Developing a Logic Model for Maternal Health Programs

A logic model is a roadmap that depicts the relationship between a program's activities and intended effects and impact. There are different approaches to building logic models for program evaluations: basic, theory of change, outcomes approach, activities approach, and research performance. The most appropriate logic model depends upon the scope of the maternal health program.

A standard logic model contains 5 or 6 common components including:

1. Inputs: resources required for program implementation
2. Activities: services provided with the resources
3. Outputs: deliverables resulting from the work of the program, including products and increased capacity
4. Short-term outcomes: changes in conditions or in the knowledge, attitudes, and behaviors of the target population because of the activities and outputs
5. Mid-term outcomes: changes in conditions or in behaviors and decision-making of the target population because of the activities, outputs, and short-term outcomes
6. Long-term outcomes: long-term social, economic, or environmental outcomes

To build a logic model, the maternal health program must:

1. Work closely with the target community to understand their needs. It is helpful to be as specific as possible when describing the population in terms of age, gender, location, income status, health status, language, and ethnicity group, for example. Maternal health programs may be tailored for pregnant women, children, and families.
2. Identify the required resources (inputs) that will provide the services in the program and allow the program to reach its objectives. The detailed description of the targeted community and its needs may be extremely helpful in identifying funding opportunities and cultural nuances. Examples of rural maternal health program inputs include funding sources, human resources, physical space, office supplies, special equipment, time, and any in-kind materials.
3. Identify the strategies (activities) that will help achieve the objectives for the targeted community. Include activities in a logical and sequential order that will help the program achieve its desired goals. Examples of rural maternal health program activities can be found in Module 2 of this toolkit.
4. Describe the process (output) of the intervention. This step will provide a detailed description of the program in terms of participation or completion regarding activities or services. This section is used to tell whether program objectives are being met and if the program will deliver the desired impact, based on participation and completion of activities. Examples of rural maternal health program outputs might include the number of childbirth classes held or the number of doulas trained. Outputs will vary depending on the objectives of the individual program.
5. Identify the measurable changes that will occur in the target community/population (outcomes). Evaluators often divide outcomes into short-term and long-term outcomes but, regardless of how they are divided, the plan should be limited to a maximum of three outcomes. Limiting the number of outcomes ensures clarity among stakeholders and focuses all the resources (inputs) on achieving the changes that matter the most. It is also useful when collecting data, as the more outcomes that are included, the more data are required, which is not always realistic or feasible. Examples of rural maternal health program outcomes might include the percentage of women who receive prenatal care in the first trimester, the number of pregnant women who use tobacco products, or the number of women who breastfeed their infants for the first six months.

Pregnancy is a unique time-limited period so results from programs focused on pregnancy and pregnancy outcomes will be evident relatively quickly, compared to other types of public health programs. Healthy birth outcomes, breastfeeding initiation, and postpartum mental wellness are all visible within a year of giving birth. What may take longer is tracking changes in the culture in which maternal health results were accomplished. Environmental changes fall into the long-term outcomes (Step 6 above) of the logic model.

Once the intended program outcomes have been determined, it is important to gather feedback from program staff and stakeholders. Stakeholders may include community leaders, mothers, pregnant women, local experts, local health providers, local health organizations, funders, and other collaborators. Stakeholders may contribute valuable information and feedback to the project team, and they may help assess progress towards meeting the intended outcomes. This is an ideal opportunity to engage key stakeholders in the program and seek support regarding endorsement, participation, advertising, and funding. This is also an important step for appropriately disseminating program results. For more information on dissemination, see Module 7.

Resources to Learn More

Logic Models: Better Thinking for Better Results
Document
Provides quick reference on the benefits of developing a logic model, and the components and characteristics necessary for building an effective logic model.
Organizations(s): Wilder Research
Date: 2/2010