‘all children have the best start in - PowerPoint Presentation

1. ‘all children have the best start in life’Proportionate Universalism and Maternal Early Childhood Sustained Home Visiting (MECSH)Lynn Kemp Professor and Director, Translational Research and Social Innovation (TReSI)

2. Council of Australian Governments (COAG) 2009. Investing in the Early Years—A National Early Childhood Development StrategyBy 2020 all children have the best start in life to create a better future for themselves and for the nation

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5. Level of investmentHigh capacity/resourceLow capacity/resourceCrisis managementCurrent investment patternAll families

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7. Proportionate universalismUniversal preventionLevel of investmentAll familiesSome families all of the timeSome families some of the timeHigh capacity/resourceLow capacity/resourceSelective preventionIndicated preventionCowley S, Kemp L, Day C, Appleton J. (2012) Research and the organization of complex provision: conceptualising health visiting services and early years programmes. Journal of Research in Nursing 17:108-124.

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9. MECSH is:a structured, evidence based (HomVEE approved) programme of sustained home visiting, group work and service connection provided by Child & Family Health Nurses from pregnancy or early postnatal engagement up to child-age 2 years.integrated into the child and familyhealth service (low marginal cost).Key elements of MECSH and its implementation

10. Key elements of MECSH and its implementationMECSH provides a comprehensive intervention for the broad range of families who need additional support to parent effectively and meet their aspirations, including:mothers of all agesmothers with any number of childrenmothers of any gestation up to 6-8 weeks from commencement of parentingfamilies experiencing a broad range of risks that impact upon their capacity to parent effectively including, for example, postnatal depression, significant life stressor (including child health or disability issues), mental health issues, family violence, drug and/or alcohol misusefamilies engaged with the child protection system.

11. Key elements of MECSH and its implementationNot seeking “a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity.” (WHO 1946)Seeking “health, as the ability to adapt and to self manage” (Health Council of the Netherlands 2009)Can not prevent all the changes, instability and difficulties families faceDeveloping child can not wait for family to be ‘cured’Can intercept detrimental parenting processes that may be triggered by these difficulties (protection, buffering (Shonkoff))Can support families to “parent effectively despite” the difficulties they face“parenting effectively despite”

12. Programme components

13. Group activitiesOther services and supports (dealing with the ‘despites’)Home visitingCommunity visibilityProgramme structure

14. Program outcomesKemp L, Harris E, McMahon C, Matthey S, Vimpani G, Anderson T, Schmied V, Aslam H, Zapart S. (2011) Child and family outcomes of a long-term nurse home visitation program: a randomised controlled trial. Archives of Disease in Childhood 96:533-540Kemp L, Harris E, McMahon C, Matthey S, Vimpani G, Anderson T, Schmied V, Aslam H. (2013) Benefits of psychosocial intervention and continuity of care by child and family health nurses in the pre and postnatal period: Process evaluation. Journal of Advanced Nursing 69(8), 1850-1861ChildrenMore engagedImproved developmentMothersLess birthing interventionImproved healthLonger time breastfeedingImproved confidenceImproved use of servicesFamiliesImproved home environmentCommunityFewer vulnerable children at school entry

15. Somerset TrialEnablementMean

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18. Program research and implementation teamsSupporting services Project fundersParticipating familiesFurther informationlynn.kemp@westernsydney.edu.auhttp://www.earlychildhoodconnect.edu.au/ Thank you