The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a federally funded $4.1 billion-a-year nutrition assistance program administered by the U.S. Department of Agriculture’s Food and Nutrition Service (FNS). During fiscal year 2000, this program provided $3 billion for supplemental foods and $1.1 billion for nutrition services and administration to assist lower-income pregnant, breastfeeding, and postpartum women, infants, and children up to age 5 who are at nutritional risk. FNS provided annual cash grants to support program operations at 88 state-level agencies. These 88 agencies administered the program through more than 1,800 local WIC agencies.
To help the Congress better understand the costs of delivering nutrition services and administering WIC, the William F. Goodling Child Nutrition Reauthorization Act of 1998 (PL 105-336) directed GAO to assess various aspects of WIC nutrition services and administration. This report, the third in a series responding to this request, examines the performance measures that FNS uses to assess the nutrition education, breastfeeding promotion and support, and health referral services provided to WIC program participants.
We based our evaluation on the performance measurement framework contained in the Government Performance and Results Act of 1993 (Results Act), which, among other things, encourages agencies to measure program performance by determining the extent to which intended program outcomes have been achieved. Program outcomes are the results of delivering a program’s products and services, while program outputs are the products and services delivered. An example of the distinction between the two concepts can be seen in the case of a job-training program. In such a program, an output could be the number or percentage of program participants who completed the training. A program outcome, on the other hand, could be the number or percentage of program participants employed 1 year after the training. Outcome measures on which objective data can be collected at reasonable cost can be difficult to develop, particularly for programs that are intended to influence the behavior of individuals. While emphasizing the use of outcome measures, the Results Act recognized that the output measures traditionally used by agencies for measuring performance remain critical to program management.
Consistent with the Results Act’s approach to performance measurement, this report discusses FNS’ use of both outcome and output performance measures. Specifically, it provides information on how FNS measures (1) the outcomes of three services provided by the WIC program—nutrition education, breastfeeding promotion and support, and health referral services; and (2) program outputs for these three service areas.