The PPOR approach was developed during 2000-2004 by CityMatCH and its member health departments, with the support and involvement of the Centers for Disease Control and Prevention, the Health Resources and Services Administration/Maternal and Child Health Bureau, and the March of Dimes.  It was adapted for U.S. cities from an approach used by the World Health Organization (The Healthy Newborn Lawn J, McCarthy BJ, and Ross SR.1)  PPOR methods are detailed in a suite of articles in the Maternal and Child Health Journal.Stories of the development of PPOR and accounts of its use in several cities were published by CityMatCH in the Fall 2012 issue of CityLights . 3 

 The "BABIES" Matrix, by Dr. Brian McCarthy         

"BABIES" Matrix, by Dr. Brian McCarthy

In 1997 CityMatCH convened a national working group of local and state MCH practitioners and public health scientists to find ways to improve local MCH data and assessment capacity. This group recommended an approach created by Dr. Brian McCarthy and used in developing countries, called the Periods of Risk Approach. With support from the Centers for Disease Control and Prevention (CDC), the National March of Dimes Birth Defects Foundation, the Health Resources and Services Administration/Maternal and Child Health Bureau (HRSA/MCHB), CityMatCH led national efforts to validate, enhance and adapt this approach for use in US cities with high infant mortality rates.


Since 2004, with funding from the CDC and the National Healthy Start Association, CityMatCH has promoted the integration of PPOR with broader MCH practice at the state and local levels, and has provided training and technical assistance to urban health departments, Healthy Start sites, and others who wish to use the approach to reduce infant mortality in their communities.



1The Healthy Newborn is available for download here: )


2 MCHJ  Volume 16, Number 6/November 2010

Core PPOR Methods Articles.


The Fall 2012  issue of CityLights is available here All rights reserved©