Nancy Londono is a Community Health Worker With the Vanderburgh County Health Department’s Pre-to Three program.
It’s October of 2023 and she’s here to see client Darling Herrera and her baby Aaron, who was 6 weeks old at the time. Home visits start before the baby is born.
“We just get (to) be part of the family,” Londono said. “So many times we are with the family for almost four years … being part of the struggles being part of the happiness being part of maybe when the child is sick …”
Londono is having Herrera check her son’s hearing, while he’s on a blanket on the floor, gently calling his name, watching for a reaction.
On average, Vanderburgh County sees nearly eight infant deaths per 1,000 births annually. In 2024 — the most recent complete reporting year — the numbers dropped to three point six deaths per 1,000 births. In this case “infant mortality” refers to the death of a child before reaching one year of age.
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Causes include unsafe sleep practices and perinatal risk factors, pre-term deliveries and low-birth weighs.
Pre To Three is one of the Key pillars for success in reducing infant mortality rates to the Health Department and community partners.
“One of the big things is maternal support and also family support during pregnancy and postpartum,” said Charissa Schuetz, director of Outreach Services at the Vanderburg County Health Department. “And so one of the big initiatives throughout the group, through the Fetal Infant Mortality Review Team and Community Action Team, is really normalizing home visiting in our community.”
This is especially important when more than half of the pregnancies measured within the program are unplanned, said Lynn Herr, Health Department Director of Clinical Services.
“Because if you didn't plan on getting pregnant, and you have not addressed your smoking or nicotine use, you haven't addressed your weight, you haven't started vitamins.”
According to a 5-year study on the program published in 2025, outcomes include improved breastfeeding initiation, safe sleep practices, adequate prenatal care, child vaccination rates, food security, housing stability and employment status.
This is done with advice and referrals to wraparound services for the family. Program supervisor Sophie French said they use an “evidence-based curriculum” for visits called Growing Great Kids Next Generation. She said each family is assigned a team that consists of a Community Health Worker, Registered Nurse and Client Advocate.
Londono said these visits just start with a conversation about how the mother is doing and how the baby is doing. They can work on troubleshooting areas of need.
“Trying to see in which way Pre To 3 can help the family to go up in that situation and impact the family.”
Londono’s first language is Spanish. This is important for clients like Herrera who only recently emigrated from Venezuela.
Herrera said the lack of a language barrier makes communication quick and effective. She said the program refreshed her knowledge of newborn care and breastfeeding.
This is Herrera’s first child born in the US, so everything was new to her.
“Even you know, the car seat installation, going to a hospital, going to an appointments,” Londono said. “She's a sweet mom, dedicated mom. She just want to do the best for the kids. And that's what this program wants to support — help the moms and their families to grow, just to have healthy kids in the future.”
Aaron is now nearly 2.5 and doing well, so he just sees Nancy every month.
While numbers are improved in children born in 2024, the infant mortality rates for 2025 have already surpassed the 3.6 average, Herr said.
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