[Invited Lecture Ⅳ] Improving Outcomes for All Vulnerable Families with Young Children

다국어 초록 (Multilingual Abstract)

Children born to families experiencing disadvantage do not have the same opportunity for good health as those living in more advantaged circumstances. In Australia and internationally there is increased interest in developing interventions that will reduce health inequalities and recognition that early childhood sustained nurse home visiting interventions offer the greatest potential for long term change. In response many countries have invested in home visiting program for families with specific risk factors (such as being a first-time teenaged mother). This targeted investment, however, will not produce change in the levels of vulnerability in whole populations. Families are, or may become vulnerable for many reasons and at many times through their experience of parenting with up to 40 percent of families in the population requiring additional support either some or all of the time. It is now recognised that to make a difference to improve outcomes for whole communities and populations, children"s access to positive early experiences needs to be tackled along the whole social gradient, with services and support being proportionally targeted to the needs and capacities of all families.
This paper will discuss the essential role that nurses working through universal health systems have in supporting families when they are experiencing vulnerabilities. The paper will focus on the Maternal Early Childhood Sustained Home-visiting (MECSH) program of sustained nurse home visiting for vulnerable families at risk of poorer maternal and child health and development outcomes. MECSH draws together the best available evidence on the importance of the early years, children"s health and development, the types of support parents need, parent-infant interaction and holistic, ecological approaches to supporting families to establish the foundations of a positive life trajectory for their children. Targeting 20-25 percent of the population who need ongoing support, MECSH is delivered as part of an integrated approach to services for young children and their families. To encompass the range of needs encountered, it is broad based and multi-faceted, and also aims to exploit and integrate with resources available in the wider community.
The program is delivered by public health nurses who are embedded within universal child and family health services, as part of a comprehensive program that includes group activities, and engagement with and referral to other services. MECSH is explicitly designed to support and develop child and family health nursing services to provide effective prevention and early intervention programs to achieve improved outcomes for all vulnerable families.

목차 (Table of Contents)

• ABSTRACT
• Improving outcomes for all vulnerable families with young children
• MECSH program structure
• MECSH program goals
• MECSH program components
• MECSH program structure
• References