Assessing capacity and measuring performance in maternal and child health.
OBJECTIVE
To understand the similarities, differences, and relationships between three tools for performance and capacity assessment currently available for Maternal and Child Health (MCH) programs and for state and local health agencies.


METHODS
Three tools for performance and capacity assessment currently available for Maternal and Child Health (MCH) programs and for state and local health agencies, the Title V MCH Block Grant Performance and Outcome Measures (Title V "24"), CAST-5, and the National Public Health Performance Standards Program (NPHPSP) were compared using two metrics, a conceptual model of the public health system, and a set of attributes related to the use of the instruments.


RESULTS
Both CAST-5 and the NPHPSP are focused on the capacity and key processes (10 Essential Public Health Services) of the public health system, although CAST-5 is intended for capacity assessment and the NPHPSP is intended for performance measurement. The Title V "24" tool is also intended for performance measurement; however, its focus is on the outputs and outcomes of the health system. The Title V "24" tool is the only one of the three that is mandatory, and the only one whose results at the current time can be used to compare across entities. In addition, both the Title V "24" and the NPHPSP include explicit standards, while CAST-5 does not specify explicit standards against which to compare findings.


CONCLUSIONS
While there are various tools available to MCH practitioners for capacity assessment and performance measurement, knowing how the tools relate to each other, and their defining characteristics, should lead to more effective and productive use.
Handler
Arden
A
Community Health Sciences, University of Illinois School of Public Health, Chicago 60612, USA. Handler@uic.edu
Grason
Holly
H
Ruderman
Marjory
M
Issel
Michele
M
Turnock
Bernard
B
D002648:Child; D002662:Child Health Services / Q000458:organization & administration* / Q000592:standards; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration* / Q000592:standards; D008430:Maternal-Child Health Centers / Q000458:organization & administration* / Q000592:standards; D017146:Models, Organizational; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D011247:Pregnancy; D015397:Program Evaluation / Q000379:methods*; D011635:Public Health Administration / Q000592:standards*; D019984:Quality Indicators, Health Care; D014481:United States