The MIHOW (Maternal Infant Health Outreach Worker) Program was founded in 1982, after Vanderbilt Center for Health Services surveyed community clinics and agencies to find out how health and early child development could be improved if a limited amount of money were made available to them. The response was to begin peer outreach to isolated, low-income, pregnant women using trained laywomen in their own community. MIHOW serves families in four states - Kentucky, Mississippi, Tennessee, and West Virginia.