weight and obesity, and innovative nutrition education interventions. The findings will be presented in 2016.


HRSA is the primary federal agency tasked with improving access to health care services for people who are uninsured, isolated, or medically vulnerable. The agency has 6 bureaus and 10 offices. Two of the bureaus have particular relevance to the work of the Committee on Implementation of the IOM Pregnancy Weight Gain Guidelines: the Maternal and Child Health Bureau (MCHB), which is primarily focused on the delivery of core public health services, and the Bureau of Primary Health Care (BPHC), which oversees community health centers and is more focused on the delivery of primary care.

Programs within both bureaus provide significant opportunities for encouraging the implementation of the 2009 guidelines. MCHB has a longstanding history of involvement in maternal nutrition and perinatal health, including having provided funding support to the IOM for the development of nutrition reports as far back as the 1970s.

MCHB’s largest program, in terms of funding dollars, is the Maternal and Child Health Block Grant program, which was authorized under Title V of the Social Security Act. The program provides formula block grants to states that are awarded annually, with the amounts based partly on the number of children in poverty within a given state versus the number of children in poverty nationally. The block grants support a range of services in the states that are designed to ensure the health of the nation’s mothers, infants, and children, including children with special health care needs. In fiscal year 2011, the 59 states and jurisdictions in the program served more than 44 million individuals, including more than 2.3 million pregnant women. Over the years, national and state leadership provided by Title V–supported programs has contributed to implementing recommended standards for prenatal care and for improved nutritional practices during pregnancy. The states are also expressing a growing interest in applying the life-course perspective to maternal and child health practice.

In addition to national performance measures and indicators on which states report annually, states develop between 7 and 10 state performance measures to address individual priority needs to the extent that they are not addressed by the national measures. Twenty-six such measures specifically focus on the weight status of women before, dur-

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