Maternal and Child Health Competencies

The Maternal and Child Health (MCH) Competencies are intended to provide the basis for curriculum development and continuing education programming for MCH graduate education programs and MCH professionals. These competencies, considered as an evolving document, are periodically revised to reflect priorities and needs in the dynamic MCH practice and research environments.

The MCH Competencies were developed with various constituencies in mind. Within graduate education programs, the competencies can be used for curriculum development and evaluation. They also can be used to assess individual student learning needs and progress for master's and doctoral level students. It is expected that schools with MCH programs will emphasize different aspects of the competencies depending on student and community needs and faculty interests and expertise. The competencies provide a mechanism with which educators, students, and potential applicants can compare elements of curricula across graduate education programs. Within communities, the competencies will facilitate the development of continuing education programs. The competencies will assist leaders within MCH organizations in their efforts to set standards and promote the use of performance measures. Similarly, competencies can be used by practicing MCH professionals for professional development. Of course, MCH professionals will vary in their own capacities and needs to meet these competencies.

The following competencies address MCH and general public health content in the areas of the scientific basis of MCH and public health, methodological/analytical skills, management and communication skills, policy and advocacy skills, and values and ethics in MCH public health practice2. Throughout this document, the historical phrase maternal and child health (MCH) refers to women, infants, children of all ages, adolescents, and families. The guiding philosophical approach to the competencies is developmental and intergenerational. This approach incorporates the promotion of family-centered, community-based maternal and child health services and programs and embodies the principles of cultural competence and community development and empowerment.

Developed by the education committee of the Association of Teachers of Maternal and Child Health (ATMCH) and approved by the membership and the Association of Schools of Public Health MCH Council in 1993, and revised in 2000.
Achieving these competencies will permit MCH professionals to perform the MCH essential services within the broader context of public health core functions.
COMPETENCIES FOR MCH PROFESSIONALSA. SCIENTIFIC BASIS
MCH Professionals should have knowledge and understanding of:

The major domestic and international causes of mortality and morbidity within MCH populations including differences between the United States and other developed and less developed countries.

The normal patterns of individual and family growth and development from an intergenerational and lifespan perspective.

The determinants of health and illness, and concomitant theories including biological, behavioral and socio-cultural influences such as racism, sexism, and economic disparity, as well as protective factors.

The characteristics of health care systems, including dimensions of, use of, and access to health care.

The principles and theories of population-based health promotion at the individual, family and community levels.

The theories and principles of community organization, change, and development.

A comprehension of the foundations of scientific inquiry, and the uses and limitations of conceptual frameworks. MCH Professionals should be able to demonstrate the following skills:

Describe MCH problems in terms of time, magnitude/severity, scope, dispersion/location, and co-occurrence/co-morbidity.

Identify the scientific underpinnings and determine the validity of evidence for interventions addressing MCH problems.

Apply knowledge of demographic, health, familial, socio-cultural, environmental and community factors to the design of MCH programs and services.

Critically analyze inequities in health status based on race/ethnicity, socioeconomic position, and gender.

Recognize different strengths, needs, values, and practices of diverse cultural, racial, ethnic, and socioeconomic groups and determine how these factors affect health status, health behaviors, and program design.
B. METHODOLOGICAL/ANALYTICAL SKILLS
MCH Professionals should have knowledge and understanding of:

Research design, sampling, basic descriptive and inferential statistics, and validity/reliability assessment of measures.

Epidemiological concepts and descriptive epidemiology.

The use of data to illuminate ethical, political, scientific, economic, and overall public health issues.

Strengths and limitations of qualitative and quantitative methods.

Data collection strategies and their strengths and limitations, including surveys, focus groups, and record-based information.

Principles and key features of community assessment, program design, implementation, and evaluation. MCH Professionals should be able to demonstrate the following skills:

Prepare and interpret data from vital statistics, censuses, surveys, service utilization, and other relevant reports on the health of MCH populations, and have the ability to detect meaningful inferences from data and the translation of data into information.

Apply appropriate qualitative methods to understand maternal and child health status.

Ability to conceptualize and appropriately use data and statistical/epidemiological methods for problem and asset identification, assessment, program planning, implementation, and evaluation.

Formulate hypotheses or research questions, develop and implement a analytic strategy.

Evaluate the integrity and comparability of data and identify existing gaps.

Extract data from primary and secondary sources; use basic statistical and graphics software, including programs such as EPI-info, SPSS, and SAS for data management, analysis, and the linkage of data sets.
C. MANAGEMENT AND COMMUNICATION SKILLS
MCH Professionals should have knowledge and understanding of:

Organizational and management theories and practices, and their administration in both public and private agencies.

The application of inter-organizational theories including contractual agreements and linkages and the use of principles of systems development, management, and analysis.

The purpose, rationale, activities, and performance measures for existing major MCH programs.

Appropriate use of networking, team building, small group processes, advocacy, negotiation, and conflict resolution skills, and the knowledge of community organization and coalition- building techniques to address maternal and child health issues and problems.

Techniques for soliciting and maintaining consumer and other constituency involvement at all levels of an organization.

The processes, organization, and administration of quality management techniques in maternal and child health programs and agencies, including an understanding of the appropriate use, analysis, and interpretation of quality improvement data as it applies to employees, clients, and management. MCH Professionals should be able to demonstrate the following skills:

Apply knowledge of management and organizational theories and practices to the development, planning, staffing, administration, and evaluation of public health programs, including the implementation of strategies promoting integrated service systems for MCH populations.

Integrate population-based health promotion and disease prevention strategies within primary care and other service delivery systems.

Develop mechanisms to monitor and evaluate programs and service networks for their effectiveness and quality, including the use of performance measures.

Develop, justify, and present a budget.

Develop the background and significance section of a grant application and/or develop the rationale for a program or intervention, incorporating scientific, methodological, and practice knowledge and skills as appropriate.

Effective written and oral communication skills, including accurate and effective preparation and presentation of reports to agency boards, administrative organizations, legislative bodies, consumers, and/or the media using demographic, statistical, programmatic, and scientific information.

Use appropriate techniques for development and dissemination of professional development and continuing education programs for MCH professionals.

Effectively resolve internal employee and/or organizational conflicts through a knowledge of applicable management techniques.

Develop and maintain an affiliation with community/consumer boards, boards of directors, and coalitions.

Effective and appropriate use of information technology, including but not limited to computer graphics and other software necessary for efficient program management and communication.

Develop strategies to assure integrated service systems for MCH populations.
D. POLICY AND ADVOCACY SKILLS
MCH Professionals should have knowledge and understanding of:

The historical development and scientific basis of MCH public policies and practices in the United States for federal, state, and local agencies and programs serving maternal and child health populations.

Significant past and current national legislative mandates relevant to the development and delivery of maternal and child health services.

The structure and roles of legislative, judicial, and administrative bodies at the national, state, and local levels.

The organization and financing of health services in the United States and the position of MCH within the system.

The theories and mechanisms of MCH policy development and implementation within the scope of health and other public policy programs in the United States.

The operation of federal entitlement programs in conjunction with private insurers to financially support maternal and child health services. MCH Professionals should be able to demonstrate the following skills:

Identify essential gaps in existing MCH programs and implement appropriate policy and advocacy measures to assure optimal care.

Identify public health laws, regulations, and policies related to specific programs.

Place a maternal and child health program within the historical and current context of related programs.

Collect and summarize data relevant to a particular policy/problem; articulate the health, fiscal, administrative, legal, social, and political implications of each policy option.

State the feasibility and expected outcomes of and barriers to achieving each policy option and decide on the appropriate course of action.

Write a clear and concise policy statement, position paper, and/or testimony appropriate for a specific audience.

Develop a plan to implement a policy, including goals, outcome and process objectives, implementation steps and evaluation plan.

Translate policy into organizational plans, structures, and programs.
E. VALUES AND ETHICS IN MCH PUBLIC HEALTH PRACTICE
MCH Professionals should have knowledge and understanding of:

The philosophy, values, and social justice concepts associated with public health practices in MCH, and an appreciation that concepts and theories apply to all MCH populations, irrespective of socioeconomic or Title V eligibility status.

The principles and issues involved in the ethical and sensitive conduct of practice and research within MCH populations, and in the organization and delivery of public health services within communities and governmental agencies; including the ethical and confidential collection of data and its management, analysis, and dissemination.

The philosophical concepts and rationale underlying the delivery of familycentered, comprehensive, community-based, and culturally competent MCH and public health services and programs, including recognition of community assets. MCH Professionals should be able to demonstrate the following skills:

Ethical conduct in practice, program management, research, and data collection and storage.

Promotion of cultural competence concepts within diverse MCH settings.

Ability to build partnerships within MCH communities and constituencies to foster community empowerment, reciprocal learning and involvement in design, implementation, and research aspects of MCH programs and systems.