National Public Health Performance Standards

National Public Health Performance Standards

The National Public Health Performance Standards (NPHPS) is a collaborative effort to enhance the Nation’s public health systems. Seven national public health organizations have partnered to develop national performance standards for State and local public health systems.

NPHPS tools are used to

  • Identify partners and community members in the public health system
  • Engage those partners in health assessment and health improvement planning
  • Promote improvement in agencies, systems, and communities

For more information on the background and benefits of the NPHPS, please click here.

Funding for this project was provided by the Centers for Disease Control and Prevention, Office for State, Tribal, Local and Territorial Support, under grant #5U38HM000454-05.

ASTHO supports states in their assessment preparation and implementation efforts and contributes to the development, implementation, and evaluation activities of the national program and the partnership. The NPHPS assessments can help states identify areas for system improvement, strengthen their partnerships with state and local agencies, and ultimately assure that a strong system is in place.

The Assessments

The NPHPS is based on the ten Essential Public Health Services, and is designed to assist state and local public health systems, and local governance entities in assessing and improving their public health systems or boards of health. The State Public Health System Assessment Instrument focuses on the state public health system, which includes state public health agencies and other partners that contribute to public health services at the state level. The State Public Health System Performance Assessment measures the capacity and infrastructure of state public health systems and helps states to recognize where improvements can be made.

The latest version of the Assessment, Version 3.0, is now available for download. Please see links below.

The links above are for the State versions of the Performance Standards. Click here for the Local Public Health System Assessment, hosted by the National Association of County and City Health Officials or the Public Health Governing Entity Assessment, hosted by the Centers for Disease Control and Prevention.

For further information about the Performance Standards or for technical assistance, please contact Denise Pavletic.

Note: There are a number of limitations to the NPHPS assessment data due to self-report, wide variations in the breadth and knowledge of participants, the variety of assessment methods used, and differences in interpretation of assessment questions. Data and resultant information should not be interpreted to reflect the capacity or performance of any single agency or organization within the public health system or used for comparisons between jurisdictions or organizations. Use of NPHPS generated data and associated recommendations are limited to guiding an overall public health infrastructure and performance improvement process for the public health system as determined by organizations involved in the assessment.

Submitting NPHPS Data for Results

The NPHPS score sheet and reporting process is hosted and supported by CDC’s partners at the Public Health Foundation (PHF). Sites will enter their scores from the Performance Assessment, Summary Comments, Priority Rating Questionnaire (optional), and Agency Contribution Questionnaire (optional) into specific fields in the data spreadsheet section, which are formatted in Microsoft Excel. Scores will then automatically populate in the report section. Once all data has been entered, sites can then print and save the complete final report section as a PDF. Visit to register and download a spreadsheet. For more information, contact

Case Study

The Perfect Storm: Case Study from the Kansas Department of Health and Environment

Has your state used the NPHPS? If so, we’d love to hear about your experiences! Please share with us by emailing Denise Pavletic. We look forward to featuring your stories!

NPHPS Partners

In addition to ASTHO, the NPHPS Partners consist of CDC, NACCHO, NALBOH, NNPHI, and the PHF. Collectively, they contribute to the advancement of the program by providing technical assistance and support, and ensuring that the program and resources meet the needs of users.