In 1982, the Vanderbilt Center for Health Services surveyed administrators of community clinics and service agencies in Appalachia to find out how health and early child development could be improved if a limited amount of money were made available to them. They responded by envisioning peer outreach to isolated, low-income pregnant women using trained lay women indigenous to the community. Later that year, the Ford Foundation funded four Maternal Infant Health Outreach Worker sites in Tennessee and Kentucky. In the spring of 1983, the Robert Wood Johnson Foundation funded two additional sites in West Virginia. In 1987, the Bernard van Leer Foundation provided support for expansion into Virginia. Over the past three decades, the program has expanded programatically and geographically, addressing emerging issues and adding urban sites. Today MIHOW serves families in four states — Kentucky, Mississippi, Tennessee, and West Virginia.
In 2013, The MIHOW Program became part of the Vanderbilt School of Nursing.