The presentation was prepared by Natasha Hampton, an ANFPP client who will soon graduate from the program; Jasmine Campbell, an Aboriginal Community Worker (ACW); and Clare Levy, Nurse Home Visitor (NHV). Together they worked to create an hour-long overview of the program, its aims, its ways of working and the impact it is having on clients in the Alice Springs area.

Natasha, whose twins are about to graduate from the program, spoke about her experiences as a client and the ways in which the program had supported her as a mother. She generously shared her experiences about what the ANFPP has meant to her, including the sense of friendship and community spirit she felt. She shared her experiences of becoming a strong, proud and informed mum. Reflecting back on the value of the confidential support she has received during her time with the ANFPP, Natasha says she would recommend the program to other eligible women and noted the lack of “pressure” she felt around her participation in the program. As the first mother of twins to participate in the ANFPP at Congress, Natasha was also instrumental in sourcing suitable materials for mothers with twins and says she values the partnership approach that underpinned this work with her NHV.

Jasmine Campbell, ACW, was unable to attend the presentation in person in Darwin, however, her section of the presentation was shared on her behalf and received great feedback from conference participants. Jasmine’s reflections focused on how the Alice Springs community has responded to the ANFPP, including positive community conversation about the program and the active participation of family members – including men and grandmothers – in visits. Jasmine also looked at the positive responses of women to the program and the benefits it has for their children. These factors contribute to how much the program means to Jasmine: she appreciates meeting the clients, helping and supporting the nurses, learning new things and seeing the clients graduate.

Claire Levy, a NHV in the program, also spoke about how privileged she feels to participate in the ANFPP, sharing one of the most momentous times in the lives of women and their families. She spoke about how clients share their intimate stories and reflected on the strength she draws from working in an evidenced-based program that is well-supported at the organisational level, with a team of dedicated, passionate people. Claire also identified some of the challenges faced by the program including the transience of the Alice Springs‟ population; the complex needs of some clients; the underlying determinants of health that the program is unable to address; and the need to be emotionally available for clients. She also noted that working in an office full of strong women can be a challenging as well as rewarding aspect of the ANFPP!

Together these three women shared some of their fabulous experiences with the CDN Conference and were delighted to be able to connect with other practitioners working in the area.

For more information on the Chronic Diseases Network you can look at their page on the Northern Territory Government’s website.

http://www.health.nt.gov.au/Chronic_Conditions/Chronic_Disease_Network/index.aspx

Pilar Baca has been involved with the Nurse-Family Partnership (NFP) since its early trials. Currently the Clinical Director of Program Development at the Prevention Research Centre (PRC), Pilar has held several NFP-related roles, as a team member, a trainer and technical advisor to international replication sites of the program. As one of the original Nurse Home Visitors (NHVs) to take part in the  clinical trials of the program, she brings a unique depth and breadth of experience with the NFP, its implementation, successes and of course challenges.

Pilar has supported the ANFPP as an  advisor since 2008, acting as a  technical resource for both the Support Service and the ANFPP implementing teams. As a new program in Australia, Pilar offered support to implementation that would otherwise have been unavailable as there were literally no NFP “experts” in Australia at the time of its inception. 

Pilar’s initial role was to support training for the Support Service (the body tasked with the workforce development and training for the ANFPP as a whole) in the program’s core elements. This training helped establish what the ANFPP would “look like” in the Australian context in areas such as core training, required materials, data collection and monitoring.

After this initial phase of support to the program’s establishment in and adaptation to the Australian context, Pilar was available for on-call technical advice and assistance that helped to combine the elements of the NFP into a coherent program that would be suitable to the Australian context.

Pilar’s approach to the ANFPP team has always modelled the program’s approach to clients. Rather than taking a didactic approach, Pilar frequently asked participants how things work in Australia, exploring and learning more about the Indigenous cultural context in which the program would be operating. In her contributions, she has never lost sight of the five client-centred principles, which are reflected in whatever context she speaks. In eliciting information about the program, its participants and stakeholders, she was identifying where the ANFPP team was at so that she could build on our strengths. She knew that the challenges ahead would not be about what happened in a specific visit, but that what would determine whether the program worked in Australia would be whether we could reproduce the spirit of the program in our particular organisational and community contexts. 

Throughout the last four years, Pilar has been in constant contact with the Workforce Development Team at the ANFPP Support Service. She has assisted in resolving many challenges, always providing the calming reassurance that only someone who has lived and breathed the program for as long as she has is able to do. She regularly supported the ANFPP Support Service Leadership Team and the teams of Nurse Home Visitors. Direct access to program leaders such as Pilar has been immensely valuable to the teams in the development .

From a personal perspective, the real benefit I gained was during the precious moments between training sessions when I was able to touch base with Pilar face-to-face to talk through some thorny issues or challenges that I had in my own role. Pilar always demonstrated reflective practice at its best, leaving me with both renewed confidence and a way forward. 

On a lighter note, Pilar has actively embraced the interpersonal and cross-cultural connections between the ANFPP sites and team members, taking time where possible to meet members of the community and to learn more about the program contexts. I will always remember Pilar, gamely aboard a kayak in Raby Bay in Brisbane off to see a sea turtle.

Thank you, Pilar, for everything.

The Australian Nurse-Family Partnership Program (ANFPP) is a part of the Australian Government’s commitment to improve the health of Aboriginal and Torres Strait Islander people.

The ANFPP supports women pregnant with an Aboriginal and/or Torres Strait Islander child to improve their own health and the health of their baby. The ANFPP will also help with the baby’s development in their early years.

Under the ANFPP, trained nurses visit families in their own homes to help them grow a stronger family.

The ANFPP delivers assistance for mothers and fathers to help them become the best parents they can be.

The ANFPP is being set up by health services across Australia. The ANFPP is currently at three sites. These are:

• Wuchopperen Health Service – Cairns
• Central Australian Aboriginal Congress – Alice Springs
• Wellington Aboriginal Corporation Health Service – Wellington

On this website, you will find all the information you need about the ANFPP, the services available, and how you can be involved in the program.

The Australian Nurse-Family Partnership Program model is based on the Nurse-Family Partnership model developed by Professor David Olds in the USA over the last 30 years. Click on the icon to find out more about Professor David Olds and the Nurse-Family Partnership model.

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I would like to begin by paying my respects to the Arrernte elders, past and present, on whose land we are meeting today and to Lhere Artepe the representative body for the Alice Springs native title holders.

I would also like to acknowledge the Congress cabinet and Alukura Cultural Advisory Council and invited guests including the Hon Warren Snowdon, the Hon Alison Anderson and the NT OATSIH Director Jacki Barton.

The launch of the Australian Nurse-Family Partnership Program today is the result of almost a decade of work by the Central Australian Aboriginal Congress.

Congress became aware of the potential significance of the nurse led home visitation program for Aboriginal health soon after Prof Olds first published the results of his randomised controlled trials in 1999. Congress was especially interested because of the following key reported outcomes from the program:

• Infant mortality was reduced by about 50%
• Long term follow up of the children who were visited to age 2 revealed that at age 15 they were about twice as likely to still be in school, about half as likely to engage in risk behaviours including alcohol and other drugs and unprotected sex and much less likely to have got into trouble with the law along with other outcomes.

Congress CEO Stephanie Bell (right) and Congress ANFPP Program Manager Leshay Maidment (left) at the site's ANFPP Launch

Here we had a primary prevention program that was making a big difference in areas that are of major concern here in Alice Springs.

Thus, in 2000 Congress restructured our DHF funded under 2’s program in an attempt to begin nurse led home visitation to a small number of very high risk first time mothers. From the beginning Congress included an Aboriginal Family Support worker working alongside the home visiting nurse and this has been an adaption to the model that has been now accepted throughout Australia and is a welcome part of the new program.

However, Congress only had 1.5 full time equivalent home visitors and this was nowhere near what was needed to meet the need for universal home visitation amongst the 160 women who give birth each year in our health service area. This along with the fact that the program was very new and not being run anywhere else in the country made it very difficult to recruit and train nurses that understood and were skilled enough to maintain the integrity of the program.

Congress lobbied extensively for more funding to expand the program and submissions were written and tenders put in to both the Australian and Territory governments. Is spite of the policy rhetoric from all levels of government about the importance if universal nurse led home visitation this amounted to no new resources and Congress was very frustrated. Multiple presentations were made by Congress at Conference and politicians were lobbied highlighting the contradictions between government policy in this area and the lack of funding to deliver on the ground.

In 2006 the OATSIH Healthy for Life program was funded focusing on maternal and child health and chronic disease. Congress used most of this new funding to expand our nurse home visitation program and also ensure that there was better access to training for the nurses in the program along with stronger program management. Unfortunately, the courses available, while useful, did not directly address the needs of nurses working in this program. As part of the process of developing the proposal for Health for Life Congress developed a detailed submission for the full funding of the program in Alice Springs based on 11 full time equivalent nurses, 6 Aboriginal community workers and other staff. Unfortunately, Healthy for Life was only able to fund 1.5 additional home visiting nurses and an additional Aboriginal community worker. The full submission however was ready to go when the funding for the ANFPP was announced in the 2007/08 budget.

Also in 2006, Congress worked through AMSANT to lobby the Australian government and along with the AMA and the Australian Divisions of General Practice met with the then health Minister, Tony Abbott and the then Minster for Aboriginal Affairs, Family and Children’s Services, Mal Brough to lobby for a universal home visitation program for Aboriginal mothers throughout Australia. The total cost of the program was estimated to be more than $100 million and it was agreed that it was reasonable to prove the programs effectiveness in Aboriginal communities in a number of key sites prior to making such a substantial investment. As a result of this advocacy along with a strong commitment to the program inside government from OATSIH, especially the former first assistant secretary Leslie Podesta, the funding for the program was announced in the 2007/08 budget.

For many Aboriginal communities around Australia this new program may appear to be the result of a “Top Down” government decision as they do not know about the advocacy of Aboriginal health services here in the NT to get this program funded. This is a story that needs to be told across Australia – it was Congress in Alice Springs along with other Aboriginal health leaders here in the NT that recognised the importance of this program and for us it has been a long struggle to get there and very much a “bottom up” process.

Congress was very pleased to be selected to be one of the first 3 sites to be rolled out across the nation. The current program is well resourced and well supported in every way including in the critical area of training to ensure all nurses are able to deliver the program in accordance with the Old’s model.

A quick word about workforce which is often now used as an excuse to not fund much needed programs and services. Although it was originally argued that we would not be able to recruit nurses due to the severe shortage in nurses in Alice Springs Congress was always confident that this would not be the case. Nurses enjoy the opportunity of being part of such a meaningful and well supported program where they are able to work with Aboriginal Family Support workers and develop relationships with mothers and their families over a two and half year period. There have therefore been multiple applications for all positions so far and Congress has been able to very quickly recruit and retain a team of 9 staff including 4 full time equivalent nurses and 2 Aboriginal community workers along with a nursing supervisor. 2 new nurses and another Aboriginal community worker will soon be recruited to. The program has also managed to secure a fantastic location.

Thus, after a long struggle Congress has finally achieved what we think will become a vitally important program in improving the health and well being of our community by supporting the early childhood growth and development of our children. Minister Snowdon will later relate some early success stories from the program.

I would finally like to thank our staff, the management, the Aboriginal community and all those who have worked tirelessly to make this service happen. I want everyone hear to spread the word about this program and encourage all mothers to access this great program.