A Decade of Achievements and Challenges for the Australian Nurse-Family Partnership Program

The Australian Nurse-Family Partnership (ANFPP)  is a home visiting program designed to empower women to set goals and follow their heart’s desires by taking small steps. Women are supported in their efforts to stay healthy during pregnancy, identify their support network, recognize healthy relationships, learn new skills and develop a vision for their future. Abt has managed the ANFPP for 10 years; to celebrate, we sat down with Sally de-Vitry Smith, ANFPP NPC National Program Manager, Austrailian Nurse – Family Partnership Program to discuss how far the program has come and where it’s going.

1. How has ANFPP effected Indigenous mothers, families and communities in Australia and what were the initial challenges?

Sally de-Vitry Smith: In Australia, Aboriginal people have a history of trauma, colonisation, racism, exclusion. A visit to Cherbourg showed first-hand the impact of removing children from their parents and culture—it is something I will never forget. Health professionals were frequently involved in removing children during the era of the stolen generation. Many factors have combined, resulting in socio economic disadvantage and poorer health outcomes.

In setting up ANFPP, the initial challenges involved dispelling community distrust and skepticism by gaining community support, local ownership and investment. Two factors helped the ANFPP earn that support. Firstly, advocacy from Aboriginal Community Controlled Health Organizations that saw the opportunities for a program based on solid evidence. Secondly, the employment of Indigenous Family Partnership Workers from the local area to provide cultural knowledge.

2. What has ANFPP accomplished in the last 10 years?

Sally: The ANFPP began in three communities in 2009 and has since been expanded to 13 sites. This is an enormous accomplishment. The program is mostly delivered by Aboriginal Community Controlled health services that are embedded in the community and provide holistic care. The ANFPP has improved the lives of Indigenous mothers and their families by joining them on their journey, supporting their efforts to achieve goals such as getting a driver’s license, finding safe accommodations and developing mothering skills. The program data shows our clients have an immunization rate of 95 percent at two years of age and 84 percent of mothers initiate breastfeeding. In the last year smoking during pregnancy decreased by 7 percent.

3. How has Abt influenced/supported the program?

Sally: Abt provided the knowledge, expertise and infrastructure to introduce and then expand the program in Australia. Staff at Abt are passionate about their work and there is an accumulation of collected wisdom we can use to support our work.

Abt values collaboration, excellent and working relationships based on trust, mutual respect and shared pride in our work and its impact.  The objectives of ANFPP fit well with Abt’s mission and vision. ANFPPs objectives are to help women engage in good preventative health practices, support parents to improve child health and development and help parents develop a vision for their own future.

4. What will the trajectory or trend for Australian indigenous health be as a result of the work done in the last 10 years?)

Sally: The ANFPP is part of the  Australian Government’s Closing the Gap strategy that aims to reduce disadvantages among Aboriginal and Torres Strait Islander people. The trajectory for indigenous health will be influenced by the Closing the Gap refresh has shifted the strategy towards the principles of empowerment and self-determination. The new focus appears to foster achievement and success rather than deficits. Using a strengths-based approach means having a positive target, such as increasing school attendance and reading and numeracy rather than a focus on closing a gap.

I think there will be more of a focus on improving birthweight, educational attainment and employment, as well as a closer examination of disaggregated data. We need more Indigenous people leading programs and setting the direction from their own lived experience and knowledge. It would be wonderful to see the program integrated into more communities. It would be useful to follow children whose mothers were in the program to look at their long-term outcomes; I suspect this would provide very powerful information.

5. How has leading this program changed you personally?

Sally: It has been a privilege to visit sites where the program is provided, meet staff and clients and hear the inspiring stories of how their lives have been changed. I always believed getting childhood right was important for how an individual’s life unfolded. This has been reinforced by witnessing how supporting a mother during pregnancy and for the first two years of her child’s life can make a remarkable difference to her life and the life of her child by priming the child for resilience rather than vulnerability. I have a new respect for the strength women show in challenging circumstances, and the love they have for their children.