Welcome to the Institute for Equity in Birth Outcomes

Identify Your Strategy

IdentifyNow that you are in the SET phase, your coalition should be meeting on a regular basis. Similarly, now that your local MCH data has been mined and analyzed, it is time to use the data, along with the discussions that you've had among the coalition and community members, to identify your equity-focused strategy(ies).

As your coalition ponders the appropriate strategy(ies), consider these components of successful strategic frameworks inspired by Hanleybrown, Kania & Kramer (2012):

  • a clear description and understanding of the issues at hand for the intervention community
  • solid MCH and related data
  • a mutual goal or set of goals to be reached through the equity-focused intervention
  • a menu of strategies from which to choose that are evidence-based, promising, and aimed at population-level change
  • evaluation plan

Source: Hanleybrown, F., Kania, J., & Kramer, M. (2012). Channeling change: Making collective impact work. Stanford Social Innovation Review, 20, 1-8.


The following topics will lead you through steps needed to identify your strategy. Please use the Read More links to learn about each step and for additional resources.

Look Upstream and Downstream

There is a body of evidence that links maternal health across the life course to future pregnancy outcomes. Because of this link, coalitions across all 3 Equity Institutes were encouraged to use a Life Course perspective when selecting an upstream intervention focusing on factors such as housing, neighborhood conditions, social and economic policies, and improving socioeconomic status.

Coalitions were also encouraged to implement short-term strategies downstream where the impact could be measured in eighteen to twenty four months. Equity Institute coalitions quickly realized that the changes they sought to measure did not materialize in that short time span. One of the biggest barriers faced is the ability to access accurate and current data.

To learn more about these two types of strategies, and to see visual representations, click Read More.


This list is by no means exhaustive, and CityMatCH recognizes that many experts and resources exist outside of this list.



Examples from Current Equity Institute Teams

This example was shared with current Equity Institute Teams: Two public health workers are out for a walk along their city's river where they come upon a population in peril.

People are floating toward the cliff!

The public health workers need rescue vehicles, and thanks to their health department's emergency preparedness efforts, rescue vehicles are stashed along the river.

The first worker begins to load her boat with life preservers and other rescue equipment. She plans to paddle downstream to help people out of the river.

The second worker is pushing off in the opposite direction with a boat full of supplies. She has a fence, a warning sign, and oddly, she also has jobs and education programs. Riding along with her is an elephant. That elephant is historic racism and healing strategies.

The first worker yells, "Where are you going?! We must go downstream to rescue the people in the river!"

The second worker shouts back, "I'm going upstream to prevent more people from falling in the river!"

You see, both public health workers have the right idea. They're both performing critical jobs, even in different directions.


Upstream Strategies:

•  Education
•  Housing
•  Labor
•  Justice
•  Transportation
•  Agriculture
•  Environment
•  Etc.

Downstream Strategies:

  • Family Planning
  • Maternal Stress Prevention and Management
  • Tobacco, Alcohol, and other Drug Cessation
  • Progesterone
  • Kangaroo Care
  • Safe Sleep
  • Etc.

Prevention Vehicles:

  • Home Visiting
  • Medical Homes and Neighborhoods
  • Case Management
  • WIC
  • Centering
  • Baby-friendly Hospitals and Birthing Clinics
  • Doula Care
  • Etc.

Develop a Shared Measurement

Once a common agenda is developed and an initiative is selected, the next step in the collective impact approach is to develop a shared measurement strategy. This will ensure that all the members of your team are collecting data and measuring results consistently and helps to keep your collective efforts aligned during the implementation process. For specifics on shared measurement, click Read More.

While developing a shared measurement system can be difficult, it is critically important in achieving collective impact. Shared measurement:

  • Establishes a common language
  • Measures progress on the common agenda
  • Creates greater alignment among the different organizations
  • Becomes a platform for an ongoing learning community
  • Illustrates the mutually reinforcing activities that are happening in your community.

After developing the shared measurements, participants must regularly share their results in order to learn from one another and refine their collective activities.


This list is by no means exhaustive, and CityMatCH recognizes that many experts and resources exist outside of this list.


Additional Resources

Identify a Backbone Organization

The backbone organization acts as the coordinating agency for all collective impact activities. Selection of a backbone organization is critical in ensuring successful implementation of any collective impact initiative. There are six major roles of the backbone organization:

  • Guiding the vision and strategy of the initiative—collective impact participants understand the need and desired result of the initiative
  • Supporting aligned activities—participants communicate and coordinate their activities toward a common goal
  • Establishing shared measurement practices—participants understand the value of data sharing
  • Building public will—the community is committed to change around the issue
  • Advancing policy –policymakers are aware and supportive of the collective impact’s policy agenda
  • Mobilizing funding—funding is secured to help support collective impact activities


This list is by no means exhaustive, and CityMatCH recognizes that many experts and resources exist outside of this list.


Additional Resources

Back Develop Your Road Map