Maternal and Child Health Jurisdictional Survey Instrument for the Title V MCH Block Grant Program

OMB 0906-0042

OMB 0906-0042

HRSA/MCHB needs the Title V MCH Block Grant Jurisdictional MCH Survey to create a mechanism for jurisdictions to begin collecting, reporting and monitoring key MCH indicators over time. This data collection will enable the eight jurisdictions (i.e., American Samoa, Federated States of Micronesia, Guam, Marshall Islands, Northern Mariana Islands, Palau, Puerto Rico, and U.S. Virgin Islands) to meet Federal performance reporting requirements and to demonstrate the impact of Title V funding relative to MCH outcomes for the U.S. jurisdictions in reporting on their unique MCH priority needs. Having these data will allow for better annual reporting by the Federal program office in reporting to Congress on the jurisdictions’ Title V program accomplishments.

The latest form for Maternal and Child Health Jurisdictional Survey Instrument for the Title V MCH Block Grant Program expires 2022-04-30 and can be found here.


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