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- Framework and Tools
- List of Tools by Step
- Step 1. Engage Partners
- Step 2. Assess Needs
- Step 3. Examine Strengths and Capacity
- Step 4. Select Priorities
- Step 5. Set Performance Objectives
- Step 6. Develop Action Plan
- Step 7. Seek and Allocate Resources
- Step 8. Monitor Progress for Impact on Outcomes
- Step 9. Report Back to Partners
- State and Jurisdiction Links
3. Examine Strengths and Capacity
Introduction
On Your Mark: Start Here with Grounding Concepts and the Evidence BaseThe third step in the process involves examining the Title V agency's capacity to engage in various activities such as conducting the statewide five-year needs assessment and collecting/reporting performance data based on the five MCH population health domains.
Specifically, this step entails describing and assessing the state’s current resources, activities, and services as well as the state’s ability to continue to provide quality services by each of the three MCH service levels:
- Direct Services.
- Enabling Services.
- Public Health Services and Systems.
Importance of Examining Strengths and Capacity
By starting the needs assessment process with an examination of the agency's own strengths and capacity, this allows the Title V team to:
- Lay the groundwork for conducting the actual assessment. Understanding the agency's current capabilities is crucial for identifying gaps and developing strategies to address community health needs effectively.
- Inform resource allocation decisions. A clear picture of the agency's resources, activities, and services allows for informed decisions about resource allocation, ensuring that funds and personnel are utilized efficiently and effectively.
- Promote continuous improvement. Regular examination of capacity enables the agency to identify areas for improvement and implement strategies to enhance its ability to address evolving community needs and emerging health threats.
Barriers to Examining Strengths and Capacity
There are a number of barriers that can make it difficult to conduct internal capacity. These include:
- Lack of standardized assessment tools. The absence of uniform assessment tools and frameworks makes it challenging to compare results across different agencies, hindering benchmarking and best practice sharing.
- Resource constraints. Public health departments often face budgetary limitations and staffing shortages, making it difficult to dedicate resources to conducting a comprehensive capacity examination.
- Dynamic nature of public health. The ever-changing landscape of public health necessitates regular reevaluations of capacity to ensure that the Title V agency remains adaptable and responsive to emerging challenges and opportunities.
The MCH Evidence Center has reviewed the literature to find strategies for examining strenghs and capacity:
- Brownson R.C., Fielding J.E., Green L.W. Building Capacity for Evidence-Based Public Health: Reconciling the Pulls of Practice and the Push of Research. Annual Review of Public Health 2018 39:1, 27-53
- Raskind, I.G., Chapple-McGruder, T., Mendez, D.D., Kramer, M.R., Liller, K.D., Cilenti, D., Wingate, M.S., Castrucci, B.C., Gould, E. and Stampfel, C., 2019. MCH workforce capacity: Maximizing opportunities afforded by a changing public health system. Maternal and Child Health Journal, 23, pp.979-988.
- Ramos, L.R., Tissue, M.M., Johnson, A., Kavanagh, L. and Warren, M., 2022. Building the MCH public health workforce of the future: A call to action from the MCHB strategic plan. Maternal and Child Health Journa, 26(Suppl 1), pp.44-50.
Learn What Works
Get Ready: Immerse Yourself in Effective Strategies and Learn MoreThere are a number of strategies that can be used to examine the Title V agency's capacity as part of the needs assessment process. These include:
- Embrace a participatory approach. Engage participants from various levels, including agency staff, community members, and external experts, to gather diverse perspectives and foster a shared understanding of the agency's strengths and weaknesses.
- Rely on data-driven methods. Utilize a combination of quantitative and qualitative data collection methods, such as surveys, focus groups, performance reviews, and data analysis, to obtain a comprehensive assessment of the agency's capacity.
- Engage in a continuous quality improvement framework. Adopt a continuous quality improvement framework that encourages regular evaluation, identification of areas for improvement, and implementation of evidence-based strategies to enhance capacity over time.
- Evaluate leadership and management practices. Assess the effectiveness of leadership and management practices in areas such as strategic planning, decision-making, performance management, and communication.
- Analyze organizational structure and culture. Evaluate the agency's organizational structure and culture to identify areas that may hinder or facilitate effective functioning.
- Assess workforce capacity. Evaluate the qualifications, skills, and experience of the agency's workforce to determine if they align with the department's goals and objectives.
- Measure program effectiveness. Evaluate the effectiveness of the department's programs and services in achieving desired outcomes and improving community health.
- Compare performance to benchmarks. Compare the agency's performance to national, state, or local benchmarks to identify areas where improvement is needed.
- Conduct external reviews. Engage external experts to conduct a comprehensive review of the agency's capacity, providing an objective and unbiased assessment.
- Utilize technology. Leverage technology tools, such as data management systems, performance dashboards, and collaboration platforms, to enhance capacity assessment efforts.
- Seek accreditation. Pursue accreditation from a recognized public health organization, which involves a rigorous assessment of the agency's capacity against established standards.
These trainings have been collected by the MCH Navigator:
- Advancing Health Equity through Asset Framing. Developed: 2022. Source: National MCH Workforce Development Center and MCH Navigator. Presenter(s): Jeannine Herrick and Ki'Yonna Jones. Type: MCHwork Microlearning Program. Level: Intermediate.
- Asset Mapping: Starting System Change with What You Already Have. Developed: 2019. Source: National MCH Workforce Development Center. Presenter(s): Rebecca Wells. Type: Video. Level: Intermediate.
- Data Reporting and Quality Measurement—An Introduction. Developed: 2016. Source: Substance Abuse and Mental Health Services Administration. Presenter(s): Peggy O’Brien, PhD, JD. Type: Webinar. Level: Introductory. Length: 60 minutes.
- Public Health Pronto-Analytical/Assessment Skills. Developed: 2016. Source: MCH Navigator. Presenter(s): Suzanne Bronheim, PhD. Type: Webinar. Level: Introductory. Length: 6 minutes.
- Measures and Measurement. Source: The George Washington University, School of Nursing. Type: Video Lecture. Level: Introductory. Length: 8 minutes.
Tools to Try
Get Set: Use these Tools to Move from Knowledge to ImplementationThese tools and examples have been developed by the National MCH Workforce Development Center or collected by the MCH Digital Library:
- Asset Mapping. A tool to help stakeholders examine assets and gaps within the maternal and child health system. Understanding assets will help stakeholders select priorities and act.
- Capacity Assessment for State Title V (CAST-5). A set of assessment and planning tools for examining organizational capacity to carry out key MCH program functions.
- Hexagon Tool. This planning and evaluation tool guides the selection of the appropriate, evidence-based/informed strategies through a six-step exploration process. It can be used in collaboration with your partners to better understand how a new or existing program fits into your existing work, context, and health equity priorities.
- Network Mapping and Analysis. A tool to identify what partnerships and collaborations exist to support selected priorities. This tool helps identify linkages that need to be created or strengthened to reach our outcome.
- Whole System Mapping. A tool used to capture a full picture of current services provided for maternal and child health, including where, by whom, and intensity of service. This tool provides an opportunity for stakeholders to see complementary system components and discuss how the parts (could) work together to address identified needs.
These resources have been collected by the MCH Digital Library:
- Using a Workforce Capability Assessment for Organisational Development. This article walks through the whys of consistently assessing workforce capability and exactly how to do it.
- CliftonStrengths Explains HowYou Are Uniquely Powerful. Use the Clifton Strengths finder to learn about each employee’s strengths and help them thrive at work.
- Everything DISC. An assessment-based learning experience helps your people better understand themselves and others – empowering them to work better together.
- How to Assess Employee Skills in the Workplace. An approach to measure and assess employee skills.
- Public Health Workforce Interest and Needs Survey. Use these dashboards to explore the national findings from PH WINS 2021. To examine the data in more detail, try applying filters, comparing subsets of the workforce, or selecting a topic or subgroup of interest.
Title V Tools and Examples
Go: Learn from Your Peers Across the CountryThese tools have been collected by AMCHP and the MCH Evidence Center:
- Wisconsin: Staff Capacity Survey. This anonymous survey is used to assess staff capacity at the Wisconsin Department of Health Services Maternal and Child Health Program.
- Oregon: Capacity and Forces of Change Questions for Online Discussion Forum. These are the questions that were used in an online discussion forum to solicit feedback from partners on capacity and forces of change in Oregon. Partners included in these discussion forums included Coordinated Care Organizations, Early Learning Hubs, and community agency partners.
- MCH Workforce Profile. An example of a workforce assessment can be found in this Kansas Title V Needs Assessment (see page 41).
Share Your Stories and Strategies
Please take a moment to share your stories and strategies related to Step 3 of your needs assessment that you would like highlighted on this page. By sharing your stories, you help to document the needs assessment process for use by other Title V agencies during this cycle and will help preserve this knowledge for needs assessment processes in the future.