Spartanburg, South Carolina, aims to enhance child and family health and well-being through the Hello Family initiative, offering a continuum of evidence-based early childhood services to its residents. Hello Family builds on parents’ strengths and equips them with knowledge, skills, and competence to promote healthy births and safe and thriving early years for their children. Urban Institute is the lead evaluator of this initiative under two project phases.

Phase 1

To support program financing, the City of Spartanburg structured a pay for success project, in which private lenders provide the capital to fund the programs and are repaid only if agreed-on outcomes are observed. This payment structure minimizes risk to the city’s limited public dollars and provides immediate social benefits to Spartanburg children and families.

Three programs are included in the phase 1 project:

• BirthMatters doula program
• Family Connects universal newborn home visiting
• Triple P: Positive Parenting Program

Using synthetic control methods, the evaluation assesses impacts on six target outcomes:

• Four birth outcomes among Medicaid-paid births where the mother was younger than age 25 by their third trimester and resided in Spartanburg at delivery: reduction in the percentage of babies delivered by cesarean section, reduction in the percentage of babies with low birthweight, reduction in the percentage of newborns admitted to the NICU, and increase in the percentage of mothers breastfeeding their babies by hospital discharge after giving birth
• Reductions in the rate of infant emergency medical care use for all babies born in Spartanburg, which accounts for the total emergency room visits and non-birth-related overnight hospital stays during first six months after birth
• Reductions in the rate of substantiated child maltreatment among children under age 8

The city evaluation will track outcomes observed over a five-year period from 2022–26.

Phase 2

With funding from a Social Impact Partnerships to Pay for Results Act (SIPPRA) grant from US Treasury awarded in 2024, Spartanburg County is building on the success of the pilot city initiative. SIPPRA funding is being used to expand BirthMatters doula services for pregnant women with low incomes and Family Connects universal newborn home visiting to reduce the incidence of low-birthweight babies and emergency medical care use within the first six months of birth.

The SIPPRA evaluation will track outcomes for five birth cohorts for babies born in 2026–30.