The U. S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB) has conducted several independent evaluations of the Federal Healthy Start Program since the program began in 1991. The Bureau awarded a multi-year contract in 2009 to Abt Associates Inc. to conduct the current evaluation.

The first national evaluation of the Federal Healthy Start Program, conducted by Mathematica Policy Research in 1997 – 1999, examined the implementation of the 15 demonstration projects during fiscal years 1992 and 1996, and whether these projects achieved the goals of Healthy Start in reducing infant mortality and improving maternal and infant health. Findings suggested that Healthy Start was associated with improvements in measurements of prenatal care utilization, preterm birth rate, low and very-low birth weight rates, and the infant mortality rate. Specifically, several sites had significantly better outcomes than comparison sites.

The second national evaluation was comprised of two phases. A key objective of the first phase of this evaluation (conducted from 2002 to 2004) was to provide information about the funded grantees and the implementation of the program components of the National Healthy Start program. Findings from this first phase were published in a similar report in 2006. The second phase consisted of eight case studies, including a survey of Healthy Start participants.

The current evaluation, which builds on the previous evaluations, and uses a logic model (shown in Appendix 1.1) to illustrate how implementation of the nine program components may lead to a progression of the achievement of some short-term outcomes, which in turn, may translate into intermediate outcomes and then to longer-term outcomes. This evaluation is consistent with the needs of the MCHB to meet the requirements of the Government Performance and Results Act (GPRA).

This report provides the descriptive findings from the Grantee Project Director Survey of 2011 and documents the accomplishments of the Federal Healthy Start Program.