- Home
- 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

Framework and Tools
Introduction
Start Here with the Needs Assessment Process
Needs assessment is a systematic process to acquire an accurate picture of the strengths and weaknesses of a state or jurisdiction's public health system, and essential in identifying the most appropriate programs and policies to promote the health of women, children, adolescents and their families. MCH assessments are to be population-based and community-focused and serve as a fundamental element of any program planning activity.1
The needs assessment process includes the collection and examination of information about the state or jurisdiction's capacity and infrastructure, needs, and desired outcomes for the MCH population, and legislative mandates. This information is used to determine priority goals, develop a plan of action, and allocate funds and resources. The needs assessment is a collaborative process that should include the HRSA/MCHB, the full Department of Health, families, practitioners, the community, and other agencies and organizations within each state or jurisdiction that have an interest in the wellbeing of the MCH population.
Title V of the Social Security Act requires states to conduct a statewide Needs Assessment every five years with the primary goal of improving MCH outcomes and strengthening state, local and community partnerships.
This page presents a practical framework that illustrates the continuity of the Needs Assessment process and its relationship to the planning and monitoring functions of Title V and the population that is serves. It also pulls together all the tools presented throughout the website.
- Study the guidance and make a list of tasks to be completed.
- Put one person in charge of the needs assessment.
- Make a master plan:
- Discuss with MCHB project officer; obtain technical assistance if needed.
- Gather existing documents (e.g., last needs assessment, data updates, studies, reports, program evaluations, SLAITS data, etc.).
- Assign every task to someone to complete by deadline.
- Develop a calendar of key assignments and due dates. Build adequate time into the needs assessment calendar for an advisory group to review the resulting data, trends and other information.
- Hold a stakeholders meeting for all interested parties (staff, family advisory, and coordinating programs both within and outside your agency) to review master plan; periodic meetings thereafter for steering needs assessment activities.
- Conduct an environmental scan early in the process to determine what data, program evaluations and other information you have readily available.
- Use learning materials and resources from this toolkit to help guide your efforts.
- Obtain new data and analyses.
- Use consultants as needed.
- Read draft report from front to back; edit.
- Share draft with stakeholders; conduct process to develop list of needs and priorities based on needs assessment findings.
- Share final needs assessment report, including listing of needs and priorities, widely - with state agency leadership, "sister" agencies, advocacy groups, legislature, governor's office, etc.
- Celebrate a job well done!
Conceptual Framework
This Nine-Step Process is Detailed in the Links to the Left
Implementation Tools
The Right Tools at the Right TimeThese resources help move you from knowledge to practice with your needs assessment work. A list of all tools are presented below; specific tools are also repeated on the corresponding Needs Assessment Step page. You can also access a list of tools by step on this summary page.
- 30/30 Action Plan: PDF | Word document (editable). A simple way to monitor progress and record future action steps in ongoing work. The idea is that the team meets for 30 minutes every 30 days to discuss progress over the past month. The progress, roadblocks and other relevant ideas are noted on the form, along with an action plan for the following month.
- A3 Change Tool. A tool designed for quality improvement and managing change. On the assessment side, it helps groups to frame their work together, uncover perspectives, find root causes, and establish measures of success for the change. On the action side it encourages learning, prototyping and testing. The tool is meant to be used longitudinally to track change over time.
- Overview and facilitator script
- Tool Template (editable Word document)
- Appreciative Inquiry. A tool that focuses on how to build on existing strengths and how to engage stakeholders to create change. This tool can also be used in Step 4 (Selecting Priorities) and Step 5 (Setting Performance Objectives).
- 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.
- Balance of Petals. This tool can be used to clarify needs from and benefits to community partners. Knowing what you need from the partnerships you form, as well as what each partner stands to gain from your initiative is an important part of allocating resources. Use this tool to identify which partners need to be engaged for your initiative to succeed, what you need from each partner (including political support, data, funding, and/or effort), what each partner has to gain (and lose) from your initiative.
- Birth Action Plan. An interactive map that describes urgent actions needed by specific system actors in the next five years to address identified barriers to change. The tool is intended to accelerate the work of communities, coalitions, and funders in strategically assessing their efforts, identifying opportunities, and committing to specific actions to strengthen the ecosystem. The map can be used as a needs assessment tool to help Title V programs strategize on their role in improving birth outcomes and identify the most urgent and influential actions in their contexts that they can impact, while staying rooted in the big picture system during planning to increase the systems change impact of their investment/action.
- 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.
- Causal Loop Diagramming. A tool used to help stakeholders identify leverage points/priorities to shift the entire structure and not simply treat the “symptom” of the problem. This tool will help your stakeholders understand the forces shaping the problem, uncover assumptions about the problem, identify unintended consequences, and identify strategies to influence the system.
- Concept Mapping. A tool used to help stakeholders identify areas of consensus and priorities that are important and actionable.
- Data Placemats. Data placemats help stakeholders interpret and draw meaning from data. They can be particularly effective in communicating the current health status of sub-groups, and can be easily customized for sharing data with various audiences.
- Data Resources:
- ESM Review & Resources: National Summary. This report serves as a conversation starter as we learn how to strengthen our strategies, work with the Evidence Center, and look toward the next iteration of block grant applications and work.
- Evaluation Resources:
- Evaluation Learning Bundle. This training spotlight uses the CDC framework as a conceptual model to organize learning opportunities. It presents introductions to the six steps of program evaluation in short video podcasts. You can also download materials from the CDC about each step. After reviewing the introductory material, you can access additional learning opportunities to gain knowledge and skills related to each step of the framework.
- Evaluation Toolkit. This deep-dive resource contains an evaluation primer, a collection of key resources, and an interactive Choose-and-Use tool to assist users in finding instructions on how to conduct evaluations and examples of successful evaluations from the field.
- Federal Resources:
- MCH Needs Assessment and its Uses in Program Planning: Promising Approaches and Challenges. Health Resources and Services Administration. 2004. 68 pp.
- Promising Practices in MCH Needs Assessment: A Guide Based on a National Study. Health Resources and Services Administration. 2004. 68 pp.
- State application/annual report. U.S. Maternal and Child Health Bureau. 2019.
- State priorities. U.S. Maternal and Child Health Bureau. 2019.
- The Five Rs. A tool used to break down elements of a complex problem. It consolidates stakeholders’ perspectives on the system supporting MCH.
- Guide to Prioritization Techniques. NACCHO has developed a prioritization technique that provides a structured mechanism for objectively ranking issues and making decisions, while at the same time gathering input from agency-wide staff and taking into consideration all facets of the competing health issues.
- 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 outcomes priorities.
- How to Engage Stakeholders Tool. As part of the Cottage Center for Population Health's evaluation toolkit, this tool is part of their Engage Stakeholders page that provides background, case studies and tools to use.
- Individual + Policy, System, and Environmental (I+PSE) Conceptual Framework for Action. This framework focuses on identifying needs and aligning programs by integrating direct service initiatives with policy (organizational/ public), system (simple/complex) and environmental (built/natural) approaches.
- Impact Matrix. A tool to help groups identify and achieve agreement on activities that can be implemented with maximum impact given the effort invested. This is an easy-to-facilitate tool that can be used when a team (including partners) has many ideas about potential courses of action and wants to consider the impact of all potential solutions before deciding on a course of action.
- Facilitation guide
- Tool template: PDF | Word document (editable)
- Keep, Adapt, Let Go, Create. This tool (in editable Word format) asks a series of questions to (1) examine the future state of work that could benefit from Title V resources; (2) determine what is being done currently that could be kept, adapted, let go, or created; and (3) plan for what could, should, and will be done.
- Key Driver Diagram (KDD). This tool documents the team’s theory about the changes needed to achieve the desired improvement; becomes the team’s roadmap for change; and elps to define what should be measured to best learn how your interventions are impacting your system.
- Logic Models. Logic Models are simplified graphic depictions of a program, initiative, or strategy. They provide a map of the relationships between the resources, activities, and benefits or changes that result. Logic Models demonstrate the theory of change, and can be useful in program planning, management, communicating with partners, and needs assessment. This tool (downloadable as a Word document) contains instructions and an editable logic model template.
- Measurement Tables. A Measurement table documents your plan to monitor progress toward goals over time. If you have already completed logic models for each domain, a Measurement Table can be used to further flesh out ideas for measuring each activity described in the logic model.
- Measurement Table Overview and Script
- Measurement Table Template: PDF | Word document (editable)
- 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.
- Nutrition Resources:
- Incorporating Nutrition in the Title V Five-Year Needs Assessment: for Public Health Nutritionists. U.S. Maternal and Child Health Bureau. 2020. 2pp.
- Resources for Addressing Nutrition in the Title V Five-Year Needs Assessment: for State MCH Title V Programs. U.S. Maternal and Child Health Bureau. 2020. 2pp.
- Plan-Do-Study-Act Cycle. A tool used to help stakeholders test strategies and innovations on a small scale in order to learn how to adapt the strategy to fit with the environment in which it is being implemented. The tool provides a structured way to plan how the test will be carried out, try it, observe and collect data, and adapt the strategy based on what is learned.
- Policy Review TA Brief on Title V agencies that have conducted a policy review as part of their needs assessment.
- Prioritization Matrix. The last phase of the CAST-5 Process highlights selecting priorities. This document provides an overview and tool for Prioritizing Needs.
- Results-Based Accountability Tools:
- Developing Stronger ESMs. Follow the full RBA process to assist in developing new or reviewing current ESMs.
- ESM Quadrant Measurement Tool. Use this tool to develop strong ESMs to measure your strategies.
- Results Based Accountability (RBA) Tip Sheet. Check out this quick "cheat sheet" to learn about how RBA relates to ESMs and for tips on writing effective measures.
- The Role of Title V in Adapting and Implementing Strategies. Read about common strategies that Title V supports.
- Turn-the-Curve (TTC) Strategy Tool. Use this tool to select priorities and develop new strategies that align with your population needs and advance each NPM. TTC is a quick method to strategically think about your needs assessment data and develop strong measures to assess progress we make in changing the trajectory of your work.
- Return on Investment (ROI). ROI is a tool used to evaluate the efficiency of an investment or compare the efficiency of several investments. The use of ROI can help guide the allocation of resources. This guidebook is designed to assist local health department staff assess the value of their contributions, with a particular focus on population-based prevention interventions.
- Poster: Using “Return on Investment” Analysis Helps Drive Quality Improvement
- ROI Calculator for Partnerships to Address the Social Determinants of Health. The Commonwealth Fund. This calculator is designed to help community-based organizations and their health system partners plan sustainable financial arrangements to fund the delivery of social services to high-need, high-cost (HNHC) patients.
- Root-Cause Analysis (RCA) is a structured facilitated team process to identify root causes of an event that resulted in an undesired outcome and develop corrective actions. The RCA process provides a way to identify breakdowns in processes and systems that contributed to the event and how to prevent future events. The purpose of an RCA is to find out what happened, why it happened, and determine what changes need to be made.
- Read more about RCA.
- Interactive Fishbone Diagram. This tool has been designed specifically for MCH programs, for use in determining causes. This diagram is in PowerPoint format for easy group work.
- Learn more about Fishbone Diagrams from the National MCH Workforce Development Center.
- Simulation. A tool used to predict outcomes based on formulas and selected variables and interventions. This tool allows stakeholders “test” interventions in a virtual arena and understand the impacts of selected interventions.
- Successful Engagement with People who have Lived Experience. National MCH Workforce Development Center. The purpose of this workbook is to provide detailed steps for professionals who seek to authentically engage with people who have lived experience to improve policy, services, supports, systems of care, health outcomes, etc. This document provides guidance for setting the stage in order to create trusting relationships and engage individuals with lived experience at the beginning of your work.
- System Support Mapping. A tool used to understand the role, responsibilities, needs, resources, and wishes of individuals navigating or supporting the MCH system.
- 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.
- Youth Engagement:
- Example of why and how to partner with youth (AMCHP)
- Examples of youth engagement through youth centered care, focus groups/listening sessions, partnerships, and advisory structures