Maternal and Child Health Epidemiology Capacity within Urban Local Health Departments *

BACKGROUND: In July 2013, the Ohio Department of Health and CityMatCH partnered with nine urban counties to launch the Ohio Institute for Equity in Birth Outcomes (OEI).  This three-year initiative strives for data-driven decision making for public health practices; therefore assessing maternal and child health (MCH) epidemiology capacity within local health departments of OEI counties was important to ensure accurate use and interpretation of data to influence interventions.  However, capacity was unknown.  To ensure adequate state support for departments and plan capacity building strategies, we assessed local epidemiology capacity, including functional capacity, skills, strengths, and limitations. 

METHODS: The MCH module of CSTE’s Epidemiology Capacity Assessment (ECA) and CDC’s MCH Epidemiology Program capacity tool were adapted into a 33-question local ECA instrument.  During 2013, the instrument was distributed electronically to epidemiology unit supervisors in the 11 departments within OEI counties (100% response rate).  Respondents self-reported skills on a 3-level Likert scale.  Five open-ended questions on capacity building were analyzed qualitatively by manually grouping responses, and keywords were used to develop common themes. 

RESULTS: Of 58 epidemiologists enumerated by departments, 37 were reported as MCH Epidemiologists (MCHE) based on the work they performed.  About 75% of MCHEs received some formal epidemiology training; the most common academic preparation was Master’s level (58%), while 11% had doctoral training.  Four of the 11 departments reported having an MCHE with greater than 50% time devoted to MCH activities.  Among skills assessed, 4 of 11 departments possessed above average capacity for data analysis, while 5 departments had above average capacity in data collection and program evaluation skills.  Staff ability to communicate data was similar for most departments.  Respondents identified areas where the state could help build capacity: workforce development (e.g. trainings and webinars), data access, and financial support.  Capacity limitations most commonly reported: staff availability, data analysis, and competing priorities.

CONCLUSIONS: This assessment described the current capacity of MCH epidemiology in urban departments and identified areas of need.  For urban departments with less capacity, the OEI data responsibilities for MCHEs may require more outside support compared to departments with greater capacity.  Results guided the state’s development of technical assistance activities around core MCH functions and the epidemiology competencies to support OEI work.  Assessment of local epidemiology capacity can be valuable to state health departments for identifying local skill development strategies and enhancing state and local collaboration on shared priorities.