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.

MCH Block Grant Application

We invite you to review our Title V FY2022 Block Grant Application, which also includes our FY2020 Annual Report. Our annual Title V Application was submitted on August 31,2021. This application, along with our State Action Plan, will be our guide for the work we will continue to accomplish over the next four years. We are committed to continuing our efforts to collaborate with our partners and community members to ensure that our efforts and resources are aligned with the priority needs of Delaware’s mothers, children and youth with special health care needs.

We welcome your ideas, suggestions, and comments on our Title V Block Grant Application. Additionally, if you have any input regarding our progress, we’d love to hear that as well.

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

Elizabeth.Orndorff@delaware.gov
Crystal.Sherman@delaware.gov

MCH FY2022 Title V Block Grant

 

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

 

MCH Performance Measures

The 15 National Performance Measures (NPMs) and 38 National Outcome Measures (NOMs) were established for the Title V Block Grant program. Each one crosses a maternal and child health (MCH) population domain and reflects our MCH population health status. The chart below displays Delaware’s baseline data for each of the NPMs and NOMs in addition to each data source used to track the measure.

During the summer of 2021, Delaware sought to complete a Mini Needs Assessment to gauge the impacts of the COVID-19 pandemic on our maternal and child health population as well as our partners. Through a Stakeholder Survey, we also wanted to identify ways MCH can better support our Title V funded partners with technical assistance. This data sheet was created as a result of the survey, where 60% of our Title V partners requested MCH provide data as a way to support and assist them with their needs.

We hope this MCH Performance Measure data sheet will support our partners and our stakeholders with the very important maternal and child health work they do!

MCH Performance Measures

 

Executive Summary

Delaware’s Title V priorities and plans for the coming year are presented below by population domain, as defined by the federal Maternal and Child Health Bureau. These population domain “snapshots” convey a brief overview of our goals, progress, and plans for each health area. In some of the health areas, we are building on years of previous work and partnerships and have very detailed action plans forward. In others, we are forging into new territory and will be spending the time over the course of the five year grant cycle learning, building expertise, and establishing new relationships.

Please note that these plans represent the role that the Title V Program can play in improving the health of mothers and children, given our resources and capacity, and are not intended to be a comprehensive strategic plan to address each of the targeted health areas. Moving the needle on any of these health priority areas will require collective effort from many partners throughout the state. For more detail, please review Delaware’s full Title V Maternal and Child Health Block Grant application.

Program Overview Executive Summary

 

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 –
Women
Preventive Dental Visit - Children National Performance Measure 13.2: Preventive Dental Visit –
Children
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

 

Response to Covid-19 Mini Needs Assessment

As we continue to face the ongoing consequences of the COVID-19 pandemic, Title V remains committed to improving our ability to support programs that continue to address the maternal and child health populations. During the summer of 2021, MCH sought to better understand how COVID-19 has impacted our populations as well as how our stakeholders have been adapting to the ongoing challenges of the pandemic. Additionally, our goal was to be more informed of the ways that our partners were adjusting to address COVID-related response needs.

We asked our partners and stakeholders to complete a voluntary survey so that we could determine how each health domain is being impacted and whether revisions to our health priorities are necessary. We asked questions about our partners’ experiences, such as the use of telehealth and virtual services, as well as the importance of each health domain, given the pandemic, shifts in staffing, and more.

This report is a summary of our Mini Needs Assessment. We invite you to read through the report for response analysis and additional information.

Download Survey Results Document


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!

KEY INFORMANT INTERVIEW REPORT

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.