s health R&D ecosystem can drive meaningful progress toward a healthier, more equitable future for all women. 

The term “women” in the context of “women’s health,” is inclusive of both sex as a biological variable and gender as a social variable across the life course. This definition includes people assigned female at birth, transgender women and men, and non-binary people affected by the topics covered by the Opportunity Map. We recognize that not all people who identify as women have the same reproductive anatomy, and not all people assigned female at birth identify as women. 

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