Title V Maternal and Child Health

Title V of the Social Security Act reflects our nation’s commitment to improving the health and well-being of mothers, children, including children with special health care needs, and their families.  It is operationalized through a block grant.

In Delaware, the Title V Block Grant serves as the foundation for much of our Maternal & Child Health (MCH) Program.  The Division of Public Health (DPH) coordinates and collaborates with many organizations and other state agencies to implement activities that address grant goals and objectives.


Title V MCH Block Grant Application

Our annual Title V FY2021 Block Grant Application was submitted on September 15, 2020. This, along with our State Action Plan, will guide the work we do over the next five years. We are committed to continuing to collaborate with our partners and community members to ensure that our efforts and resources are aligned with the priorities of Delaware’s mothers, children, and youth with special health care needs.

Please reach out to our Title V MCH Coordinator, Elizabeth Orndorff, or our MCH Deputy Director, Crystal Sherman, with any ideas, suggestions, and comments. Their contact information is below.


MCH FY2021 Title V Block Grant


Title V State Action Plan Snapshot

As part of the Title V Maternal and Child Health (MCH) Block Grant, Delaware has developed a five-year State Action Plan Snapshot to address our priority needs. Our Plan is organized by six reporting domains, which includes five MCH population domains (Women/Maternal Health, Perinatal/Infant Health, Child Health, Children and Youth with Special Health Care Needs (CYSHCN), and Adolescent Health). The sixth domain addresses state-specific Cross-cutting/Systems Building needs.

This State Action Plan offers an at-a-glance snapshot for the public, our partners, and our stakeholders to better understand our five-year plan. This report identifies the priority needs within each of the six domains, the program objectives, key strategies and relevant national and state performance measures for addressing each objective.

Delaware’s Maternal and Child Health Five-Year Plan — 2020-2025


Title V Executive Summary

Part of the MCH Title V Application contains an Executive Summary component. This is divided into three sections: Program Overview, How Federal Title V Funds Support State MCH Efforts, and MCH Success Story. If you’d like to review our Executive Summary, it begins on page 7 of the Title V Block Grant Application.

Delaware also created a version of the Executive Summary that condenses the information into an easy-to-read table. The sections are broken down into the five health domains: Women and Maternal Health, Perinatal and Infant Health, Child Health, Adolescent Health, and Children and Youth with Special Health Care Needs.

We hope this remodeled Executive Summary helps you understand Delaware’s needs, accomplishments, and plans.

Program Overview Executive Summary


Title V Needs Assessment

Every five years MCH conducts a Five Years Needs Assessment, which takes anywhere from 12-18 months to complete and is quite extensive in nature.  As part of the process, MCH will need to identify findings, such as Delaware’s:

  • Population Health Status
  • Title V Program Capacity (Organizational Structure, Agency Capacity and MCH Workforce Capacity)
  • Program Partnerships, Collaboration and Coordination
  • 7-10 State Priority Needs

MCH conducts a Needs Assessment every five years to obtain:

  • An accurate and complete picture of the strengths and weaknesses of a state’s public health system
  • Inform priorities, understand gaps, and set the agenda
  • Understand, allocate, and develop available resources to meet needs
  • Improve maternal, child, family, and community health outcomes


How Can You Help?

  • Complete the Stakeholder Survey.
  • Review Title V data infographics and chat n chew (qualitative) analysis for further information.
  • Participate in the Key Informant Interviews, if contacted.
  • Check back often for updated information and resources! Thank you!


National Performance Measures for Title V

There are 15 National Performance Measures that have been identified for the Title V MCH Services Block Grant.  These Performance Measures are arranged under five Population Domains: Women/Maternal Health, Perinatal/Infant Health, Child Health, Adolescent Health, and Children with Special Health Care Needs.

These 15 National Performance Measures are: Well-Woman Visit, Low-Risk Cesarean Delivery, Risk-Appropriate Perinatal Care, Breastfeeding, Safe Sleep, Developmental Screening, Injury Hospitalization, Physical Activity, Bullying, Adolescent Well-Visit, Medical Home, Transition, Preventive Dental Visit, Smoking, and Adequate Insurance.

Displayed below is an Infographic created for each National Performance Measure to help you better understand each performance measure, the objectives of each as well as Delaware’s baseline data for each performance measure.


National Performance Measures

Well Woman Visit National Performance Measure 1: Well Woman Visit
Low Risk Cesarean Delivery National Performance Measure 2: Low Risk Cesarean Delivery
Risk Appropriate Perinatal Care National Performance Measure 3: Risk Appropriate Perinatal Care
Breastfeeding National Performance Measure 4: Breastfeeding
Safe Sleep National Performance Measure 5: Safe Sleep
Developmental Screening National Performance Measure 6: Developmental Screening
Injury Hospitalization National Performance Measure 7: Injury Hospitalization
Physical Activity National Performance Measure 8: Physical Activity
Bullying National Performance Measure 9: Bullying
Adolescent Well Visit National Performance Measure 10: Adolescent Well Visit
Medical Home National Performance Measure 11: Medical Home
Transition National Performance Measure 12: Transition
Preventive Dental Visit - Women National Performance Measure 13.1: Preventive Dental Visit –
Preventive Dental Visit - Children National Performance Measure 13.2: Preventive Dental Visit –
Smoking National Performance Measure 14: Smoking
Adequate Insurance National Performance Measure 15: Adequate Insurance


National Outcome Measures

National Outcome Measure 5: Preterm Birth
National Outcome Measure 9: Infant Mortality
National Outcome Measure 11: Neonatal Abstinence Syndrome



To create solutions to address the complex challenges of the Maternal and Child Health system, it is important to understand how the system and its components shape health. The Five-Year Needs Assessment process allows state Title V programs to begin to understand the complexity of these challenges, identify needs, and select priority areas of focus.

In Spring 2020, the Maternal and Child Health section contracted JSI Research and Training Institute, Inc. to conduct key informant interviews with identified stakeholders to gather insight into the strengths and needs of the MCH populations, as well as gaps and leverage points in the system of care.

A total of 13 interviews were completed with stakeholders with expertise in at least one of the five MCH population domains: 1) Women and Maternal Health; 2) Perinatal and Infant Health; 3) Child Health; 4) Adolescent Health; and 5) Children and Youth with Special Health Care Needs. Informants included administrative and clinical staff as well as service coordinators. The interview asked informants to describe their organization’s role in addressing a specific population domain, its reach and population focus, its partnerships, the strengths and challenges of Delaware’s current system of care, and disparities and emerging issues.

Key Informant Interviews Final Report

Focus Group Analysis – A Review of Key Findings and Recommendations

The focus group study, commissioned by the Delaware Division of Public Health (DPH), Maternal and Child Health section, was conducted over a period of several months, from July through September 2019, by several consultants who moderated, recruited participants, observed, transcribed notes, and prepared written reports.

The overall objective was to learn from the study’s various subgroups about the general health care and reproductive health needs and concerns of women in Delaware, in order to improve service delivery and the health outcomes of women, children, and their families.

Twelve discussion groups were held statewide – in Wilmington, for New Castle County; and in Dover, Georgetown, and Milford for Kent and Sussex counties.  Moderators led two-hour discussions, with groups of either nine or 10 respondents.

The 12 Focus Groups were broken down by: four Pregnant Women and Women with Children groups, four Parents of Children and Youth With Special Health Care Needs groups, two Father/Partner groups and two Preconception Women groups.

We invite you to explore the Focus Group Analysis and Recommendations for further information.

Focus Group Analysis


Stakeholder Survey Analysis

Delaware’s needs assessment process is collecting information from stakeholders in a variety of ways, including focus groups with community members, a survey of stakeholders, and key informant interviews with partners. Each source provides important perspectives, context, and data to help the Title V program identify priorities.

The survey was ultimately distributed to 851 stakeholders, after undeliverable email addresses were removed. Of those, 172 people accessed the survey, but 53 people either did not answer any questions (n=27) or answered only the first question or two (n=36). The remaining 109 survey responses were quite usable — they were made up of 104 completed surveys and five partially completed surveys (made it about halfway through). The analysis presented in this report is based on the 109 usable surveys, which represent a 13% response rate (109/851).

This report is a summary of the findings of the Stakeholder Survey. We invite you to explore the Stakeholder Survey Analysis and Recommendations for additional information.

Delaware Stakeholder Survey Report


Needs Assessment Conceptual Framework

Needs Assessment Conceptual Framework


Be on The Lookout!

We invite you to review the qualitative analysis of our Title V Focus Group Reports, where the Division of Public Health sought to gain insight from community members.  We’d also welcome you to review our Needs Assessment Conceptual Framework, where you can better understand the Needs Assessment process and be informed of upcoming events.  In addition, once the results and analysis of the Stakeholder Survey are received, they will be posted for review.