Skip Navigation

Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 1: Well-Woman Visit

MCH Best Logo well-woman visit

Strategy. Home Visiting

Approach. Support home visiting programs that promote annual well-woman visits and preventive cancer screenings.

Return to main MCH Best page >>

Overview. Studies indicate that home visiting nurses and lay health advisors can be effective advocates for annual well woman visits and preventive cancer screenings. They can help educate women on the importance of preventive check-ups, help schedule appointments, and follow up with reminders.

Evidence. Emerging. This strategy has been tested more than once and results trend positive overall. However, results vary across different populations and may be less effective due to language and cultural barriers.1 Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Patient/Consumer.

Outcome. Increase annual well-woman visits, preventive screening, and HPV vaccination among women who participate in home visiting programs. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the “Intervention Results” for each study. 

Examples from the Field. Access descriptions of ESMs from across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Support home visiting programs that promote annual well-woman visits and preventive screenings,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of women served by the MIECHV or Family Planning Programs who received referral to prenatal care when needed.
  • Number of women enrolled in home visiting that receive a reminder regarding an annual preventive visit.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of women who received referrals to prenatal care when needed.
  • Percent of women enrolled in home visiting that receive a reminder regarding an annual preventive visit.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Percent of increased utilization of prenatal visits and prenatal care.
  • Number of women enrolled in home visiting that receive a reminder regarding an annual preventive visit who subsequently schedule an annual visit.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of women who had healthy pregnancies and better birth outcomes.
  • Percent of women enrolled in home visiting that receive a reminder regarding an annual preventive visit who subsequently schedule an annual visit.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


Reference:

1 Home visiting programs during the postpartum period can serve as a crucial link between prenatal care/labor and delivery and well woman/interconception care, but they are not a substitute for a woman’s visit with a medical provider. (Handler, A., Zimmermann, K., Dominik, B., & Garland, C. E. (2019). Universal Early Home Visiting: A Strategy for Reaching All Postpartum Women. Maternal and child health journal23(10), 1414–1423. https://doi.org/10.1007/s10995-019-02794-5)

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.