Use of mchb performance measures for evaluation of the federal healthy start program

Background: The Maternal and Child Health Bureau (MCHB) utilizes 15 performance measures (PM) to monitor the progress of Federal Healthy Start (HS) projects towards improving maternal and infant health. In the national evaluation of the Federal HS Program, we analyzed trends in six birth outcome PMs that are the same as state and national benchmarks. Methods: We calculated overall weighted averages of HS project PM rates with 95% confidence intervals for each year of 2006 to 2009, estimated the total and annual average percent change from 2006-2009, and charted 2-year moving averages. Healthy Start PM rates were compared with applicable state and national benchmarks. Results: The HS program serves high risk populations, but in 2009, over 60% of HS projects achieved lower rates of neonatal and post-neonatal mortality than the US rate. From 2006 to 2009, there were modest (≤ 5%), but not significant, average annual declines in the mean rates of very low birth weight, low birth weight, neonatal mortality, and perinatal mortality among HS projects (N=99) with available data. There were non-significant increases in the mean rates of infant mortality and post-neonatal mortality among all projects. Data availability and quality issues limited the ability to perform analyses for some PM. Conclusion: MCHB birth outcome performance measures are a source of information for assessments of the progress and outcomes of the Federal Healthy Start program. Refinements in some performance measure definitions and a continued focus on gathering consistent data over time should be pursued to support robust evaluation activities.