Collective care begins with a simple premise: Everyone has something to contribute, and everyone needs care in return. It is a web of relationships that surrounds families, connecting clinical care with community support and making health and well-being a shared responsibility.
That idea anchored the conversation at the 16th annual Dr. Bernard Guyer Lecture in Public Health, held Friday, November 6, 2026, at the Memorial Art Gallery, where public health professionals, clinicians, community leaders, and advocates explored what collective care could mean for maternal healthcare in Rochester and the Finger Lakes.
It was especially meaningful to have Bernard Guyer, MD, MPH, there to offer remarks and help center the discussion around the relationship between health systems and the communities they serve.
“This link between medical institutions and community services is at the heart of improving health in this country,” said Guyer, reflecting on the people who support families through pregnancy, birth, and the postpartum period. “When you’re in public health, the community is the bedside for you.”
Designing collective care
Keynote speaker Aza Nedhari, DHS, CPM, LPC, is co-founder and CEO of Mamatoto Village, a Washington, D.C.-based organization that provides community-centered perinatal care and develops the maternal health workforce. She invited attendees to look beyond what is going wrong in maternal health and study what communities are already doing well.
“What if collective care were the intervention?” she asked.
Nedhari described collective care as a web of interconnected and interdependent relationships in which everyone gives and receives care. It is not limited to one provider, one patient, or one appointment. Nor does it wait until a family reaches a crisis. It is built into the way people and organizations work together. That distinction is important, she said, because care that appears only in an organization’s values or mission statement will not be enough.
“Care that is not designed into the system, that’s not intentionally baked into the system, is an abstraction,” Nedhari said. “It doesn’t have a mechanism. It doesn’t have a policy. It doesn’t have a practice for how it’s going to happen.”
Mamatoto Village has worked to give collective care that structure. Its model prioritizes relationships rather than individual appointments, brings care to the places where families live, connects multidisciplinary teams through shared information, and develops a workforce from within the community. That approach seems to be working.
For 13 years, Nedhari said, Mamatoto Village’s Mothers Rising Home Visiting program has had zero pregnancy-related deaths among participating mothers. Across its programs, the organization has supported more than 3,500 mothers and families. She encouraged researchers, clinicians, and policymakers to examine the relationships, practices, and design choices inside that “zero,” not simply view it as an outcome.
“We don’t outsource trust,” she said. “We build it house by house, one home visit at a time.”
Making care easier to reach and navigate
A panel of Rochester-area experts brought Nedhari’s invitation into a local context. Juanita Lyde, chief impact officer for the Combined Entity of Common Ground Health-Finger Lakes Performing Provider System-Rochester RHIO, moderated the discussion, which explored the challenges families face, the partnerships successfully responding to those needs, and changes still required.
Panelists pointed to mistrust, racism and bias, transportation and childcare barriers, limited provider capacity, restrictive program eligibility, fragmented information systems, and the difficulty of navigating services during an already demanding period.
Danielle Jones, LMHC, a certified doula, owner of Divine Connection Doula Care, and founder of Place of Wisdom Maternal Wellness Center, said families can become exhausted by repeatedly trying to connect with services.
“I’ve heard moms say, ‘I just got tired of reaching out and not hearing back, so I don’t even want to do it anymore,’” Jones said. “They wanted the help and support, but they were not able to connect with someone to get the services that they needed.”
Building on what is working
The panel also highlighted promising efforts already underway in Rochester. Dr. Scott Hartman, director of women’s and maternity services at University of Rochester Medicine, described how research listening to Black women’s birth experiences helped inform the Fourth Trimester program, which combines medical and social risk assessments, more comprehensive birth planning, an early postpartum visit, and connections to community services.
“We learned that patients needed more contact with not just the doctor, but services and navigation,” Hartman said. “The patients in our family health center get two postpartum visits, and we really have some great outcomes so far. They seem to be equivalent across races and ethnicities. So it seems to be a way of, I won’t say equalizing everything, but trying to get at racial equity.”
Other examples showed collective care taking shape through relationships. Danielle Jones described a postpartum support group for Black mothers whose members formed their own group chat, spent time together outside the program, and attended their babies’ birthday parties.
“Those moms created their own support system,” Jones said. “It was beautiful to see that.”
Panelists also pointed to the Birth Action Collaborative, the Maternal Child Health Advisory Group, community doula networks, Nurse-Family Partnership group activities, CenteringPregnancy, ROC Family Teleconnects, Project TEACH, and the new family resource navigation tool available through 211. Together, these efforts demonstrate that Rochester and the Finger Lakes already have many of the elements of collective care. The opportunity is to connect them more intentionally, make them easier for families to navigate, and expand the approaches that are producing results.
Everyone has a role
Collective care does not belong to one profession or organization. Researchers can investigate the models that are already producing better outcomes. Health care professionals can listen differently and work with families to develop realistic care plans. Policymakers and funders can create payment structures that support coordination and longer-term postpartum care. Community organizations can strengthen relationships and make referrals easier to navigate. Friends, relatives, neighbors, and faith communities can help families build the village that is too often missing.
Nedhari encouraged attendees to consider the power, privilege, presence, position, and permission they bring into every encounter. She also offered a practical question for evaluating whether an interaction was truly person-centered: “Did they leave feeling seen, or did I leave having just performed?”
In her closing remarks, Edith Williams, PhD, MS, director of the Center for Community Health & Prevention, returned to three ideas from the keynote: “zero, preventable, and intentional.” Mamatoto Village’s record of zero pregnancy-related deaths among participants in its Mothers Rising program points to what is possible, she said, while the fact that many maternal deaths are preventable shows that change is within reach.
“We have the power, we have the capability, we have the competency, we have everything that we need to care for each other,” Williams said. “We have the time. We need to design it differently. We have the skill. We need to apply it in a more intentional way.”
Williams called the gathering itself “a cross-sector collaboration in the making,” bringing together physicians, public health professionals, faculty, nurses, midwives, doulas, faith leaders, and others. The opportunity, she said, is to be intentional about what they do with that time and connection after leaving the room.
The message builds on last year’s Guyer Lecture, when speakers called for respectful, culturally aligned birth care designed with families, not for them. This year’s discussion moved that commitment forward by asking how trusted relationships and community expertise can be intentionally built into everyday systems of care.
For the Combined Entity of Common Ground Health-FLPPS-Rochester RHIO, that work continues through data, community engagement, cross-sector partnerships, and collaboration with organizations across Rochester and the Finger Lakes. The goal is not simply to connect more families to individual services. It is to help create a system in which families are seen, supported, and surrounded by care before, during, and long after birth.
As Nedhari reminded the audience, maternal health is everyone’s business. The question for each of us is not whether we have a role, but how we will use it.