The Healthy Start Program, created in 1991, is a federal initiative aimed at improving pregnancy outcomes for women and children.  Over the past 30 years, the program has grown from a small demonstration project to a national program serving 101 grantees in 34 states, the District of Columbia, and Puerto Rico.  Administered by the Division of Healthy Start and Perinatal Services (DHSPS) within the Maternal and Child Health Bureau (MCHB) at the Health Resources and Services Administration (HRSA), the program was transformed in 2014 to emphasize standardized approaches to improving maternal health outcomes and reducing disparities in perinatal outcomes in the United States. In particular, the newly-focused Healthy Start program applies evidence-based practices, community collaboration, organizational performance monitoring, and quality improvement to service delivery for high-risk pregnant women, infants, and children up to the age of 18 months.


Contact Information

In order to better serve the needs of all grantees, we encourage you to fully participate in all webinars that are offered related to data collection and reporting, and to review the FAQs and other pertinent documents shared directly via email and posted at the Healthy Start EPIC website.  We also ask that you share this information, as appropriate, with all staff involved in any element of data reporting. If your question is still not answered, please send an email to the appropriate point of contact below, as well as copy your Project Officer.

  • Healthy Start data collection and client-level/aggregate-level reporting questions:  Contact the Healthy Start Data Mailbox at [email protected]


Summary of the 2017 National Healthy Start Evaluation

In February 2020, a national evaluation of the Healthy Start program was completed which aimed to:

  • describe HS participants, allowing us to assess whether the program serves specific, intended populations
  • identify factors among HS participants that are associated with a higher risk of adverse outcomes in order to inform targeted efforts of the program
  • compare maternal and infant health outcomes among the HS population to those among socio-demographically similar non-participants
  • compare participant outcomes to program targets

This evaluation used three different data sources from 2017:

  • participant-level program data for HS participants collected via the Healthy Start Monitoring and Evaluation Data (HSMED) system
  • live birth and infant death data from state vital records offices
  • Centers for Disease Control and Prevention’s (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS) data

This was the first attempt to conduct a matched analysis for Healthy Start conducted on a multi-state level, representing a successful collaboration of multiple national and local partners. The Healthy Start Evaluation Final Report (February 2020) is provided below. This document details the evaluation’s methodology, results, limitations, and conclusions/recommendations. The Summary of the 2017 National Healthy Start Evaluation highlights a number of key findings from the Final Report’s evaluation analysis, and briefly describes some of the limitations and challenges.

Healthy Start Evaluation Final Report (February 2020)

Summary of the 2017 National Healthy Start Evaluation (Posted May 2021)


Reporting Annual Performance Measures and Benchmarks

Midway through each budget period, Healthy Start grantees are required to submit a Progress Report to HRSA describing their progress toward achieving their annual work plan goals for the 19 Healthy Start Benchmarks. At the conclusion of each budget period, grantees must submit a Performance Report to HRSA/MCHB’s Discretionary Grant Information System (DGIS) with final calendar year calculations for the cross-cutting and Healthy Start-specific Performance Measures. The HS Benchmarks Data Dictionary (Nov. 2020) provides a crosswalk between the 19 Healthy Start Benchmarks, the DGIS Performance Measures, and the three Healthy Start Data Collection Forms to assist grantees in accurately calculating the required reporting measures and completing the annual reports. The HS Benchmarks Data Dictionary provides definitions for each Benchmark/Performance Measure, details the numerator and denominator calculations for each measure, and identifies the HS Data Collection Form questions to be used to calculate each measure.

HS Benchmarks Data Dictionary (Nov. 2020)


Reporting Monthly Aggregate-level Data

The Healthy Start Aggregate Data Reporting Template allows HRSA to collect aggregate-level information and report on key data components from all Healthy Start programs. Download and complete the template on a monthly basis. Refer to the corresponding Healthy Start Aggregate Template User Guide and Data Dictionary for instructions on how to complete the template, due dates, and where to send your data.


Reporting Monthly Client-level Data to the HSMED-II

Beginning November 19th, 2020, Healthy Start program grantees will resume submitting client-level data as required by their grant awards. Client-level information is collected using the three Healthy Start Data Collection Forms and must be submitted monthly through the Healthy Start Monitoring and Evaluation Data System (HSMED-II). The HSMED-II is now integrated with HRSA’s Electronic Handbooks (EHBs), and is accessible using EHBs login information. The HSMED-II Fact Sheet provides a brief overview of the new system, and answers to common grantee questions, including reporting dates and expectations. The HSMED-II User Manual includes in-depth instructions on accessing the new system, uploading data, submitting finalized reports for approval, and requesting Technical Assistance. The HSMED Common Issues Guide provides helpful tips and troubleshooting instructions to resolve general issues grantees have encountered when uploading files to the HSMED-II.

HSMED-II Fact Sheet (Nov. 2020)

HSMED-II User Manual (Nov. 2020)

HSMED-II Common Issues Guide

To successfully submit monthly client-level information, each grantee must create and upload Extensible Markup Language (XML) or Comma Separated Values (CSV) files containing client-level data collected during the month prior to reporting. The structure, sequence, values, and format of the data elements in the client-level data files must conform to the definitions specified in the XML/CSV reference materials. Once the client-level data files are uploaded, each grantee will use the HSMED-II’s validation tool to ensure the uploaded files conform to the data schema and business rules outlined in the XML/CSV reference materials before finalizing their submission.

*Note: No CSV-to-XML conversion is required to submit client-level data; the HSMED2 will accept both XML and CSV data files.

XML-CSV Schema & Data Dictionary (Feb. 2022) and XML-CSV Templates (Feb. 2022) are zip files that contain the HSMED-II Healthy Start client-level data XML/CSV schema and related files. You will need to “unzip” the files using these instructions for Windows/PC or Mac.

HSMED-II Implementation Guides for each data collection form are linked below. General instructions for generating compliant files are included in the Background Form Implementation Guide. A tracked changes file is also available to assist grantees in identifying updates made to the implementation guides in November 2020.

Instruction and Background Form Implementation Guide (Feb. 2022)

Prenatal Form Implementation Guide (Feb. 2022)

Parent/Child Form Implementation Guide (Feb. 2022)

Tracked Changes File (Feb. 2022)


HSMED Aggregate Dashboard – Video Transcript

In July 2021, the HSMED Reports Dashboard was released to provide grantees near-real time insights into their monthly submitted client-level data. The HSMED Reports Dashboard is accessed via HRSA’s Electronic Handbooks (EHBs), and includes three reports – Participants Served, Data Collection Detail, and Participant Linkages. Similarly to the HSMED, Healthy Start Project Directors control access to the dashboards and can grant access privileges to any individual with an EHBs account. For an overview of the HSMED Reports Dashboard, including instructions for Project Directors to grant access privileges to others, please see the below training video and video transcript