For more than three decades, the Special Supplemental Nutrition Program for Women, Infants & Children (WIC) has helped ensure that pregnant women, nursing mothers and babies get the best nutrition possible, even if they live in poverty, by providing food vouchers, free formula and plenty of counseling and support through community-based WIC centers.
In Rhode Island, the largest WIC provider is Providence Community Health Centers, which serves nearly 8,000 WIC clients at its five centers – one-third of the state’s total caseload. Lori J. Hurley, the center’s WIC coordinator, and Marie Ghazal, vice president for patient care and nursing services, spoke about the program, why it works and the challenges ahead.
PBN: How do women come to be enrolled in WIC at the center?
HURLEY: About 50 percent of the WIC participants are also patients at the health center.
GHAZAL: They don’t have to come here for their health care; they can go to private doctors who don’t have WIC programs, or other clinics. We try to get all of our health center patients who are eligible for WIC to come here, because it’s convenient for them.
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PBN: What are the main benefits of WIC?
HURLEY: When they come in for a WIC appointment, we do an assessment of their height and weight, we ask them if they have any medical problems, we do a dietary history, we talk to them about good nutrition during pregnancy, and we follow them up every two months. They’re also seen by a peer counselor who encourages breastfeeding and talks to them throughout the pregnancy. At the end of the appointment, they get checks to use in the grocery store to buy food like milk, cheese, eggs, juice, cereal, beans, peanut butter … and after they have the baby, if they choose to breastfeed, they’re seen in the hospital by a lactation consultant from the WIC program and they come in within 10 days, and we see how they’re doing. If they choose to bottle-feed, we give them a supplemental amount of formula.
PBN: How many women choose to breastfeed, and how much do you push them to do it?
HURLEY: Unfortunately, our percentage of breastfeeding women at the health centers is about 35 to 40 percent, which is the highest in the state. We encourage them, we talk to them about breastfeeding … and if they say right away they’re not interested, we kind of drop it until the end of the pregnancy. We might bring it up again [then], but we value their decision. But part of the WIC program is encouraging breastfeeding, because it has such protective and preventative benefits, like [fewer] doctors’ visits, less ear infections, less allergies, less prone to obesity – there’s so many benefits.
PBN: How big of a financial incentive is there for women to participate in WIC, and does participating in WIC encourage them to get better prenatal and postpartum care?
HURLEY: The food package runs about $50 a month, but the formula package is much more, because the formula is very expensive. If they’re not breastfeeding, they get 10 cans of powdered formula a month or 31 cans of concentrate a month. … [In terms of getting better health care], it definitely gives them an incentive to be seen in the health centers, because most of the WIC offices are next to the obstetrics and pediatrics departments, so we can refer them to the doctors … so it’s very cohesive, and I think it really benefits the mom to become a WIC participant. One out of every three families in the country are in the WIC program, and it does improve their health care.
PBN: Medicaid has been really strained recently by increases in enrollment and states’ financial problems. How is WIC doing? Do you get enough money to meet the demand?
GHAZAL: All the federal dollars go to the Department of Health, and based on the number of participants we have, that’s how much money we get. Right now we’d like to get more funds, because we don’t get enough money to cover our administrative costs. And we try to take more people, but right now we’re at the max of how many we can serve. … We’re looking at ways right now that we can continue to serve everyone, but it’s challenging.
