Healthy Start focuses on reducing disparities in infant mortality and adverse perinatal outcomes by:

  1. Improving women’s health,
  2. Improving family health and wellness,
  3. Promoting systems change, and
  4. Assuring impact and effectiveness through workforce development, data collection, quality improvement, performance monitoring, and evaluation.

The 19 Healthy Start benchmarks which specify the program’s aims for achieving the four approaches are described below. For each benchmark there is a Performance Measure Resource Sheet that outlines strategies and activities to help your program make progress on the benchmark and effectively serve participants.

 

Health Insurance

Increase the proportion of Healthy Start women and child participants with health insurance to 90% (reduce uninsured to less than 10%).

Healthy Start participants should enroll in health insurance to ensure their access to both preventive and essential health care services. Although uninsured rates are decreasing in the U.S., disparities persist within race, income, and age groups. Under the Affordable Care Act, many women not previously insured now qualify for health insurance (including Medicaid and Marketplace coverage) but may not realize this, and may need assistance in accessing it.

Performance Measure Resource Sheet is available summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

 

Reproductive Life Plan

To omen talking

Increase the proportion of Healthy Start women participants who have a documented reproductive life plan to 90%

A reproductive life plan is a set of personal goals about having (or not having) children, accompanied by family planning intended to help achieve those goals. The CDC recommends that everyone make a reproductive life plan based on personal values and resources. Reproductive life plans reduce the risk of unintended pregnancy and increase the number of women who plan their pregnancies, and engage in healthy behaviors before becoming pregnant.

Performance Measure Resource Sheet is available summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

 

Postpartum Visit

Increase the proportion of Healthy Start women participants who receive a postpartum visit to 80%.

Since the period immediately following birth is a time of many physical and emotional adjustments, ACOG recommends a visit for the mother with a healthcare provider within the first three weeks postpartum. Recovery from the delivery can be assessed, and preventive health measures such as screening for postpartum depression, providing contraception, and reinforcing the health benefits of breastfeeding can be provided.

Performance Measure Resource Sheet is available summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

 

Usual Source of Care

Increase proportion of Healthy Start women and child participants who have a usual source of medical care 80%.

“Usual source of care” refers to a place an individual or family usually goes to when sick, such as a doctor’s office, clinic or health center but not an emergency room.  Having a usual source of medical care has been shown to increase quality of care,  boost access to preventive services, improve health outcomes, and reduce overall health care costs.

Performance Measure Resource Sheet is available summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

 

Well-Woman Visits

Increase proportion of Healthy Start women participants that receive a well-woman visit to 80%.

ACOG recommends annual assessments to counsel women about preventive care and to provide recommended services such as screening and immunizations. A number of illnesses can be prevented when proper well-woman care is a priority, and even illnesses that can’t be prevented have a much better prognosis when detected early. In addition, a woman who has been receiving annual well-woman care is more likely to be in optimal health before any subsequent pregnancy.

Performance Measure Resource Sheet is available summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

 

Image of mother reaching out to infant in a bassinetSafe Sleep

Increase proportion of Healthy Start women participants who engage in safe sleep practices to 80%.

The American Academy of Pediatrics recommends that all babies be placed on their backs for every sleep time because this practice has been shown to reduce the incidence of Sudden Infant Death Syndrome (SIDS). Additional safe sleep strategies that can decrease the risk of infant death by asphyxia/suffocation include use of a firm sleep surface free of soft objects or loose bedding, room-sharing without bed-sharing, and sleeping in a smoke-free environment.

Performance Measure Resource Sheet is available summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

 

Initiating Breastfeeding

Increase proportion of Healthy Start child participants whose parent/caregiver reports they were ever breastfed or pumped breast milk to feed their baby to 82%.

Breast milk contains vitamins and nutrients babies need for good health and protection from disease. Research shows that any amount of breastfeeding is beneficial for the baby and that the skin-to-skin contact of breastfeeding has physical and emotional benefits. Prenatal counseling and education of pregnant women can correct misperceptions about breastfeeding and encourage more of them to breastfeed.

Performance Measure Resource Sheet is available summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

 

Sustaining Breastfeeding

Increase proportion of Healthy Start child participants whose parent/caregiver reports they were breastfed or fed breast milk at 6 months to 61%.

The American Academy of Pediatrics recommends exclusively breastfeeding for the first six months because breastfeeding is good for both the baby’s and the mother’s health. Benefits for the baby include decreased diarrheal illness, gastroenteritis, and respiratory tract infections, fewer allergies, and reduced risk of obesity and diabetes. Benefits for the mother include decreased obesity and Type II diabetes, reduced risk of breast cancer, and decreased postpartum depression.

Performance Measure Resource Sheet is available summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

 

Smoking Abstinence

Increase the proportion of pregnant Healthy Start participants that abstain from cigarette smoking to 90%.

Research shows that smoking in pregnancy is directly linked to poor outcomes including preterm birth, low birth weight, certain birth defects such as cleft lip or cleft palate, Sudden Infant Death Syndrome (SIDS), and premature separation of the placenta from the uterus. Women who smoke may also have a harder time getting pregnant and an increased risk of miscarriage. All of these risks can be reduced if a woman quits smoking before or even during pregnancy.

Performance Measure Resource Sheet is available summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

 

Mother, father, toddler, and babyBirth Spacing

Reduce the proportion of Healthy Start women participants who conceive within 18 months of a previous birth to 30%.

Pregnancies should be spaced at least 18 months apart to reduce health risks for both mother and baby. Increased risks for babies conceived within 18 months of a prior birth include preterm birth, low birth weight, and small size for gestational age. Additionally, in order to achieve optimal health before another pregnancy, the mother needs time to fully recover from the previous birth.

Performance Measure Resource Sheet is available summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

 

Well Child Visits

Increase proportion of Healthy Start child participants who receive the last age-appropriate recommended well child visit based on AAP schedule to 90%.

The American Academy of Pediatrics recommends regular well-child visits to assess if the child is meeting developmental milestones on hearing, vision, nutrition, safety, sleep, diseases, and growth. These visits also provide an opportunity for additional age- and developmentally-appropriate preventive services such as immunizations and anticipatory guidance.

Performance Measure Resource Sheet is available summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

 

Depression Screening

Increase proportion of HS participants who receive depression screening and referral to 100%.

Perinatal depression is one of the most common complications of pregnancy. It is important to identify women with depression because untreated mood disorders can have adverse effects on women, infants, and families. ACOG recommends that pregnant women should be screened for depression at least once during the perinatal period.

Performance Measure Resource Sheet summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

 

Intimate Partner Violence

Increase proportion of Healthy Start women participants who receive intimate partner violence (IPV) screening to 100%.

Intimate Partner Violence, a pattern of abuse by one partner against another in a relationship such as marriage, cohabitation, or dating, is a substantial yet preventable public health problem. Every year women experience 4.8 million incidents of physical or sexual assault by an intimate partner. This violence tends to persist or even increase during pregnancy. The U.S. Department of Health and Human Services recommends that IPV screening and counseling be a core component of both prenatal and well-woman healthcare visits.

Performance Measure Resource Sheet is available summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

Smiling young father reading a book for his girlsFather/Partner Prenatal Involvement

Increase the proportion of HS grantees that demonstrate father and/or partner involvement (e.g., attend appointments, classes, infant/child care) during pregnancy to 90%

Paternal involvement has an impact on both pregnancy and infant outcomes. The father or partner can, for example, participate in childbirth classes, prenatal and pediatric medical appointments, and infant care. Paternal involvement during pregnancy has been shown to reduce negative maternal health behaviors, risk of preterm birth, fetal growth restriction, and low birth weight.

Performance Measure Resource Sheet is available summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

 

Father/Partner Parenting Involvement

Increase proportion of Healthy Start women participants that demonstrate father and/or partner involvement (e.g., attend appointments, classes, infant/child care) with their child participant to 80%.

Early male involvement in children’s lives has been shown to have a positive effect on both sons and daughters in several areas. It is associated with future academic success, reduces the chance of delinquency, and decreases the incidence of substance misuse.

Performance Measure Resource Sheet is available summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

 

Reading to Child

Increase the proportion of Healthy Start child participants aged <24 months who are read to by a parent or family member 3 or more times per week to 50%.

Reading to a child teaches him or her about communication, introduces concepts such as numbers, letters, colors, and shapes, builds listening, memory, and vocabulary skills, and provides information about the surrounding world. It is also associated with future academic success. Because of this, a mother or father should read to the infant or young child every day.

Performance Measure Resource Sheet is available summarizing recommended strategies and a selection of resources and evidence-based practices related to this benchmark to aid Healthy Start grantee organizations, partners and their staff in supporting the women and families they serve.

 

CAN Implementation

Increase the proportion of HS grantees with a fully implemented Community Action Network (CAN) to 100%.

A Community Action Network, or CAN, is a formally organized partnership, advisory board or coalition of organizations and individuals. The CAN represents consumers and appropriate agencies that unite in an effort to collectively apply their resources to the implementation of one or more commons strategies to achieve a common goal within their service area.

 

Image of two women giving a high fiveParticipant Membership in CAN

Increase the proportion of Healthy Start grantees with at least 25% community members and Healthy Start program participants serving as members of their CAN to 100%.

HS participant involvement in setting the community agenda and informing efforts to effectively meet the community’s needs is critical to the effectiveness of the Community Action Network (CAN).

 

Quality Improvement/Evaluation

Increase the proportion of HS grantees who establish a quality improvement and performance monitoring process to 100%.

Quality improvement (QI) consists of systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted populations. Quality improvement and performance monitoring processes provide a mechanism for assessing the degree to which program goals are met and the effectiveness of corrective actions to ensure the best health outcomes for participants.