3. Examine Strengths and Capacity

3. Examine Strengths and Capacity

Introduction

On Your Mark: Start Here with Grounding Concepts and the Evidence Base

The 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:

  1. Direct Services.
  2. Enabling Services.
  3. 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 strengths and capacity:

Learn What Works

Get Ready: Immerse Yourself in Effective Strategies and Learn More

There 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:

Tools to Try

Get Set: Use these Tools to Move from Knowledge to Implementation

These tools and examples have been developed by the National MCH Workforce Development Center or collected by the MCH Digital Library:

  • Start Here: MCH Workforce Capacity Assessment Templates. This Word document presents two draft assessment tools based on (1) capacity related to MCH levels of service and (2) capacity based on internal staff capacity. Users can adopt or adapt either or both tools to assess capacity and areas for growth.
  • 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:

Title V Tools and Examples

Go: Learn from Your Peers Across the Country

Tools

These 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).

Stories and Strategies for Peer-to-Peer Learning

These stories and strategies have been collected by AMCHP and the MCH Evidence Center related to Step 3:

  • Hawaii: Conducting quantitive/focus groups partnering with community organizations. Finding good consultants to help analyze - qualitative data, assist with planning.
  • Kentucky: ID strengths, weaknesses, assets. How do you do this? ID partners. 1. funder. 2. convener. 3. informed. 3–4 sessions for small states. 3. Strengths and capacity. 4. Select priorities. What I'm doing! 1. coordinating the needs assessment activities in my MCH division, Meetings, communication, partners/stakeholders, outside consultants, etc. 2. Communicating progress of our various steps along the way. Why am working! 1. Set a plan and stick to plan! 2. Be clear and concise as the steps you are following or want to follow. There are so many ways to go about this.
  • North Dakota: The state health assessment is complete. Developed the MCH stakeholders survey. Compiled and preparing other data for analysis.
  • North Dakota: 1. Complete MCH stakeholder survey. 2. Compile and analyze other data. 3. Access data to help prioritize strategies.
  • U.S. Virgin Islands: Convene an internal meeting of all program leads to assess program strengths and capacity. Engage members of advisory committee to assess their perception of MCH strategies and capacity. Using a participatory approach fosters by-in and support for the needs assessment process and some level of accountability. Best advice: start early!!
  • Commonwealth of the Northern Mariana Islands: Include CYSHN and families with lived experiences in the action plan. Having all MCH managers involved in the needs assessment. It will address more domains.
  • Delaware: Boot camp: putting together in-person, all day internal stakeholders to examine strengths/capacity and select partners using state developed ranking sheet.
  • Hawaii: Where we are now. Clear impact (data people) as we will look into procuring this.
  • Idaho: Forming internal advisory team. Conducting external stakeholder meetings (in person and virtual) to help prioritize and identify new partners for the work ahead. Working with contracted facilitator for meetings and small team strategy work.
  • Commonwealth of the Northern Mariana Islands: Partner engagement. Ensure population representation. Keep partners in the loop (informed) of every stage of the NA process.
  • Louisiana: Systems mapping (external) (systems of care). Mapping internal strengths/weaknesses: Data, Convening statewide coordination mechanisms, Family and community engagement. Crosstabs for systems need and internal capacities.
  • Wisconsin: Created a needs assessment data collection monitoring dashboard. Allowed us to monitor our overall progress, but more importantly, if we were reaching (pre-determined) priority populations (some MCH domain specific, but also BIPOC, AI/AN, Spanish-speaking, Hmong, youth, LBGTQIA). This allowed us to shift efforts, adjust communication strategy, increase outreach efforts, etc. Also pointed out some pretty glaring gaps, Re: partnerships.
  • New York: We engage with several partners for our Project Teach project to help bring mental healthcare to schools. They are working with us to help further both ours and each other's goals for improving health and safety in schools. They then send data they collect to a different partner to assess the successes, failures, and places of improvement which we've been analyze. We do this, so that way we are collecting data from local communities year-round for these priorities.
  • Indiana: Supplementing needs assessment with targeted focus groups to prioritize the voices of incarcerated women, non-English-speaking communities, and fathers across the state.
  • Washington: Working with partners to determine priorities and assess needs. Present quantitative and qualitative data to partners (local health departments, families, providers, others) and having them prioritize areas and determine programs to influence, impact, and address equity.
  • Colorado: Learning how to do systems mapping in a meaningful and manageable way after priorities are set to explore how to shift resources to address needs/gaps. mchcolorado.org has our logic, models, action plans, and summaries as resources for others.
  • Oklahoma: We have completed listening sessions and surveys. We are moving to setting priorities by meeting with key partners. This is my first needs assessment, so I'm not quite sure how well it's working, but valuable information was gathered in listening sessions.
  • Oklahoma: 1. Form partnerships. 2. Systems mapping.
  • California: 1. We completed our year needs assessment with our 61 LHJ's. 2. We will be engaging partners next month.
  • Virginia: We are thinking regionally: Broad strategies that will allow for regional activities that are more aligned with unique populations/cultural needs. We are reading out to nontraditional partners: • We hope to see other state Title V programs as our partners! Shared regional strategies to address, deep, generational issues. • We are hoping to find a new relationship with our state chapter of National Association of Social Workers. They are definitely conduits to work around SDOH.
  • Missouri: Although we talk about the 'Title V MCH block grant' and Title V provides essential MCH funding, it is important to think beyond Title V to the broader MCH system. Understanding your state's MCH strength and capacity requires assessing the strength and capacity of the entire system, not just those parts of the system that receive Title V funding and or or actively engage with Title V.
  • Florida: Maybe a map or list with contact info by state and/or national or county of available partnership or entities that are categorized by NPMs and NOM's. For example: Infant Mortality --> March of Dimes.

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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.

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