Model indicators for maternal and child health: an overview of process, product, and applications.

OBJECTIVES: Further improvements in the health of mothers and children depend, in part, on collecting, analyzing, and interpreting relevant data correctly. Despite consistent efforts to improve data capacity and use during the past two decades, the need persists for a model set of maternal and child health (MCH) indicators to guide decisions about health conditions to be monitored, elements to be included in data sets, and definitions of measures. This article describes development, key characteristics, and major applications of a set of MCH Model Indicators (MCH MI) created to address these needs. METHODS: A conceptual model with five domains was created to organize and guide development of the indicators. The development process included systematic specification of concepts, formulas, age/gender groups, and data sources, as well as recommendations for frequency of surveillance. Information sources included published reports and expert opinion. RESULTS: There are 217 indicators distributed across domains as follows: 75 health status, 9 contextual characteristics, 16 health systems capacity and adequacy, 49 risk/protective status, and 68 health and related services. Twenty of the indicators, all of them in the health status domain, are recommended for routine surveillance. CONCLUSIONS: The indicators can be used to identify and address MCH problems, to complement and expand other sets of MCH indicators, to serve as standards for consistent definitions, to provide guidance for creation and revision of MCH and related data bases, and to provide a foundation for the development of related sets of indicators. Some of the indicators require further development, but the total MCH MI package constitutes a solid foundation for subsequent work, as well as for ongoing modifications that are essential if the Model Indicators are to remain responsive to MCH needs.

Southeastern Title V program staff perceptions of state-level maternal and child health assessment skills.

OBJECTIVES: Since the publication of the Future of Public Health, a high priority has been placed on the development of the assessment capacity in public health programs. METHOD: Key informant interviews were conducted by telephone with selected program personnel of state Maternal and Child Health and Children with Special Health Care Needs programs in ten southeastern states to determine perceived deficiencies in skills needed to carry out assessments. RESULTS: We found that professional staff perceived that several fundamental assessment skills were available in their units, including collecting secondary data, and creating interagency groups and frameworks for assessment. In contrast, program staff perceived that their units did not have adequate skills to carry out many other critical assessment tasks, including the ability to analyze data using descriptive statistics. CONCLUSIONS: Our findings support the argument that more funds and staff resources must be devoted to the development of analytic skills, and to ensuring that consistent application of these skills is reinforced.

Prospects for childhood immunization registries in public health assessment and assurance: initial observations from the All Kids Count initiative projects.

This article offers an overview of selected evaluation findings from the initial implementation year of the Robert Wood Johnson Foundation's All Kids Count childhood immunization initiative in which demonstration projects were funded to develop community-based immunization registry and follow-up systems in 14 sites throughout the United States. The basic components of these systems, the process through which these registries were developed, efforts to secure the participation of private sector providers, the prospects for system success at the community level, and the potential for these immunization programs to influence other aspects of primary health care for children are addressed.