Montanas MCH Needs Assessment and Strategic Planning

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Montanas MCH Needs Assessment and Strategic
Planning
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Montana Overview

• Just under 1,000,000 state population
• 50 of population urban, 50 rural
• Largest city is just over 100,000
• 87 white, 7 American Indian
• 12,000 births annually
• 84 white, 11 American Indian
• Family and Community Health Bureau includes
  MCHBG, WIC, Title X, Childrens Special Health
  Services (CSHCN), home visiting, fetal, infant,
  child mortality reviews, newborn hearing and
  metabolic screening

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Montanas Needs Assessment

• Stakeholder survey
• WIC and Health Start parents and staff, county
  PHNs, tribal partners, advisory councils, program
  managers, physicians
• Over 1000 survey responses
• Data
• Summarized needs by population groups
• Broad perspective

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Montanas Strategic Planning

• Scattered and diverse stakeholders
• Variety of tools used
• Surveys (paper and electronic)
• Emails
• Large group meetings with facilitators
• Workgroups
• Section meetings
• Tied in to all of the grant requirements/reporting
  requirements in Bureau (WIC, Title X, MCHBG,
  Oral Health, FASD, Youth Suicide Prevention,
  etc.)
• Partnerships were key

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Needs Assessment
Stakeholder meeting Draft Vision, Mission,
Guiding Principles, Priority Areas
Stakeholder survey Finalize Vision, Mission,
Guiding Principles
Stakeholder survey CAST-5 Process Indicators
Workgroups Priority Areas
Stakeholder meeting CAST-5 SWOT and Capacity
Needs
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Needs Assessment
Stakeholder meeting Draft Vision, Mission,
Guiding Principles, Priority Areas
Stakeholder survey Finalize Vision, Mission,
Guiding Principles
Stakeholder survey CAST-5 Process Indicators
Workgroups Priority Areas
Stakeholder meeting CAST-5 SWOT and Capacity
Needs
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CAST-5

• Capacity Assessment for State Title V
• AMCHP and JHU Womens and Childrens Health
  Policy Center
• Based on 10 essential services for MCH
• Assessment and planning tools for examining
  organizational capacity
• Framework for discussion
• Can use portions of the tools

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10 MCH Essential Services

• 1. Assess and monitor maternal and child health
  status to identify and address problems.
• 2. Diagnose and investigate health problems and
  hazards affecting women, children, and youth.
• 3. Inform and educate the public and families
  about maternal and child health issues.
• 4. Mobilize community partnerships between
  policymakers, health care providers, families,
  the general public, and others to identify and
  solve maternal and child health problems.
• 5. Provide leadership for priority-setting,
  planning, and policy development to support
  community efforts to assure the health of women,
  children, youth and their families.
• 6. Promote and enforce legal requirements that
  protect the health and safety of women, children
  and youth, and ensure public accountability for
  their well-being.
• 7. Link women, children and youth to health and
  other community and family services, and assure
  access to comprehensive, quality systems of care.
• 8. Assure the capacity and competency of the
  public health and personal health workforce to
  effectively and efficiently address maternal and
  child health needs.
• 9. Evaluate the effectiveness, accessibility, and
  quality of personal health and population-based
  maternal and child health services.
• 10. Support research and demonstrations to gain
  new insights and innovative solutions to maternal
  and child health-related problems.

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Survey
Meeting
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Process Indicator Example
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Capacity Need Example
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Capacity Needs Priorities

• Greater authority, and sufficient funds to carry
  out mandates and meet needs.
• Adequate data infrastructure (access to more and
  better data).
• More capabilities related to translation and
  communication of data.
• Staff with basic data skills in all
  units/programs of FCHB, and additional staff with
  advanced skills in data analysis.
• Improved collaborative working partnerships with
  state and local health programs.
• Enhanced management and organizational
  development skills among staff.
• Expanded relationships with additional
  stakeholders, policy makers, advocacy groups,
  funders, and the business sector.

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Capacity Needs Workgroups

• Data Capacity
• Adequate data infrastructure
• More capabilities related to translation and
  communication of data
• Staff with basic data skills in all
  units/programs of FCHB, and additional staff with
  advanced skills in data analysis
• Organizational Relationships
• Improved collaborative working partnerships with
  state and local health programs
• Expanded relationships with additional
  stakeholders, policy makers, advocacy groups,
  funders, and the business sector
• Skills
• Staff with basic data skills in all
  units/programs of FCHB, and additional staff with
  advanced skills in data analysis
• Enhanced management and organizational
  development skills among staff

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Needs Assessment
Stakeholder meeting Draft Vision, Mission,
Guiding Principles, Priority Areas
Stakeholder survey Finalize Vision, Mission,
Guiding Principles
Stakeholder survey CAST-5 Process Indicators
Workgroups Priority Areas
Stakeholder meeting CAST-5 SWOT and Capacity
Needs
Workgroups Capacity Needs
Bureau- and section-level meetings Goals,
Objectives, New Priority Area
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Thats Not My Job

• This is a story about four people
• Everybody, Somebody, Anybody and Nobody.
• There was an important job to be done and
  Everybody was asked to do it.
• Everybody was sure that Somebody would do it.
• Anybody could have done it, but Nobody did.
• Somebody got angry (about that) because it was
  Everybodys job.
• Everybody knew that Anybody could do it, but
  Nobody realized that Somebody wouldnt do it.
• And it ended up that Everybody blamed Somebody
  because Nobody did what Anybody could have done.

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You Manage ThingsYou Lead People.

• - Rear Admiral Grace Murray Hopper

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If you dont know where you are going, you will
probably end up somewhere else.

• Laurence J Peter, 1919-90
• 1969 book The Peter Principle

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Met needs, unmet needs and priorities

• To what extent and in what ways can a needs
  assessment identify met versus unmet needs? How
  should met and unmet needs relate to priorities?
• Example Immunizations arent identified as a
  need by county public health staff and parents
  because they havent had trouble providing
  immunization services or accessing immunizations
  for their children. They may be considered a met
  need, not an unmet need. However, if asked, they
  may identify continuation of immunization
  services as a priority.

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Balancing types of input

• How do you weight or balance differing
  perspectives? How should the types of input and
  types of needs identified relate to priorities?
  What role does data play when it conflicts with
  the majority of stakeholders?
• Example Public health professionals may
  recognize the importance of newborn screening,
  but parents and others who dont work with kids
  and families who may have benefited from
  screening may not recognize it as a need or
  priority.