The following speech was delivered by Central Australian Aboriginal Congress CEO Stephanie Bell at the Congress ANFPP Launch in Alice Springs:

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.