The relationship between needs assessments and state strategies for meeting healthy people 2000 objectives: lessons from the Maternal and Child Health Services Block Grant.

Recognizing the critical role of needs assessments in the development of public health policy, the Omnibus Budget Reconciliation Act of 1989 required states to include needs assessments in their Maternal and Child Health Services Block Grant applications and to demonstrate a link between needs and programs. We examined this link by analyzing the relationship between strategies to meet health objectives and needs assessments in the applications for fiscal year 1992 for the eight states in the southeast (DHHS Region 4). Overall, the proportion of strategies based on reported needs was 88%. Numerous other needs, however, were not related to any strategies. Furthermore, there were neither needs nor strategies described for many objectives. These data required extensive analysis of the applications. A uniform structured report would facilitate the explicit collection of this information and thus the usefulness of this important document for policy development and accountability.