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Evaluating HRSA’s Healthy Start Program


  • HRSA requested a rigorous evaluation of the Healthy Start program.
  • Abt conducted the first matched analysis for HS on a national level.
  • Abt presented findings through a final evaluation report and in-person briefing.
The Challenge

HRSA’s Maternal and Child Health Bureau (MCHB) has administered the Federal Healthy Start (HS) Program for 25 years to promote and improve the health of women and children.  In 2014, HS began funding grantees to incorporate new, more rigorous approaches to program evaluation. To support efforts to reduce infant mortality rates and other adverse maternal and infant health outcomes nationallyas well as reduce racial and ethnic disparities in rates of infant deathan analysis to describe HS women, examine associations between individual characteristics and selected health and behavioral outcomes, and compare outcomes between HS women and matched non-HS women was needed.

The Approach

Abt used three different data sources for a multimethod approach, which is generally considered to provide more robust and more complete results than single-method designs. Few local HS programs have undertaken the complex and resource-intensive process required to link program data to state vital records, and even fewer have incorporated surveillance data. Abt’s study not only linked HS program data to state vital live birth and infant death records, but also to CDC PRAMS survey data. This assessment is the first matched analysis for HS on a national level.

The Results

Abt presented evaluation findings through a final report and in-person briefing to key HRSA MCHB staff. HRSA MCHB presented the evaluation findings at the CityMatCH Leadership and MCH Epidemiology Conference in September 2020. Abt is currently collaborating with HRSA MCHB and CDC on a manuscript related to the evaluation.