Echo Health – Health, Nappies and Happy Families
By Barry Nelson
Young, first-time mums in the region are benefiting from frequent home visits by a new kind of health worker. Health Editor Barry Nelson investigates one American import which seems to be having a good influence over here
MODERN America might seem an odd role-model when it comes to promoting the welfare of young British families.
The kind of free, universal healthcare we take for granted in the UK is largely absent in the US, where millions of families lack basic medical cover because they can?t afford to pay insurance premiums.
But it seems we can learn something from America when it comes to finding ways to provide additional support for young, low-income, firsttime mothers who might otherwise find bringing up baby a struggle.
For the last year nearly 200 young mums and their partners in County Durham and Darlington have been helped by the Family Nurse Partnership.
Many more are due to benefit in Sunderland when the second wave of pilots are rolled out later this year.
The pioneering scheme, which is designed to help young families get the best possible start in life by an intensive programme of visits by specially trained nurses and prevent possible ?social exclusion?, is being piloted in England in ten sites for three years.
It is based on the highly successful Nurse Family Partnership Home Visiting programme, originally developed by Professor David Olds of Colorado University.
It is now so successful it is offered in 20 American states and serves more than 20,000 families every year.
It is not cheap, but an independent evaluation by the Rand Corporation suggested that it is worth four times its cost in terms of its benefits to society.
Prof Olds? scheme achieves three important goals: improving children?s health and development by helping parents provide responsible and competent care for their children; improving pregnancy outcomes by helping women live healthier lives; and improving economic self-sufficiency by helping parents plan their future, continue their education and find jobs.
A key job of the US home visitors (actually highly-trained nurses) is to help parents attune emotionally with their children and to use consistent, more appropriate discipline regimes.
In essence, the American experience suggests that mothers who have been on the NFP scheme are less likely to abuse or neglect their children, have unintended pregnancies or misuse alcohol or drugs. They are also more likely to stop needing welfare support and to maintain stable employment.
Convinced by these facts, the Department for Children, Schools and Families together with the Department of Health decided to try the scheme on this side of the Atlantic.
Last week an independent review of the first year of what is known as the Family Nurse Partnership in England came to the conclusion that the ten pilot schemes ? including the one in the North-East ? are actually helping to improve the life chances of vulnerable babies, young children and their families.
It involves a formidable amount of home visiting ? a total of 64 visits from pregnancy until the child is two years old.
Initially, family nurses make weekly home visits. This is stepped down to fortnightly until the baby is born then back to weekly for the first six weeks and fortnightly until the child is 21 months old.
For the remaining period until the child?s second birthday, the visits are monthly.
Jan Finn, programme manager for the FNP in County Durham and Darlington, says: ?We are already seeing the positive effects of the programme locally, with the Family Nurses reporting an increase in the confidence of young parents on the programme, a greater interest from dads and partners in participating, and a willingness from young parents to learn about the development of their child and health related issues. ? To gauge how young couples are reacting to this intensive programme, I went to the Young Parent group at Newton Aycliffe Sure Start Children?s Centre and met some of the people who have signed up.
Beccie Foster, 18, her partner Ashley Ward, 18 and their three- monthold baby Rhyley looked happy, confident and positive when I talked to them.
?It is very helpful, it is good to be able to have a chat with someone who is not family. The nurses really know their stuff, as well, ? says Beccie.
Ashley simply says: ?I loved it. I learned loads more stuff this way. ? ?He does baby massaging and everything? he likes being involved, ? adds Beccie, approvingly.
Another mum, Leanne Smith, 19, whose son Jack is six months old, is impressed that sometimes the family nurses seem to know more than her doctor. ?Some of the things the doctor told me turned out not to be true.
It has all been really useful, ? she adds.
Her partner, Russ Gibson, 26, is also very keen to be involved in childcare.
Jacqueline Clough, 19, whose baby, Bethany, is sixmonths old, is very impressed. ?I think it is brilliant. We have had loads of help and it doesn?t just have to do with babies, just anything to do with health, ? says Jacqueline. ?The first time my family nurse came to see me it was a bit weird but now I have got to know her, it?s OK. ? Her partner, Gareth Tuck, 28, learned the correct way to bath his young son from family nurseMichelle Wolstenholme. ?It was hard the first time, but it is getting easier, ? says Gareth. ?I think there should bemore of this kind of thing. ? Jan Finn believes the work her team is doing could have far-reaching consequences. ?These are the vital first years and we have to help these young people get it right, ? she says.
Young women on the course are taught to distinguish different baby cries. ?One of the things they do is to look out for baby cues, the way they cry and their facial expressions. They are taught how to read their babies, ? she adds.
Beccie chips in: ?We know the difference between six cries. He is telling us what he wants. ? Her partner, Ashley, agrees: ?It?s great to know all this stuff. I didn?t have a clue but I know how to bath and feed babies. ? And while there is a lot of learning, there is also time for fun. ?We do a lot with play but one of the things we do is to teach people how to tell whether their child is enjoying it, making sure that your play is child-centered, ? says Michelle.
Gareth says: ?I feel really proud of what I have learned. I feel very responsible when I am playing with Bethany. As an only child it was difficult, but I feel far more confident now. ? Jan says there is also a lot of emphasis on the important of love, trust and respect as part of ensuring children have a stable home background.
?It can be a bit of a roller-coaster.
There is a lot of training and we work very closely with families, from before the baby born to age two, ? says Michelle.
Not every young mum co-operates and a small number have dropped out but, in general, clients give the programme top marks in terms of how they value the work the family nurses do.
?A happy home is the best environment to bring up a baby, ? says Michelle. ?We teach the parents to dance with their children, not wrestle. ?
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