Results-Based Planning

We use RBA as one way to align program performance (measurement of ESMs) with population goals (achievement of NPMs & NOMs).

• RBA helps ensure that ESMs align with and advance NPMs. A set of seven performance accountability questions require programs to consider:
• Desired impact change on a targeted group.
• Mechanisms to deliver services effectively.
• Ways to address barriers, identify resources, and engage appropriate partners.
• Identification of what specifically works to produce measurable outcomes.

RBA can be used by Title V agencies as a planning process in two ways:

1. To ensure that ESMs measure activities that advance National Performance Measures (NPMs). A set of population and performance accountability questions requires programs to consider:

• Desired impact on a targeted group.
• Relevant barriers and facilitators, relevant resources and potential partners.
• Identification of what works to produce measurable outcomes.
• Mechanisms to deliver programs effectively.

2. To strengthen measurement of ESMs. A four-quadrant measurement matrix assists programs to move from tracking effort (basic) to assessing effect (advanced). The quadrants are:

• Quantity of the effort (How much did we do?).
• Quality of the effort (How well did we do it?).
• Quantity of the effect (Is anyone better off?).
• Quality of the effect (How are they better off?).

RBA – also called “moving from talk to action” – is a tool that:

1. Connects your programs to desired results and supports the development of robust and feasible action plans.
2. Ensures your programs are connected to your work and advance your goals.

Read this factsheet, The Results-Based Accountability Guide from Clear Impact, for a summary of RBA.

RBA starts with the ends and works backward, step-by-step, to means. This process can serve as a way to double-check and reinforce your needs assessment process. Gather your staff, partners, and members of the community and ask these seven questions to make sure you have captured the necessary information from your stakeholders and are aligning your goals with NOMs, NPMs, and SPMs:

1. RESULTS: What are the quality of life conditions we want for the families who live in our community? These are the population results we want (e.g., children living to their first birthday, children are safe on the road).
2. EXPERIENCE: What would these conditions look like if we could see them? Ask how you would recognize these results in your everyday lives, without worrying about identifying programs or data (e.g., children not dying in their cribs while sleeping, children wearing bike helmets).
3. INDICATORS: How can we measure these conditions? How would you see these experiences in measurable terms? What data do you already have? What new data could you collect? (e.g., percent of child care facilities that are trained in safe sleep, number of bike helmets distributed). For each indicator, ask yourself how you are doing – are the numbers improving, staying the same, or getting worse?
4. BASELINE and STORY BEHIND THE CURVE: How are we doing on the most important of these measures? Map out your data over time and develop a baseline that includes 5 years ago to now and a projection 5 years into the future (ask yourself what would the data look like if you did nothing different). Write down the root causes of why the data looks the way it does – include behavior change and social determinants of health. Then map out how you would like the data to look into the future.
5. PARTNERS: Who are the partners that have a role to play in doing better? For every “cause” in step 4, think of a partner who you can work with to address the need. Include typical and new partners. Then list partners who can work to address the health issue. Are they at the table? How can you engage them?
6. WHAT WORKS: What works to do better, including no-cost and low-cost ideas?Brainstorm possible actions that Title V can work directly to address identified root causes, engage partners, and leverage other programs already in place. Ask yourself “what would it take to make the numbers better?” Use MCH Evidence Center tools to see if your ideas align with the established or emerging evidence for “what works.”
7. ACTION PLAN: What do we propose to do? The next step is to create an action plan. Start by setting priorities and a timeline: “Now,” “Next 12 Months,” and “2 to 5 years.” No-cost/low-cost actions are natural places to start. Don't wait for the perfect plan to be developed and approved. Get started right away.

RBA can also serve as a way to choose and strengthen your ESMs and SPMs. Similar to the population-level process, you could consider seven performance accountability questions once you have set your priorities, identified your NPMs, and are focused on ESMs. Note some key differences in approach:

1. CUSTOMERS: Who are our customers? Develop a complete list of who these groups are. Remember, your “customers” are the direct recipients of your strategy – they might be providers, an organization, or the MCH population group you are targeting (the customer might not be the mother/infant/child/youth/family).
2. EFFECT: How can we measure if our customers are better off? Come up with the most meaningful measures, even if you don’t have data or don’t control every aspect of the activity. These might eventually be Quadrant 4 measures (highest measurement).
3. EFFORT: How can we measure if we’re delivering services well? Your answers will usually measure what staff do and how well your programs perform. These will be Quadrant 1 and 2 measures.
4. BASELINE and STORY BEHIND THE CURVE: How are we doing on the most important of these measures? Two parts: (1) From strategies in steps 2 and 3, what are the 3 to 5 “headline measures?” Try to get a mix of Category 2 and 4. (2) Graph out your efforts and create a baseline (history and forecast). Tell the story behind the data. Why are things getting better or worse? What are the causes at work?
5. PARTNERS: Who are the partners? Consider partners inside and outside your organization. Consider active, non-active, and outside-the-box partners. What can they do to help turn the curve?
6. WHAT WORKS: What works to do better? There are two natural pointers to answer this question: (1) each part of the story behind the curve (the “cause;” e.g., poor lighting is a cause of increased fear of crime) and (2) actions that come from the partners list. Each partner has something important to turning the curve. Evidence is important here. Look at the research for what has worked in other places, both from the MCH Evidence Center’s online toolkits and from best and promising practices. List these strategies.
7. ACTION PLAN: What do we propose to do? Choose the most powerful actions from the possibilities identified in #6. You can use the criteria list (SiLVeR — specificity, leverage, values, and reach). Organize these actions into a plan that specifies the person responsible for each task, timelines, and necessary resources.