Farmworkers' labor is crucial to the production of a wide variety of crops in nearly every state in the nation. Estimates of the farmworker population are difficult to document, however estimates suggest each year approximately 4.2 million workers and families leave their homes to “follow the crops.” Very young children, between the ages of birth to 5 are not excluded from the migrant process. The circumstances of migrant farmworker children are particularly poignant because the migrant process imposes both physical and mental stresses on these children. Comparisons between the health status of migrant farmworker children and children from the general population show that migrant farmworker children are almost three times more likely to be reported in fair or poor health. Concerned with the impact of migration and the occupational safety of children in the fields, community groups advocated for the creation of a program to meet the needs of migrant children and their families. In 1969, such a program was created as part of the Head Start system. Over the years, the program has developed into what is now known as the Migrant and Seasonal Head Start (MSHS) Program.

Although Migrant and Seasonal Head Start Programs have existed since 1969, little is known about the programs and the impact that such programs have on the health status of migrant children. For this reason, the present study addresses the following three objectives: (1) examine the characteristics associated with MSHS programs that assure that health services are provided to enrolled children; (2) explore the relationship between MSHS program characteristics and program health service outcomes; (3) analyze case studies to provide recommendations to policy makers, MSHS service providers, and other stakeholders to assist low- and medium-performing programs in becoming high-performing programs in the provision of health services to enrolled children.

For this study, surveys of all MSHS directors were quantitatively analyzed to examine the project aims and ascertain those MSHS programs that could be qualified as high and low performing programs. Qualitative interviews were conducted with health services coordinators in a subset of both high- and low-performing MSHS sites as part of a case study approach. Notes were coded and thematic analysis was conducted. The survey results showed that a significant number of children did not receive mandated dental and medical services, and that variables such as language spoken by staff and age of children are statistically related to health services outcomes. Interview results suggest that staff language skills, staff ability to work with children of varying ages, community collaborations, and having a seasoned health service coordinator are all related to program performance. Findings from this study suggest that MSHS programs could increase the number of children receiving health services by increasing staff who are fluent in languages spoken by MSHS children and families and trained to work with children of varying ages, establishing community collaborations, and working to retain health service coordinators.