Summary

GAO discussed home visiting as a way to deliver preventive health and social services to women and their families. GAO noted that: (1) home visiting was a promising strategy for improving birth outcomes, preventing child mistreatment, and improving child health and development; (2) home visiting could be particularly useful for women at risk of poor outcomes, such as teenage mothers, substance-abusing women, and women living in rural areas with limited transportation; (3) home visiting could provide in-home services or link women to other services provided elsewhere; (4) home visiting combined coaching, counseling, teaching, referrals, and sometimes hands-on care; and (5) there were over 4,500 programs in the United States that used home visiting, but not all programs were successful in achieving their objectives. GAO also noted that more research is needed to determine the most cost-effective ways of improving birth outcomes and maternal and child health and well-being, primarily in such areas as: (1) the most cost-effective populations and outcomes for home-visiting; (2) whether home visiting should be universal or targeted; (3) the most cost-effective type of home visitor; (4) the most cost beneficial service configurations; and (5) the most effective curriculum or structured plan of services.