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Centering Healthcare Institute

Strengthening, Measuring, and Evaluating to Increase Capacity to Provide Maternal/Child Health


Centering Healthcare Institute


Strengthening, Measuring, and Evaluating to Increase Capacity to Provide Maternal/Child Health


How can we ensure that the systems and processes are in place to support multiple affiliates implementing and sustaining an effective model to improve maternal/child health?


Root Cause understands that many disparities exist with regard to access to quality, holistic prenatal healthcare in the U.S., most namely for Black women. According to the CDC, Black women are 3 times as likely to die from a pregnancy-related cause than white women, as well as more likely to suffer a number of other birth defects. Community-based programs that build social support have been cited by the CDC as proven to effectively address these disparities. With Health & Well-Being as one of our Key Issues, we value working with partners who improve access and quality of health care at all phases of life. 

For over two decades, Centering Healthcare Institute (CHI) has worked to improve maternal/child health outcomes by transforming care through an approach known as Centering groups. CHI provides training, consultation services, tools, and resources to support affiliate sites in successfully implementing its Centering model. Centering brings pregnant women together for prenatal visits, allowing for a more efficient, collectivist approach to prenatal care for patients. The model aims to improve maternal and child outcomes by including parental learning and connection into prenatal visits.  As other healthcare providers learned about the Centering model, demand for implementing the model at their site has grown  across the country. Today, there are over 400 Centering sites across the U.S.

In 2016 the W.K. Kellogg Foundation provided a grant to CHI to strengthen their capacity to achieve more rapid spread of Centering models of care. In the grant, CHI identified three capacity building objectives on which to focus:

  1. Improving customer engagement and support by identifying barriers to successful implementation and sustainability of Centering models of care, and developing tools and resources to overcome those identified challenges.
  2. Workforce optimization of office staff and field consultants to provide the consistently high quality customer services necessary for the transformation of health care systems and to provide ongoing site support for Centering group care.
  3.  Community-level outreach focused on developing and nurturing partnerships with individuals, agencies, and organizations to achieve exponential growth of Centering through collaborative efforts.

As a part of its grant with Kellogg, CHI needed to select a 3rd party organization to evaluate the results of their capacity building efforts. CHI chose to partner with Root Cause to gather data to inform the capacity building strategies CHI would implement, develop the performance measurement tools and process to collect data over the three years, and assess progress on an annual basis. Through this process with Root Cause, CHI  strengthened its organizational capacity as well as its ability to measure that increased capacity  confirming its critical role in  supporting provider sites to implement and sustain successful Centering models across the U.S.

“Working with Root Cause was a tremendously helpful experience. They assisted us in meeting the evaluation requirements for a grant, but also worked with us to create an evaluation framework that we can continue ourselves. The project management was invaluable - we are a team that's difficult to herd and going through tremendous growth. They gently nudged and kept us on track. We are grateful for the experience and hope to find future opportunities to partner.”

Goals & Results

Root Cause led CHI in a 4-Phase Process:

  1. Conducting a needs assessment of Centering practices
  2. Building capacity to measure outcomes of capacity building objectives
  3. Implementing Measurement Tools
  4. Data Analysis and Evaluation Reporting

Led  by Colette Stanzler in 2016, Root Cause partnered with CHI to conduct a needs assessment to determine how it could improve its customer engagement and support and identify the key barriers to sites implementing and sustaining the Centering model. Root Cause surveyed the sites and conducted focus groups, analyzed the findings and provided CHI with  recommendations on priority customer needs to address.

During Phase 2 of the project, Root Cause worked closely with CHI to develop the Performance Measurement Framework to be used to monitor whether the changes CHI implemented with funding from the Kellogg grant were effective. The framework included process and outcome indicators, how and when the data will be collected, baseline data that exists, and target and actual outcome indicators. In Phase 3, Root Cause continued to provide support to CHI to implement the measurement tools developed in Phase 2 and work through any challenges. 

In the final phase, Root Cause analyzed the data gathered over the three years and summarized the effectiveness of the changes implemented  in the three priority areas of customer engagement and support, workforce mobilization, and outreach/collaboration. The findings and learnings were included in an evaluation report provided to the Kellogg Foundation


The New York Times
Prenatal Care Takes a Village: Can group prenatal care make pregnancy and birth safer?

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CenteringPregnancy® Recognized by National Prenatal-to-3 Policy Impact Center as Successful Strategy to Better Outcomes in Maternal and Child Health

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Inside Philanthropy
How Is the Kellogg Foundation Improving Care for Pregnant Women at Risk?

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About the Partner

Centering Healthcare Institute

Centering Healthcare Institute

CHI is a non-profit organization that works closely with healthcare providers from all sectors to change healthcare. With over two decades of experience as the go-to resource for group care, CHI has developed and sustained the Centering model in more than 550 practice sites and in some of the largest health systems in the world.

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