Prematurity matters. It’s a life-threatening epidemic.

Each year across the world, one million preterm babies die within the first 28 days of life. Of the 14 million more preterm babies who survive, many are faced with a lifetime of serious health complications.

Fresno County PTBi is part of a global initiative to reduce preterm birth.

Across Fresno County, experts and families agree that improving the health of women and babies is very important. One major challenge is the high rate of babies born prematurely. Fresno County has one of California’s highest rates of babies born prematurely: approximately 1 out of every 9 babies. Being born too soon can cause serious physical and mental disabilities or even death before the baby’s first birthday. It has enormous human and financial costs for our families and affects the overall health of our community. Conditions in Fresno County must be changed so that more women can have healthy pregnancies and healthy babies.

To address this challenge, leaders in Fresno have come together to build a cross-sector, collaborative effort. Institutions and organizations across the County are working together, even those that have not previously worked together or that may not usually focus on health issues. This initiative will both improve the coordination of programs and services that are working well in the County, as well as introduce new and innovative practices.

This initiative will serve all women and families in FRESNO County, while also providing specific support and services to the communities that are at highest risk for premature birth – low income families, families living in southwest Fresno, and African American, Hispanic and Southeast Asian families.



Collective Impact is a framework to tackle deeply entrenched and complex social problems. It is an innovative and structured approach to making collaboration work across government, business, philanthropy, non-profit organizations and citizens to achieve significant and lasting social change.

All participants have a common agenda for change including a shared understanding of the problem and a joint approach to solving it through agreed upon actions.

Collecting data and measuring results consistently across all the participants ensures shared measurement for alignment and accountability.

A plan of action that outlines and coordinates mutually reinforcing activities for each participant.

Open and continuous communication is needed across the many players to build trust, assure mutual objectives, and create common motivation.

A backbone organization with staff and specific set of skills to serve the entire initiative and coordinate participating organizations and agencies.


Sandra Flores was appointed the first program director of the Fresno County Preterm Birth Collective Impact Initiative, a collaborative effort to reduce the number of babies born prematurely in Fresno County. The Fresno County Preterm Birth Initiative is part of the larger $100-million, 10-year Preterm Birth Initiative, led by the University of California, San Francisco, and funded by Lynne and Marc Benioff and the Bill and Melinda Gates Foundation. Fresno County is one of six sites selected for the Preterm Birth Initiative, and the only site implementing the collective impact model. Alameda County and San Francisco are the other two U.S. locations, with international sites that include Nairobi, Rwanda and Uganda. Sandra was the Senior Program Officer for the Central Valley Community Foundation (formerly Fresno Regional Foundation). She was with the Foundation from 2007 through 2016. As part of her role at the Central Valley Community Foundation, she oversaw the competitive grant making program which included Arts & Culture, Youth, Human Services, and Environment. As Senior Program Officer she also led the Teen Pregnancy Prevention and High Impact grant making initiatives on behalf of the foundation. A native of Fresno, Flores attended Fresno City College and received her bachelor’s degree in history from Oklahoma City University. She is a member of the Adolescent Sexual Health Work Group, an organization through the California Department of Public Health that promotes and protects the sexual and reproductive health of youth in California.

Amber Costantino is the Monitoring, Learning, and Evaluation (MLE) Specialist at the Fresno County Preterm Birth Initiative. Amber graduated in 2016 with a M.A. in Experimental Psychology from California State University, Fresno. During her graduate studies, Amber gained experience as a data analyst intern at CART High School and UCSF Fresno Medical Center. After earning her masters, Amber became a Research Data Analyst at the Central Valley Health Policy Institute and part-time faculty in the Psychology Department at California State University, Fresno. As a Fresno native, Amber recognizes the importance the Preterm Birth Initiative and is dedicated to showing the impact it has on her community.

Olga Nuñez comes from the Parent Institute for Quality Education (PIQE), a statewide organization with an office in Fresno serving the Central Valley. She joined PIQE in 2007 as Associate Director and in 2010 became the Executive Director for PIQE’s Fresno regional office. Olga was instrumental in expanding PIQE’s services to Fresno, Madera, Kings and Tulare County rural school districts. She is a member of the President’s Enrollment Management Advisory Group at California State University, Fresno. In 2013, she was named one of the Outstanding Women of the Year by assembly member Henry T. Perea for her community involvement. In 2012, she took part of the California Chronic Absence Network, an initiative to improve school attendance and advance needed local and state policy reforms, and since 2011 she has served as a Youth Leadership Institute advisory board member. Olga graduated in 2003 with a B.A. in psychology from California State University, Fresno where she was captain of the cross country team and winner of her alma mater's Cross Country Female Athlete of the Decade award. In 2014 she became the Youth Director at her church, supporting a group of 55 young ladies in their quest for professional and spiritual development. Happily married to Leo Nuñez, they have three beautiful children: Naason, Javan, and Leah. She enjoys running, singing in her church choir, and serving as Site Council Chair at the school her children attend. She is an avid basketball, football and baseball fan.   

Shelbie Yang is the Administrative Support Coordinator for the Fresno County Preterm Birth Initiative. Prior to PTBi Fresno, she served as a Laboratory Technician at Community Regional Medical Center for the Newborn and Prenatal Screening Program. Her background in maternal and child health derived from undergraduate work at UC Davis Medical Center’s Child Life Department and Shriner's Hospital for Children in Northern CA. Shelbie currently lives in Clovis with her husband, Matthew. Shelbie holds a Bachelor of Science degree in Human Development from University of California, Davis.

Kendalyn Mack is the Community Engagement Specialist for the Fresno County Preterm Birth Initiative. She holds a Bachelor’s of Science in Public Health with an emphasis in Community and has been recognized by Black Students United with the “Making a Difference" award. Former Renaissance Scholar and first generation college student from Compton, CA, Kendalyn has traveled to Accra, Ghana with University Studies Abroad Consortium and is a Gilman Scholar Alumna. She served as the first Presidential Intern of California State University, Fresno and was nominated for Dean’s Medalist by the College of Health and Human Services. Kendalyn is a member of Zeta Phi Beta Sorority, Incorporated.