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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Early Prenatal Care.

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Strategy. Mobile Reproductive Health Clinics

Approach. Initiate the use of mobile reproductive health clinics to meet the prenatal and postpartum needs of populations who have experienced ongoing difficulties receiving care.

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Overview. Mobile reproductive health clinics are medically equipped vans with clinicians that offer reproductive health services, such as pregnancy tests, prenatal and postpartum care, gynecological exams, sexually transmitted infection. (STI) screenings, health education, and referrals to social services. Vans can include a waiting room, private exam areas, an education area, and a laboratory, as well as monitors, diagnostic equipment, and educational materials.[1] Vans sometimes offer screening and referral services for health concerns outside reproductive health.[2] Mobile clinics typically serve populations that may need additional support, such as low income or uninsured individuals, in both urban and rural areas. Clinics may partner with hospitals, healthcare systems, or public health departments.[3]

Evidence. Moderate Evidence. Strategies with this rating are likely to work. These strategies have been tested more than once and results trend positive overall; however, further research is needed to confirm effects, especially with multiple population groups. These strategies also trend positive in combination with other strategies. (Clarifying Note: The WWFH database calls this "some evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. What Works for Health (WWFH) Database (County Health Rankings and Roadmaps)

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

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Health Outcomes. This strategy helps contribute to reducing avoidable differences among socioeconomic and demographic groups or geographical areas in health status and health outcomes such as disease, disability, or mortality.
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.

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. Outreach (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. As Title V agencies begin to incorporate this strategy into ESMs, examples will be available here. Until then, you can search for ESMs that have similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models 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?")

PROCESS MEASURES:

  • Number of mobile reproductive health clinics that are fully staffed with qualified providers trained by Title V. (Shows the workforce capacity and quality)
  • Number of mobile clinic visits that include comprehensive health education, counseling, and referrals to social services provided by Title V. (Indicates the holistic and integrated nature of care)

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

PROCESS MEASURES:

  • Percent of mobile reproductive health clinics that are fully staffed with qualified providers trained by Title V. (Shows the workforce capacity and quality)
  • Percent of mobile clinic visits that include comprehensive health education, counseling, and referrals to social services provided by Title V. (Indicates the holistic and integrated nature of care)

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

PROCESS MEASURES:

  • Number of referrals and linkages made by mobile clinics supported by Title V to other health and social services, such as housing, nutrition, and education. (Shows the care coordination and integration efforts)
  • Number of innovations implemented by Title V to ensure the long-term viability and sustainability of mobile reproductive health clinics. (Indicates the enabling environment and resource mobilization)

OUTCOME MEASURES:

  • Number of community-based organizations and supporters partnered with Title V that champion and promote mobile reproductive health clinics as a trusted and valuable resource. (Shows the community ownership and leadership outcomes)
  • Number of healthcare systems partnered with Title V that recognize and support mobile clinics as a critical component of the reproductive healthcare ecosystem. (Indicates the systems change and integration outcomes)

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

PROCESS MEASURES:

  • Percent of mobile clinic data and outcomes that are regularly shared with and used by communities to inform support, policy, and systems change efforts. (Shows the transparency and accountability to the community)
  • Percent of mobile clinic funding and resources that are flexibly allocated to respond to evolving community needs and priorities. (Indicates the adaptability and responsiveness of the approach)

OUTCOME MEASURES:

  • Percent reduction in community-level barriers in accessing high-quality, comprehensive reproductive healthcare, as a result of mobile clinic services and support. (Shows the social and structural impact)
  • Percent of overall community health and well-being indicators that improve over time, demonstrating the ripple effect and return on investment of mobile reproductive health clinics. (Indicates the population-level and generational impact)

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.

References

[1] O’Connell 2010 - O’Connell E, Zhang G, Leguen F, Prince J. Impact of a mobile van on prenatal care utilization and birth outcomes in Miami-Dade County. Maternal and Child Health Journal. 2010;14(4):528-34.

2 AHRQ HCIE-Bennett - Bennett J. Mobile clinic delivers culturally competent services to underserved neighborhoods, leading to identification of untreated chronic conditions, better blood pressure control, and significant return on investment. Rockville: AHRQ Health Care Innovations Exchange.

3 MHM - Mobile health map (MHM). Impact Report.

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.