Developing national performance standards for local public health systems.

Since the beginning of the 1990s, public health has struggled to measure its performance and capacity to carry out the core functions of public health practice, while facing increasing challenges within the ever-changing landscape of healthcare delivery, bioterrorism response, emerging infections, and other threats to the public's health. The article describes the development of a set of national performance standards for measuring how effectively public health systems deliver the 10 Essential Public Health Services. The standards were developed through a practice-driven approach that incorporated comprehensive field testing and iterative revisions. The standards represent a national consensus framework for measuring important aspects of public health practice.