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Strengthen the Evidence for Maternal and Child Health Programs

Find State ESMs

Find Evidence-based/informed Strategy Measures (ESMs) that are currently in use by states and jurisdictions as well as those that have been completed. You can search by key word (e.g., WIC, hospital), NPM, or state/jurisdiction.

Note: checking more items from the drop-downs narrows your search. If your search finds "no records," try another search with fewer boxes checked.

(do not choose a selection here if you choose a region above)

The MCH Evidence Center has analyzed thousands of interventions to find strategies that have the potential to be effective in practice. These strategies can be mapped across a continuum of evidence that facilitates the most rigorous MCH science while also encouraging innovation. Levels of evidence are described below. Note: current ESMs that relate directly to the evidence base align with moderate evidence, expert opinion, emerging evidence, or mixed evidence. There are many ESMs that do not directly link to an evidence-based strategy because they measure population outcomes (e.g., access to/receipts of care or improved circumstances) rather than process (i.e., strategies to facilitate outcomes).

Chart showing the Evidence Levels

To move the field from measuring "what did we do?" to "how well did we do it?" and eventually to "is anyone better off from our efforts?" we use the Results-Based Accountability framework. In this model, we want to move:

  • From measuring quantity (#s, such as counts and yes/no) to measuring quality (% reach, satisfaction, or service that meets standards) (lowest measurement is Quadrant 1).
  • From measuring effort (what we did) to measuring effect (how our target audience increased their skills/knowledge, attitude/opinion, or behavior/circumstance).

This chart summarizes the differences in measurement. Note: not everyone needs to be measuring all Quadrant 4 ESMs; the most effective measurement combines a mix of quadrants.

Chart showing four stages of measurement

The 10 Essential Public Health Services provide a framework for public health agencies to protect and promote the health of all people in all communities.To achieve optimal health for all, the Essential Public Health Services actively promote policies, systems, and services that enable good health and seek to remove obstacles and systemic and structural barriers, such as poverty, racism, gender discrimiation, and other forms of oppression, that have resulted in health inequities. Title V professionals can use the Essential Public Health Services as a structure to organize strategies. For more information, visit

Chart showing the 10 Essential Public Health Services

ESMs can be categorized based on the levels of the MCH Pyramid. As a field, we are trying to "move down the pyramid" in providing fewer direct services and more enabling and public health systems services.

Chart showing the MCH Pyramid

Each ESM has someone who is the actual recipient of a service, training, our other activity. ESMs can thus be categorized by those that focus on:

  • Activities directed to families/children/youth (e.g., Bright Futures or other outreach materials provided to families).
  • Activities directed to professionals (e.g., trainings provided to local staff).
  • Activities related to systems-building (e.g., % of birthing facilities with a Safe Sleep Certification).

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.