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Author ORCID Identifier

https://orcid.org/0009-0001-4759-0859

Date Available

4-23-2028

Year of Publication

2026

Document Type

Graduate Capstone Project

Degree Name

Master of Public Health (M.P.H.)

College

Public Health

Department/School/Program

Public Health

Faculty

Paula Arnett, DrPH, MBA

Committee Member

Keith Knapp, PhD, MHA, HSE, CNHA, FACHCA

Faculty

Min-Woong Sohn, PhD

Abstract

Kentucky has poor maternal and infant health outcomes, especially rural Kentucky. Nearly half of Kentucky counties are classified as maternity care deserts. Pendleton County is one such county with zero obstetric providers and facilities providing obstetrics care. Pregnant individuals must travel an average of over 20 miles for essential care. This travel burden can lead to delays in care, which can increase the risk of preventable maternal morbidity and mortality and adverse infant outcomes. To address these disparities, this capstone proposes the implementation of a Certified Nurse Midwife–led mobile obstetrics and gynecology clinic designed to complement Kentucky’s Rural Health Transformation Plan expanded timely perinatal telehealth initiatives.

The proposed Mobile Clinic would deliver guideline‑based prenatal and postpartum services directly within Pendleton County, reducing transportation burdens and improving timely access to care. Services include prenatal exams, laboratory testing, ultrasounds, postpartum visits, depression screening, breastfeeding support, contraception counseling, and referrals. The program relies on strategic partnerships within the community including Three Rivers District Health Department-Pendleton County, St. Elizabeth Healthcare, and the Pendleton County Extension Office. The University of Kentucky College of Public Health will provide evaluation and data advice to ensure community engagement and robust evaluation.

Short‑term outcomes focus on improving access and reducing missed appointments; medium‑term outcomes include increasing early prenatal care initiation from 73.9% to 78% within one year, enhancing continuity of care, and reducing pregnancy complications. Long‑term outcomes aim to reduce maternal and infant morbidity and mortality, strengthen health equity in rural communities, and establish a scalable model for other maternity care deserts. Although mobile clinics require substantial start‑up investment, diversified funding through grants, philanthropic support, and insurance reimbursement can support long‑term sustainability.

The Certified Nurse Midwife-led mobile clinic represents an evidence‑informed, community‑centered intervention with strong potential to improve maternal and infant health outcomes in Pendleton County and serve as a replicable model for rural regions across Kentucky.

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Available for download on Sunday, April 23, 2028

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