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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Breastfeeding.

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Strategy. On-Site Child Care

Approach. Provide guidance around workplace policies that support on-site child care

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Overview. Employers who offer on-site child care provide employees with child care options at work. Care may be provided free of charge, partially subsidized as part of an employee benefit package, for provided at market rates.

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
  • Environmental Health. This strategy improves the impact of physical, chemical, and biological factors in the environment on health.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Policy Development and Enforcement (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

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

  • Number of employers provided with guidance on implementing on-site child care policies. (Measures the reach of technical assistance efforts) Number of on-site child care policy templates, toolkits, for resources developed and disseminated. (Quantifies the tools created to support policy implementation)

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

  • Percent of on-site child care policy guidance materials that are user-friendly and appropriate for the employer audience. (Assesses quality and relevance of resources) Percent of on-site child care policy development process that engage employees who are parents. (Measures meaningful input from key community partners and end-users)

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

  • Number of on-site child care programs that offer breastfeeding education to providers and parents. (Measures integration of child care and breastfeeding support services) Number of businesses providing on-site child care that also have workplace lactation support policies. (Assesses adoption of comprehensive breastfeeding-friendly practices) Number of mothers using on-site child care who breastfeed for at least 6 months. (Measures impact on breastfeeding duration, a public health benchmark) Number of businesses providing on-site child care that are recognized as breastfeeding-friendly workplaces. (Measures external validation and positive reinforcement)

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

  • Percent of on-site child care policy guidance that addresses unique needs of small businesses for specific sectors. (Assesses tailoring of resources to different contexts) Percent of employers engaged that have a high proportion of workers who are from communities experiencing lower socioeconomic status. (Measures focus on advancing access) Percent increase in breastfeeding rates among employees experiencing socio economic challenges after on-site child care policy implemented. (Assesses impact on socioeconomic challenges) Percent of employers with on-site child care reporting lower health care costs and improved productivity. (Shows broader societal and economic benefits)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

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

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.