The Conga Line and the Case for ROI in Maternal Health

Our time at the 2026 Maternal Health Innovation Annual Meeting started with a dance party. Before anyone said a word about evidence-based maternal health care or partnerships and collaboration, maternal health experts wrapped around the hotel ballroom in a conga line. It set the tone for the rest of the day: this is a group that works hard, cares deeply about its work, and still knows how to have fun.

It was clear that everyone at the conference has a story to tell about the power of their work, from perinatal substance use and recovery support to maternal health workforce development to prevention and prenatal care services. And while there are many ways to tell a story, our plenary presentation made the case for a less obvious one: social return on investment (SROI).

Return on investment (ROI) sounds like a finance term, not a maternal health one. Our co-presenter, Katelyn Strasser, with the South Dakota Department of Health, talked about how hard it can be to think in ROI terms about human-centered work. She had been interested in applying an ROI lens to her work for a while, and went looking for help at her state's university business school. They understood the ROI side, but couldn't quite capture the public health side of it. Back at the state health department, it was the opposite: deep knowledge of the public health work, but no ROI toolkit to translate it into terms a funder or legislator would recognize. That gap, between people who know ROI and people who know public health, is exactly what our work in SROI is built to close.

SROI works by putting a dollar value on outcomes that don't normally get one: a mother who stays in prenatal care, a family that avoids a NICU stay, a workforce that is better equipped for complicated deliveries. We walked the audience through the framework we use at the Center for Social Investment, but we knew they couldn’t run a full-scale SROI study from their seats in the ballroom. Instead, we gave them tools to use the SROI framework to build an elevator pitch that links their program's activities to their outcomes, and those outcomes to their cost burdens. For example:

Our Pregnancy Care Program provides risk and blood pressure screenings to pregnant women referred from Medicaid. That means every dollar invested helps reduce undiagnosed hypertension in the prenatal period. As a result, long-term healthcare costs from complications like kidney damage, preeclampsia and eclampsia, and heart disease are reduced.

Any room that opens with a conga line isn't short on heart. But often, our mission-oriented work needs a way to put that heart into terms a funder or legislator can act on. That's the complex work our Center for Social Investment is built to do, and we're glad to have given a room that already works hard and cares deeply one more way to make its case.