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Performance Measures

With the MCH transformation and its emphasis on performance and accountability at both the state and national levels, the national performance measurement system is now intended to show more clearly the contributions of Title V programs in impacting health outcomes while still maintaining flexibility for the states. The national performance measurement system adopted is a three-tiered framework, which includes the following measure categories: National Outcome Measures (NOMs), National Performance Measures (NPMs), and State-Initiated Evidence-based or -informed Strategy Measures (ESMs).

The NPMs are intended to drive improved outcomes relative to one or more indicators of health status for the MCH population, so states will track the NOMs to monitor the impact of the NPMs. ESMs are the final tier of the national performance measurement framework, and they are the measures by which states will directly measure the impact on the NPMs. State-specific and actionable, the ESMs seek to track a state Title V program’s strategies and activities to measure evidenced-based or evidence-informed practices that will impact individual population-based NPMs. The ESMs are developed by the state, and they provide accountability for improving quality and performance related to the NPMs and to the MCH public health issues for which they are intended. While not part of the national performance measurement framework, states will also develop State Performance Measures (SPMs), in addition to the ESMs, to address priorities identified based on the findings of their Five-Year Needs Assessments and to the extent that a priority need has not been fully addressed through the selected NPMs and ESMs.

The NPMs address key national MCH priority areas. Collectively, they represent six MCH population health domains: 1) Women/Maternal Health; 2) Perinatal/Infant Health; 3) Child Health; 4) Children with Special Health Care Needs; 5) Adolescent Health; and 6) Cross-Cutting/Systems Building. The six population health domains are contained within the three legislatively-defined MCH populations.

The following links include the Alabama-selected NPMs, their associated NOMs, and the MCH Priority Needs.





Page last updated: March 1, 2024