Esmeralda Navarro is a second-year student in our Maternal, Child, and Adolescent Health MPH program. Esmeralda is a Double Bear who earned her bachelor’s degree in Public Health. A proud first-generation Latina from Salinas, California, Esmeralda developed a passion for maternal and child health while studying the impact of pesticide use in agricultural communities. This interest has driven her focus on health policy and initiatives aimed at addressing environmental health disparities.
Provide an overview of your field work experience. What were the primary objectives, key responsibilities, and specific projects or initiatives you were involved in during your time there?
Throughout my experience with the County of Monterey Health Department, I supported efforts for the dissemination of their 2023-2024 Needs Assessment. I worked closely with the Epidemiologists to analyze survey and focus group discussion data about different domains to accurately report the advocated needs of the community from various stakeholders. Furthermore, I worked with various leaders within the department to learn more about the different programs within the county that support maternal, child, and adolescent health (MCAH). This included participating in team meetings, joining Public Health Nurses and Nutritionists on client visits, supporting community outreach events, and working directly under the supervision of the Director of Public Health Nursing.
This knowledge prepared me to successfully create a training presentation for the health department staff. This presentation showcased the similarities and differences of the programs that aimed to support and improve MCAH populations through home visiting programming. Some of the programs that were researched and highlighted throughout this presentation include the Enhanced Care Management - Birth Equity, MCAH Home Visiting Program, Nurse-Family Partnership, and the Nutrition Program.
Lastly, I contributed to the information sharing of a new client referral system by creating a summary page of the county’s public health home visiting programs which will be sent to healthcare providers who refer clients to the Health Department’s programs.
What are examples from your field work that enhanced your understanding of maternal, child, and adolescent health (MCAH)?
My understanding of maternal, child, and adolescent health (MCAH) was enhanced by my experience with analyzing the county’s 2023-2024 Title V Needs Assessment data. Survey and focus group discussion data for the Needs Assessment ranged from stakeholders’ perspectives on key focus areas to improve on within the county to barriers and challenges within the community and services making an impact. After going through the data collection and analyzing it, it was evident that stakeholders were advocating beyond providing services within a patient appointment. Data from the surveys and focus group discussions were centered around access to care in terms of transportation needs, a lack of healthcare providers, long waiting times to see a provider, and difficulty linking patients to services.
The Needs Assessment data collection and analysis highlighted an increasingly important point of view for understanding MCAH. There is a need to improve MCAH through access and addressing social determinants of health. Yes, services with providers continue to be important, however, traveling to appointments, receiving necessary referrals and screening, being able to see a provider that speaks a patient's preferred language, and seeing providers in a timely manner are also important. Treating and providing services for maternal, child, and adolescent populations that support long-term health improvements includes all that they are and all that they need - not simply treating the symptoms that they have. This is why the intersection of public health and medicine throughout the county’s home visiting programs is an exemplary example of creating lasting change within MCAH.
What insights did you gain about yourself during your field work, and how have these insights contributed to your professional growth?
Coincidentally, my field work placement experience was in the county where I was born and raised in. This experience truly felt like the full circle moment I needed to truly realize I would love to one day return to my hometown and give back to the community that gave so much to me. Throughout my time working with various people within the department, I found myself building stronger professional relationships due to my lived experience growing up in the community and knowledge about the county. I had the opportunity to couple my lived experiences with my academic knowledge to feel confident in my voice within the different spaces.
This realization not only highlighted the importance of live experiences for me but also reassured my interest in working with the Latinx and immigrant populations within MCAH. After this experience, I understood that I not only connect with these populations on a personal level but I have also learned how I can connect and serve them on a professional level. This opportunity also further ignited my passion for research for Latinx and immigrant populations within MCAH as I plan to do my capstone that includes these populations. Therefore, I aspire to have my continued academic journey and life experiences become impactful assets I carry to serve my communities (and beyond) in the most equitable, compassionate, and holistic way possible.
What was your favorite part about your field work and why?
My favorite part of my field work was being able to join Public Health Nurses and Nutritionists on client visits for the county’s Nurse-Family Partnership program, MCAH Home Visiting Program, and the Nutrition Program. Joining these visits granted me the opportunity to see the intersection between public health and medicine. This intersection and collaboration provided me with another first-hand experience on a truly holistic way to provide care to clients by meeting their needs wherever they are at (in terms of location and stage in life). Additionally, because the nurses and nutritionists for these programs are wonderful professionals and humans, I was able to see how impactful empathy, compassion, and expertise are for providing sustainable care to maternal, child, and adolescent populations. These client visits were transformative for the trajectory of my career with learning how I can incorporate public health into different (future) roles that I am in.
Could you share a situation from your field work where effective communication played a crucial role in the success of a project, perhaps in negotiating with stakeholders to achieve a common goal? What strategies did you employ to convey these public health messages to diverse audiences, and what was the outcome?
For my project on the dissemination of the county’s Title V Needs Assessment, I had the opportunity to work with and receive feedback from multiple people within the Health Department. This collaboration ensured the showcasing and importance of many stakeholders throughout the dissemination process. Throughout this project, I created multiple time points for myself where I was able to send out my continued process and be able to ask other departmental staff if there were any improvements and changes that could be made. After receiving some feedback, I went back and worked on incorporating that feedback into my project. This cycle continued until I finished the project that took all feedback into consideration and showed compromise among the differing feedback that was given. By doing this, I was able to create the county’s Need Assessment summary pages that are representative of the perspectives of the community and the Health Department.
How did your work engage with the Life Course Perspective theory and/or Social Determinants of Health?
As a Maternal, Child, and Adolescent Health (MCAH) Intern within the Public Health Bureau of the County of Monterey Health Department, I had the opportunity to learn about the home visiting programs for MCAH populations. After learning about these programs through joining provider meetings, joining client visits, and collaborating with the survivors of the programs, I was able to create a training presentation for staff and a summary page for outside providers that highlighted the unique aspects of the programs along with the main goals and client eligibility. These programs were created to address the needs of clients including symptoms, navigating systems that they live in, the importance of access, increasing knowledge, and linkage to community resources beyond a provider visit. Due to the MCAH nature of these programs, many of the main goals of the programs incorporated a holistic approach to maternal and infant health by providers to create lasting health outcomes and change for birthing people, infants, children, and families.