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Strengthening the evidence base for maternal and child health programs

New: MCH Best strategies database for sample ESMs

Stronger Measurement for ESMs

multicolored speech bubblesHow To Measure ESM Impact

Results-Based Accountability (RBA) provides an intuitive framework to help you move from reporting “what did we do?” (simplest form of measurement) to “how well did we do it?” and eventually to “is anyone better off from our efforts?” and “how are they better off?” (reporting impact). RBA provides four quadrants of measurement when you look at effort and effect across quantity and quality.1

4 quadrants of RBA

Once you have identified strategies to use as your ESMs and SPMs, map them across these four quadrants. Think of how you might strengthen your strategies by moving from quadrant 1 to 2 and from 3 to 4, knowing that it’s not always feasible to move up based on data and resources available. However, measurement is important! Spend some time strategizing how to report stronger measures in your MCH Block Grant report and application. Tell the Title V story as having a quantifiable and qualifiable effect on your MCH populations.

Goals in Strengthening Your Measures. When looking at your ESMs, SPMs, or other strategies:
  • Move from measuring quantity to quality.
  • Eventually move from measuring effort to effect.
  • Quadrant 1 strategies should be used sparingly, when no other data exists. Challenge yourself to find ways to report more meaningful accomplishments.
  • The most effective measurement combines strategies in all levels, with most in quadrants 2 and 4.
  • Use all the tools at your fingertips to double-check your strategies: The Using a Structured Planning Process portal page contains ESM tip sheet, strategy shortcuts, Public Square Test, SilVeR Test, and other tools.
  • You can also read about the entire process in the ESM Development Guide.


1 Friedman M. Trying Hard Is Not Good Enough: How to Produce Measurable Improvements for Customers and Consumers. FPSI Publishing, 2005, 2009, 2015 and Implementation Guide: Results-Based Accountability. Clear Impact. All use of Results-Based Accountabilityâ„¢ materials comply with usage guidance.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.