Strategy. Income Support Programs (Pregnancy)
Approach. Implementation of housing and income supplements to pregnant and postpartum women may prevent preterm birth and prevent increased health care utilization
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Overview. Income support programs provide financial assistance and resources to help meet the basic needs of perinatal women who may be unhoused by. Income support programs can help alleviate financial strain, reduce homelessness, and improve overall well-being. By providing financial assistance for things like housing support income support programs play a vital role in supporting women who may be unhoused. Evidence has found these programs may help address immediate needs, reduce financial instability, and work toward long-term stability and self-sufficiency for pregnant unhoused persons.[1]
Evidence. Expert Opinion.
Strategies with this rating are recommended by credible, impartial experts, guidelines, or committee statements; these strategies are consistent with accepted theoretical frameworks and have good potential to work. Often there is literature-based evidence supporting these strategies in related topic areas that indicate this approach would prove effective for this issue. Further research is needed to confirm effects in this topic area.
Access the peer-reviewed evidence
through the MCH Digital Library or related evidence source.
(Read more about understanding evidence ratings).
Source. Peer-Reviewed Literature
Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):
- Social Determinants of Health. This strategy advances economic, social, and environmental factors that affect health outcomes. SDOH include the conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.
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. Individual/Family-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).
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Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")
- Number of pregnant and postpartum women identified and enrolled in housing and income support programs. (Measures reach and scale of support programs)
- Number of community-based organizations and public agencies partnering to provide comprehensive housing and income support services to pregnant and postpartum women. (Shows multi-sector collaboration and service integration)
- Number of pregnant and postpartum women who maintain stable housing and experience increased economic stability as a result of receiving housing and income supplements. (Measures direct impact of support programs on housing and financial security)
- Number of pregnant and postpartum women receiving housing and income supplements who access and utilize prenatal and postpartum health care services. (Assesses effect of economic stability on maternal health care utilization)
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Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")
- Percent of housing and income support programs for pregnant and postpartum women that are designed using evidence-based, equity-focused eligibility criteria and benefit levels. (Measures tailoring and adequacy of support to meet needs)
- Percent of housing and income support program staff who are trained in trauma-informed, culturally responsive practices to support pregnant and postpartum women. (Shows workforce competency and sensitivity)
- Percent of pregnant and postpartum women receiving housing and income supplements who report reduced stress, improved mental health, and enhanced quality of life. (Measures self-reported impact of economic support on maternal wellbeing)
- Percent of pregnant and postpartum women receiving housing and income supplements who are able to maintain stable employment and increase their earnings over time. (Assesses impact of support on economic mobility and self-sufficiency)
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Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")
- Number of healthcare providers and managed care organizations partnering with housing and income support programs to identify and refer eligible pregnant and postpartum women. (Measures healthcare sector engagement and care coordination)
- Number of public education and awareness campaigns conducted to build community understanding and support for investing in the health and economic stability of pregnant and postpartum women. (Shows narrative change and public will-building efforts)
- Number of pregnant and postpartum women receiving housing and income supplements who are able to transition off public assistance and achieve long-term economic security and mobility. (Measures transformative, intergenerational impact of support programs)
- Number of communities that experience significant reductions in adverse birth outcomes, infant mortality, and child poverty rates as a result of tailored housing and income support interventions for pregnant and postpartum women. (Assesses population health and equity impact of support programs)
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Quadrant 4:
Measuring Quality of Effect ("How are they better off?")
- Percent of housing and income support programs for pregnant and postpartum individuals that are governed by and accountable to individuals and communities most impacted by economic insecurity and maternal health inequities. (Measures shift in power and ownership of support programs)
- Percent of narratives and public conversations about housing and income support for pregnant and postpartum individuals that frame these programs as essential public goods and wise social investments, rather than as public dependency or charity. (Shows narrative shift toward equity and justice)
- Percent reduction in racial, ethnic, and socioeconomic disparities in maternal health outcomes, birth outcomes, and child development indicators among pregnant and postpartum individuals participating in housing and income support programs. (Measures impact of support programs on eliminating unjust and avoidable inequities)
- Percent of pregnant and postpartum individuals from historically medically underserved communities who report experiencing housing and income support programs as affirming of their dignity, responsive to their unique needs and strengths, and supportive of their reproductive and economic justice. (Assesses effectiveness of support programs in embodying equity and justice principles)
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Note. When looking at your ESMs, SPMs, or other strategies:
- Move from measuring quantity to quality.
- Move from measuring effort to effect.
- Quadrant 1 strategies should be used sparingly, when no other data exists.
- 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] Pantell, M. S., Baer, R. J., Torres, J. M., Felder, J. N., Gomez, A. M., Chambers, B. D., ... & Jelliffe-Pawlowski, L. L. (2019). Associations between unstable housing, obstetric outcomes, and perinatal health care utilization. American journal of obstetrics & gynecology MFM, 1(4), 100053.
