ABSTRACT
In 1982 the Ford Foundation launched the Child Survival/Fair Start (CS/FS) initiative under which it sponsored community-based strategies to improve pregnancy outcomes, infant health, and infant development among low-income families. Common objectives and measurements across projects with support for the development of strong and coherent within-project evaluations. Deciding which aspects of program services, clients, and community should be measured was a complex process; the scope and complexity of possible measures. Program parents, being educated to "signs and symptoms," might become more sensitive to the occurrence of illnesses than non-program parents. Evaluations of social programs typically have emphasized summative measures of program impact and slighted measurement of both the intervention process and the molar environmental variables that affect treatment outcomes. The perversities of public policies that prevent many impoverished married women and their children from receiving Medicaid warrant careful documentation if we are to understand the dynamics of health care utilization within the CS/FS target populations.
