Many families across Arizona continue to struggle to access adequate support after childbirth. Significant gaps remain in postpartum and maternal mental health services during a period that is crucial for the well-being of both parents and their infants.

To help bridge these gaps, the It Takes a Village initiative by 4th Trimester Arizona is working to expand access to care by training, certifying, and contracting additional community-based doulas. These professionals provide support throughout pregnancy, childbirth, and the postpartum period, helping bring essential services directly into local communities.

Backed by funding from the Blue Cross Blue Shield of Arizona Foundation's Thiru Family Trust Momentum Maker Grant, the program is strengthening Arizona's network of community-based maternal care providers while increasing access to postpartum support services. In 2025, 4th Trimester Arizona received a $100,000 grant aimed at helping doulas complete the training and certification processes required to serve families enrolled in AHCCCS, Arizona's Medicaid program.

So far, the initiative has achieved several milestones:

"The support we've received has enabled the It Takes a Village initiative to evolve from an idea into an operational program by creating the infrastructure community-based doulas need to serve AHCCCS members," said Dr. Jennie Bever, CEO of 4th Trimester Arizona. "The current healthcare system does not provide enough support for mothers. By helping doulas navigate reimbursement and credentialing pathways, we're making trusted, relationship-centered care more accessible."

The initiative arrives at a particularly important time for maternal health in Arizona:

Community-based doulas often act as trusted advocates and support partners throughout pregnancy, delivery, and the postpartum months. They help families understand available options, identify potential concerns, and access appropriate healthcare services.

"The strength of community-based doulas lies in the trust they build," Bever added. "Families are often more comfortable discussing concerns with someone who shares or understands their cultural background, language, life experiences, and community environment."

For doulas themselves, the program is creating more sustainable opportunities to provide care to underserved families.

"This incredible initiative has given me a sustainable pathway to continue my work as a community doula," said Brionna Giles, a certified doula and founder of Your Birth Story Birth Services. "I'm excited to extend that support and compassion to the families I serve."

AZ Blue continues to invest in maternal health initiatives across Arizona through its community outreach programs, philanthropic foundation, and Medicaid division, AZ Blue Health Choice.

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In the early 2000s, Dr. Shannon Hader was instrumental in the collaboration between the U.S. Centers for Disease Control and Prevention and the Zimbabwe Ministry of Health, which successfully provided HIV care to tens of thousands. After returning to the United States in 2006, she encountered a drastically different scenario in Washington, D.C., where the city was grappling with the highest HIV rates in the nation. Recognizing that the district was relying on an outdated response to the crisis, she emphasized the importance of using current data and began to implement some of the innovative strategies she had developed in Africa.
 
“For a long time, it has been easy to overlook the struggles faced by wealthy countries, assuming the issues are confined to less affluent nations,” she notes. “However, the truth is that every country must take further steps to help eradicate the HIV epidemic. As the epidemic and the tools to combat it evolve, our methods must also adapt.”
 
This perspective is at the heart of a recent report titled *Going the Extra Mile to End the HIV Epidemic*, co-authored by Shannon, Dr. Junko Tanuma from the National Center for Global Health and Medicine in Japan, and Mercy Shibemba, a health equity advocate for young people living with HIV in the UK. Commissioned and funded by Gilead, the report outlines a roadmap for countries striving to meet the United Nations' objective of eliminating HIV by 2030. It asserts that the necessary tools to end the epidemic exist, but greater action is required from nations.
 
“There’s really no reason why we can’t achieve it,” Mercy emphasizes. “Yet, with less than six years left until the UN’s target date, no country is on track to meet that goal, despite having the tools and resources available to reach zero new infections.”
 
To gauge progress, the authors analyzed programs in nine Western countries, drawing key insights from each nation's strategies and identifying areas for improvement. Despite significant advancements in scientific innovation, health system development, and access to care, millions still live with HIV worldwide.
 
The report calls for the implementation of national strategies centered on four main areas: broader prevention efforts, extensive screening for diagnosis, expansion of community-based care, and the utilization of tools to measure quality of life and success. It also addresses the social factors hindering progress, such as stigma, discrimination, and disparities in health equity and access to care.
 
Mercy’s personal journey exemplifies these challenges; she was born in 1998 with HIV, while her younger sister was not. “What set us apart was equity and access, which are crucial issues in ending the epidemic,” she explains. Growing up, Mercy feared rejection if others learned of her HIV status, a concern that she believes still prevents many from seeking the care they need.
 
Shannon concurs, stating, “HIV is fundamentally a social issue, so we must engage with individuals in their communities to help combat stigma and discrimination.”
 
Now serving as the Dean of International Service at American University in Washington, D.C., Shannon frequently urges global leaders to enhance efforts in HIV prevention, testing, and treatment within the next five years. She also looks to Gilead to continue developing groundbreaking therapies for those living with HIV and other diseases.
 
Both women envision what the epidemic might look like in 2030 and beyond, with Shannon expressing a hopeful sentiment: “My wish for you, Mercy, is that one day you’ll experience a world where the epidemic has ended and a cure exists.”