Maniilaq Health Center: Providing High-Quality Obstetric Care to American Indian/Alaska Native People in Rural Kotzebue, Alaska


The United States has one of the highest rates of maternal mortality compared to other developed countries, and most maternal deaths are preventable. Rural communities that are majority Black, Indigenous, and People of Color have the highest rates of maternal morbidity and mortality. For American Indian and Alaska Native (AI/AN) birthing people, the risk of pregnancy-related death is two to three times higher than that of white birthing people. In Alaska, the disparity is even greater; Alaska Native birthing people have the highest rates of pregnancy-associated mortality, at over five times higher than white birthing people.

Approximately 55% of the 230,000 people living in rural areas of Alaska are AI/AN. In order to give birth at a facility with the capacity to provide obstetric care, rural patients are often dependent on plane, boat, and even snowmachine travel to cover great distances outside of their home communities. In rural Alaska, paved road systems are limited and do not cover all areas; even gravel roads are not available or passable in all areas, and some remote areas have no roads at all, inhibiting access to care for remote Alaska communities. This case study provides an in-depth example of a hospital-based Tribal maternity unit located in Northwestern Alaska, and to highlight both strengths and challenges that this hospital and its patients face with childbirth.

University of Minnesota Rural Health Research Center
Hailey Baker, Katy Kozhimannil, Bridget Basile Ibrahim