February 6, 2023

Prenatal-to-Three Playbook Details State of Child Care in Allegheny County, Shares Resources

Child Trends, in partnership with The Heinz Endowments, has published the Prenatal-to-Three (PN-3) Playbook. The playbook reveals PN-3 challenges and successes in Allegheny County, and provides resources and tools that equitably support Allegheny County families with children three years-old and younger.


The Heinz Endowments partnered with Child Trends in spring of 2020 to create the Prenatal-to-Three (PN-3) Playbook. The project
team at Child Trends worked with several local child care organizations, including Trying Together, and interviewed over 30 PN-3 stakeholders in Allegheny County to develop it.

Summary of Findings

State of Child Care in Allegheny County

  • Allegheny County’s maternal and child health programs and social supports, such as its five prenatal and postnatal
    home visiting programs, successfully serve children.

    • Between 2015 and 2019, 86.9% of women who gave birth in Allegheny County received a prenatal care visit in their first trimester, nearly 10 percentage points higher than the national average.
    • Rates of prenatal care utilization do not vary by race/ethnicity in Allegheny County.
  • Allegheny County faces challenges with its disparately high rates of maternal and infant deaths among Black populations.
    • The infant mortality rate among Black infants is more than four times higher than among White infants.
    • The maternal mortality rate for Black mothers is higher in Pittsburgh than in 97 percent of similar cities.
  • Elements of early learning systems in the county are strong. For example, 43% of the county’s child care capacity meets high-quality standards.
  • There are notable gaps in access to high-quality early education.
    • Among the infants and toddlers in Allegheny County who are eligible for Child Care Works (CCW), Pennsylvania’s
      child care subsidy program, 70% remain unserved.
    • In the city of Pittsburgh, around 35% of children who potentially need child care are unable to access it. This is higher than the state’s average child care accessibility gap of 29%.
  • The evident disparities in maternal and child health outcomes and access to high-quality early childhood care are compounded by
    other county- and state-level systems and supports for families, such as access to paid family and sick leave and affordable child care. Allegheny County is taking positive steps by offering paid family leave to county employees and recently requiring most businesses in
    the county to offer paid sick leave to their employees.

New Governmental Support for Child Care

  • In 2018, Congress approved more than $2 billion in funding to support states in meeting Child Care and Development Block Grant (CCDBG) reauthorization requirements. After this, Pennsylvania’s child care funding increased by $66.1 million, allowing for more affordable and high-quality child care options.
  • Recently, child care advocates persuaded the Pennsylvania legislature to allocate $25 million in new state funding towards child care.
  • Allegheny County Department of Human Services created Hello Baby in 2019—a program that intends to serve all women and families of new babies, and specifically targets supports to the families most in need.
  • The Allegheny County Department of Health created an Infant Mortality Collaborative (IMC) to help address disparities in infant mortality rates in the region, as well as to raise awareness and knowledge of local maternal and child health issues.
  • Additionally, Allegheny County created a Department of Children’s Initiatives in 2021 to promote access to high-quality early learning.

A PN-3 Map for Allegheny County

Child Trends created an interactive, online map of Prenatal-to-Three services in Allegheny County. The playbook includes a link to the report.

The map includes: median household incomes surrounding childcare organizations, organization types, services provided by organizations, and additional organizational information.

PN-3 State and County Policy Recommendations

  • Enact state laws that require employers to provide protections and accommodations to pregnant workers.
  • Extend Medicaid benefits beyond the nationally mandated 60 days postpartum.
  • Implement paid family leave, paid sick leave that covers time to care for a child who is sick, and a state minimum hourly wage of $10 or higher.
  • Increase families’ access to child care subsidies.
  • Implement policies and programs equitably to support all families in need.

Key Considerations for Child Care Funding Allocations

  • Commit to an equitable process.
  • Listen to the voices of providers, families, and the workforce and prioritize their stated needs.
  • Use data to inform decisions and enhance data capacity.
  • Prioritize direct payments for the early care and education workforce.
  • Identify indicators at multiple levels of the system that can be used to track and monitor progress.
  • Work closely with intermediaries who maintain strong community ties, and communicate decisions with key stakeholders.
  • Build training and technical assistance to support the application and implementation processes.
  • Fund recruitment efforts.
  • Provide necessary supplies and support the home visiting workforce.
  • Finally, elevate the urgency of supporting the child care workforce and strengthen opportunities to support parents with newborns.

Learn More

Read the full report to learn more.