About the Study

The South Carolina Nurse-Family Partnership Study is a landmark evaluation of the effects of a large-scale nurse home visiting program for mothers and their children.

Policy Motivation

Prenatal and early childhood interventions may have the potential to improve health and other outcomes across the life course. These services are not, however, traditionally funded through Medicaid, and there have been relatively few rigorous evaluations measuring the causal impact of large-scale preventive programs in early childhood. This evaluation will provide policymakers with evidence on the effectiveness of a nurse home visiting program delivered at scale to first-time Medicaid-eligible mothers. It will inform decisions to leverage Medicaid funding to improve outcomes through a wider range of services.

A Randomized Evaluation to Learn

This evaluation is based on a four-year expansion of Nurse-Family Partnership led by the South Carolina Department of Health and Human Services with the goal of better understanding program impacts and how best to scale this program. The expansion of Nurse-Family Partnership services was enabled by a Pay for Success contract that coupled $17 million in philanthropic funding with a Medicaid waiver that supported the project’s costs. As part of the project, the State commissioned the landmark South Carolina Nurse-Family Partnership Study to rigorously evaluate the program’s effects, and agreed to make success payments to fund further home visiting services if pre-determined success metrics were met. The study team is using South Carolina’s linked administrative data system to track a wide range of outcomes related to families’ health and well-being.

Nurse-Family Partnership is a national maternal and child health program serving nearly 40,000 families in 40 states, the U.S. Virgin Islands and many Tribal communities. Nurse-Family Partnership pairs each first-time, low-income mother with her very own personal nurse who provides her with home visits starting during her pregnancy until her child’s second birthday. Beginning in 1977, the impact of the Nurse-Family Partnership has been studied in three randomized controlled trials which found positive outcomes on the health and well being for mothers and their children.

From April 2016 through March 2020, the Harvard and J-PAL study team enrolled a total of 5,655  first-time Medicaid-eligible mothers into the study across urban and rural areas in South Carolina. This was the fastest statewide expansion of Nurse-Family Partnership. Approximately two-thirds of study participants were randomly assigned to receive Nurse-Family Partnership’s services while the remaining moms received received the usual care available to Medicaid-eligible mothers in their communities. The study team is using South Carolina’s linked administrative data system to track outcomes over a 30-year period. This administrative data will enable the study to learn about Nurse-Family Partnership’s impact on a broad range of outcomes, including not only health but also education, economic outcomes, and more.

During the COVID-19 pandemic, Nurse-Family Partnership nurses have continued to provide support to expectant and new mothers.  NFP nurses, now operating by telehealth during the pandemic, have been providing expert information to new mothers on everything from how to stay healthy during pregnancy to what to do if their baby gets sick. Click here to read about how one NFP nurse supported her client during the pandemic.

Nurse-Family Partnership Service Areas Spanned Urban and Rural Settings in South Carolina