First 1000 Days Model of Care

Aim

To provide trauma informed midwifery and child health care to support vulnerable families from conception through firtst two years.  To reduce identified siloed care, address critical service gaps and foster early engagement with families who often face barriers to accessing care.

Outcomes

The Health Advisor model was perceived by stakeholders as an acceptable, feasible and effective approach to supporting families with complex needs during the first 1000 days. Midwives and child health nurses play a central role in early family engagement and delivering relationship-based care that improves access and health outcomes.

Families identified the service was integral for preventing Child Protection intervention and ultimately keeping baby in their care.

Discussion

For the project to succeed recommendations for practice were:

1. Prioritise funded continuity-of-care models that embed consistent Health Advisors with midwifery and child health expertise across the antenatal to postnatal continuum for families with complex needs.
2. Resource workforce capacity appropriately by expanding Health Advisor staffing and reducing caseloads to enable flexible, relationship-based, family-centred care.Opportunities for an integration model into Child Health locally and statewide.
3. Mandate trauma-informed frameworks through  policy, training service wide education.

Core themes were:

• Family, community, and cultural contexts - reducing stigma, supporting families, and strengthening partnerships between key stakeholders e.g Child Protection Services
• deliver coordinated protection and care to build capacity addressing disparities in healthcare access for vulnerable children
• Culturally responsive and community-led health model
• Reduce  child maltreatment through education, policy, and community engagement
• Opportunities for an integration model into Child Health locally and statewide.

Strengths:

• Collaboration across services between initially Maternity to Child Health, and subsequently, wider key stakeholders,
• Child Health embraced collaboration with integration of the Model of care in November 2025
• Integration and collaboration of Statewide programs to support families, including MECSH Sustained Homevisiting across the SCH.
• Early Engagement model that provides a safe, empowering, and culturally responsive
• Womens & Childrens Leadership supportive of program and facilitating purchase of pepipod for implementation.
• Innovation is accepted in the SCH across service frameworks

Weakness:

• Lack of time to develop processes and workplace instructions, especially that now the team has expanded from one FT Combined to now, ideally two FTE CN, two FTE CM
• The Health Advisor role is a unique model, and requires both a CM, CN to coordinate and navigate care for clients, it not just a clinical model which has been challenging to articulate.
• The role definition  has been a challenge for new staff who have commenced more recently.

Opportunities:

• Statewide adoption of the Health Advisor in F1000 days role
• Ongoing collaboration across services including Paediatrics, Social Work, AODS, Mental Health
• Integration and embedded across Statewide  Child health.

Next Steps;

• Integration model in Child Health in Progress,
• Collation with paediatrics and obstetrics for escalation pathways,
• Collaboration with Allied Health and Child Development service,
• Continuum of Collaboration with Children's Plus, and Child Safety

Funding for this project has been provided by 2023 SERTF.