This report focuses on three specific services— nutrition education, breastfeeding promotion and support, and health  referrals. FNS Has an Outcome- Based Measure for One of Its Three Nutrition Services

FNS established the breastfeeding initiation rate as an outcome-based  measure for the WIC program’s breastfeeding promotion and support  activities, but has no outcome measures for its nutrition education or  health referral services. For  health referrals, FNS has been unable to identify a measure that, among  other things, would permit it to appropriately link the service’s activities  with a desired outcome. FNS lacked the resources needed to develop another sample with a large  enough number of WIC participants to establish national estimates. Generally, these  measures are used to examine the types and quantities of services the state  agencies provide and whether the agencies are in compliance with grant  expenditure and other program requirements. However, they cautioned that the report addressed performance  measures as they pertained to three nutrition service components of the  WIC program and not the program in its entirety, which includes  supplemental foods and other aspects of nutrition services.
Why GAO Did This Study

GAO examined the performance measures that the Food and Nutrition Service (FNS) uses to assess the nutrition education, breastfeeding promotion and support, and health referral services provided to participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program.

What GAO Found

GAO found that FNS has an outcome-based measure for one of the three nutrition services--breastfeeding promotion and support. However, the measure, breastfeeding initiation rate, examines only one of several important aspects of the service's possible impact on WIC participants. In addition, several obstacles have hindered FNS' efforts to develop and implement outcome-based measures for nutrition education and health referral services for the WIC program. These include difficulties in identifying measures that would allow the agency to appropriately link a particular service's activity to a desired outcome and resource constraints affecting FNS' ability to collect data needed to implement a proposed measure.