Abstract
Objective The Title V Maternal and Child Health (MCH) Block Grant is the linchpin for US MCH services. The first national performance measures (NPMs) for MCH were instituted in 1997. Changing trends in MCH risk factors, outcomes, health services, data sources, and advances in scientific knowledge, in conjunction with budgetary constraints led the Maternal and Child Health Bureau (MCHB) to design a new performance measurement system.MethodsA workgroup was formed to develop a new system. The following guiding principles were used: (1) Afford States more flexibility and reduce the overall reporting burden; (2) Improve accountability to better document Title V’s impact; (3) Develop NPMs that encompass measures in: maternal and women’s health, perinatal health, child health, children with special health care needs, adolescent health, and cross-cutting areas.ResultsA three-tiered performance measurement system was proposed with national outcome measures (NOMs), NPMs and evidence-based/informed strategy measures (ESMs). NOMs are the ultimate goals that MCHB and States are attempting to achieve. NPMs are measures, generally associated with processes or programs, shown to affect NOMs. ESMs are evidence-based or informed measures that each State Title V program develops to affect the NPMs. There are 15 NPMs from which States select eight, with at least one from each population area. MCHB will provide the data for the NOMs and NPMs, when possible.ConclusionsThe new performance measurement system increases the flexibility and reduces the reporting burden for States by allowing them to choose 8 NPMs to target, and increases accountability by having States develop actionable ESMs.SignificanceThe new national performance measure framework for maternal and child health will allow States more flexibility to address their areas of greatest need, reduce their data reporting burden by having the Maternal and Child Health Bureau provide data for the National Outcome and Performance Measures, yet afford States the opportunity to develop measurable strategies to address their selected performance measures.
Highlights
The Title V Maternal and Child Health (MCH) Block Grant is the linchpin for MCH services in the United States
The new national performance measure framework for maternal and child health will allow States more flexibility to address their areas of greatest need, reduce their data reporting burden by having the Maternal and Child Health Bureau provide data for the National Outcome and Performance Measures, yet afford States the opportunity to develop measurable strategies to address their selected performance measures
The work group believed decisions on national outcome measures (NOMs) and national performance measures (NPMs) should be guided by a strategic framework which prioritized the identification of NPMs that could show the measurable impact of State Title V programs
Summary
The Title V Maternal and Child Health (MCH) Block Grant is the linchpin for MCH services in the United States. Title V became a block grant program as part of the Omnibus Budget Reconciliation Act (OBRA) of 1981 [2]. V Block Grant was significantly modified through the OBRA of 1989, introducing greater accountability for the use of funds at both the Federal and State levels [3]. These standards for accountability were further strengthened in 1993 by The Government Performance Results Act (GPRA) [4]. In order to comply with GPRA, government agencies were required to prepare annual performance plans that established the performance goals for each fiscal year, and a description of how these goals were to be met
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