The impact of the Rural Alabama Pregnancy and Infant Health (RAPIH) Program was evaluated in relation to prenatal care, birth outcome measures, and several child health and home environment outcomes. Begun in 1983, RAPIH targets poor rural blacks in three of west-central Alabama's poorest counties, where economic conditions and infant mortality are among the worst in the United States. Women who go to West Alabama Health Services' (WAHS) clinics in Greene and Hale Counties for prenatal care are invited to enroll in the RAPIH home visiting program. Other women are referred by their physicians or the Alabama Department of Human Resources. Home visitors are the special link between WAHS' health care providers and the community's mothers. Patients are enrolled during their pregnancy and visited through the first two years of the child's life for a total of 38 visits. The evaluation sample consisted of 204 mothers in four groups: WAHS visited, non-WAHS visited, WAHS nonvisited, and non-WAHS nonvisited. Data sources included interviews, prenatal medical records, hospital delivery records, and pediatric medical records. Quantitative data indicated some benefit due to home visiting, particularly regarding increased use of prenatal and pediatric care. Qualitative data offered insights into curriculum and focus of treatment, service providers, program participants, and program implementation. (RH)