When we hear the words "kindergarten readiness," we often think of ABCs and 123s. But there’s much more to early education than learning how to recite alphabets and count numbers.

Ensuring that children are born healthy and are developmentally on track will result in a healthy start for children — a healthy start that will allow them to build the early skills they need to be ready to survive and thrive in school.

Escambia County Healthy Start Coalition is among several local agencies that work with families to reach important developmental goals.

Through in-home visits to young mothers and their children, Healthy Start aims to reduce infant deaths, decrease the number of low birth-weight babies and improve the health and development outcomes for babies in Escambia County.

“Our goal is to decrease the infant mortality rate in our community,” says Janet Thomas, Escambia Healthy Start manager. “We try to get them as early as possible in their pregnancy.”

These home visits are primarily designed to reduce infant mortality disparities in places with some of the worst birth outcomes. Escambia County is in that category.

The county’s infant mortality rate at 7.5 percent is higher than both the state and national rate at 6 percent.

Even higher is the preterm birth rate. At 13.6 percent, Escambia County ranks 65^th out of 67 counties in preterm births.

Since 1991, Healthy Start has provided for universal risk screening of all Florida's pregnant women and newborn infants to identify those at risk of poor birth, health and developmental outcomes.

Healthy Start is a nonprofit that provides a variety of services aimed at improving the health of pregnant women and their babies, including education and basic medical care. The coalition also uses data and research to identify a community’s needs and improve outcomes.

Eligibility is based on your screening score and other identified risk factors, not on income or other financial factors. But many families and children who qualify for services fall are low income and at-risk of falling through the cracks without help and intervention.

By promoting health and safety and helping to identify health and developmental concerns, Healthy Start plays a critical role in school readiness.

“We partner directly with the family in their environment, and we help them build the parenting capacity,” says Theresa Chmiel, Escambia’s Healthy Start executive director. “We help them learn how to change what’s going on in their homes. We talk about making sure these kids are ready for kindergarten.”

Research by the Studer Community Institute and the University of West Florida’s Office of Economic Development and Engagement has shown that kindergarten readiness is the most critical education issue facing Escambia County.

We know that some 1,000 children in Escambia County every year are not ready for kindergarten. That means one out of three children start behind in school, and statistics bear out that they rarely, if ever, catch up.

By reaching families and children in their home, Healthy Start works to improve healthy outcomes and ultimately improve school readiness so all children are ready and able to learn.

To ensure a healthy pregnancy, reduce infant mortality and preterm births, Healthy Start reaches out to expectant mothers as early as possible.

“You can’t start to fix the problem even at birth,” Chmiel says. “You have to fix the problem during pregnancy.”

Using a universal screening tool, Healthy Start gets referrals from doctors and other community agencies.

About 3,800 babies are born annually in Escambia County, and Healthy Start screens nearly 3,000 of them. The program is voluntary, and Healthy Start too often can’t reach the mothers and children who need help the most.

Currently, 14 nurses, or care coordinators, serve about 2,400 mothers and children a year.

As coordinators, the nurses help arrange a variety of services as needed to help meet the needs and the goal for a woman having a healthy baby.

They set up service plans with families to help children developmentally and to identify risk factors, such as smoking, alcohol and drug abuse, domestic violence and unhealthy eating.

“If we feel that the family needs more intensive service than we can provide, then we refer them to the other agencies,” Chmiel says. “We don’t want duplication. That’s a surefire way to get the door slammed on everybody.”

As much as Healthy Start services are needed, there still remains a number of families that haven’t been reached or don’t accept the offer to use them.

Some families are reluctant to let people in their homes and others don’t really understand what the agency does or refuse to go through the screening process.

Mioshei Mobley, a community provider liaison for Healthy Start, is the link between the agency and the families.

She visits nail shops, hair salons and health fairs to spread the word about Healthy Start and encourage mothers to sign up and receive the free services.

“We’re trying to reach the consumer base,” Mobley says. “Oftentimes, the men accompany the ladies, so we’re able to talk and educate both men and women at the same time.”

Too often a child’s health is seen as separate and distinct from early childhood and learning rather than as an integral part of an overall school readiness strategy.

Child health is not the only factor in ensuring that children start school ready to learn, but it plays an important role.

“The interventions that we have in place do work, we just need to be promoted and promoted in the right way,” Chmiel said. “We don’t turn anybody away. We don’t have a waiting list. We do what we have to do help mothers and their babies get a healthy start.”