Summary of Key Survey FindingsThe purpose of the survey was to develop a broad understanding of the types of services being provided under New Directions Mothers and Babies Services (NDMB) funding. As there are 85 NDMB services, a survey was identified as the most practical and cost effective method of obtaining information.
A total of 54 surveys were completed in November 2012, representing 55 sites, with a response rate of 64%. The completion rate of the survey was 85%. The survey response was a representative sample by organisation type and State and Territory, with slightly more responses from WA and less from NT.
Previous and current maternal and child health servicesThe survey demonstrated an increase in the capacity of organisations that are delivering maternal and child health services directly as a result of the NDMB program, including antenatal consultations, postnatal check-ups and child health and development checks (Figure 1).
- Prior to NDMB funding, 58% of respondents (30 organisations) provided antenatal consultations and postnatal checkups. This increased to 73% and 85% of organisations delivering antenatal and postnatal care respectively, directly as a result of the NDMB funding.
- The number of organisations providing child health and development checks increased from 58% to 83%.
Figure 1: Increase in organisations that are delivering maternal and child health services directly as a result of the NDMB program
Text alternative of Figure 1: Increase in organisations that are delivering maternal and child health services directly as a result of the NDMB program
Service delivery modelsNDMB services are delivered from both single sites (36.5%) and multiple sites (63.5%). Organisations that deliver services from multiple sites did so under the following models:
- multiple sites and clinics (with and without home visiting) – 15 organisations;
- outreach/ visiting service only (with and without home visiting) – 7 organisations;
- hub and spoke model (with and without home visiting) – 6 organisations;
- predominantly a home visiting service – 3 organisations; and
- one clinic and one home visiting – 2 organisations.
WorkforceThe following table shows the most common positions employed under the NDMB program are: Midwives; Child and Family Health Nurses; and Aboriginal Health Workers. Midwives provide antenatal and postnatal care both in clinic and home settings; Child and Family Health Nurses provide child health clinics; and Aboriginal Health Workers provide more care in the home than in clinic settings.
|Workforce||Number of organisations||Total FTE (Minimum)|
|Nurse - Midwife||30||48|
|Nurse - Child and Family Health Nurse||22||33|
|Aboriginal Health Worker||21||39.5|
|Aboriginal Maternal and Infant Health Worker||12||27|
|General Practitioner (GP)||8||3.5|
|Nurse - Other||7||7.5|
|Community Support Worker||7||5.5|
|Aboriginal Health Education Officer||5||5|
Maternal and child health services provided by NDMB ServicesThe most common antenatal care services include: providing advice about healthy eating and physical activity; referrals to other health services; referrals to support services; referrals to specialists; parenting advice; social and emotional wellbeing; and antenatal consultations (Figure 2).
Figure 2: Services provided as part of antenatal care
Text alternative of Figure 2: Services provided as part of antenatal care
Postnatal services provided by most organisations include: breastfeeding support/ information; parenting advice; nutrition/ healthy eating support or education; and midwife consultations (Figure 3).
Figure 3: Services provided as part of postnatal care
Text alternative of Figure 3: Services provided as part of postnatal care
All respondents provided parenting advice to mothers and families when the child is six to eight weeks to five years old. The other most common child health services delivered as part of the program are: child health and development checks; breastfeeding support; and hearing screening (Figure 4). Seventy-seven per cent (77%) of organisations provided immunisations as part of the New Directions program. In addition, clinicians reported undertaking opportunistic adult health checks with carers present at child consultations.
Figure 4: Services provided as part of child health care
Text alternative of Figure 4: Services provided as part of child health care
Engagement strategiesThe most common strategies implemented to encourage women to receive antenatal care, postnatal care and child health services include transport assistance and home visits (96%) followed by reminders and referrals to other services (90%) and health promotion/resource packs (88%). There is little variation in the strategies used for encouraging antenatal, postnatal and child health care, with slightly more organisations implementing strategies for child health care engagement (Figure 5).
Figure 5: Strategies used to encourage women to receive antenatal, postnatal and child health care
Text alternative of Figure 5: Strategies used to encourage women to receive antenatal, postnatal and child health care
MODE OF SERVICE DELIVERYFigure 6 shows that, in response to how the organisation delivers the New Directions program, the most common strategies include:
- Home visits, which are slightly more common in the postnatal period
- Child health clinics, which are more common in the child health and postnatal period
- Women’s health clinics and mother’s groups, which are relatively even across antenatal, postnatal and child health services.
Figure 6: Mode of service delivery in the antenatal, postnatal and child health period
Text alternative of Figure 6: Mode of service delivery in the antenatal, postnatal and child health period
HEALTH PROMOTION AND EDUCATIONServices are providing a range of education and health promotion activities, most of which are provided through one-on-one consultations. Education covers a wide range of topics including alcohol, smoking and nutrition.
Antenatal health promotion and education for pregnant women is, in most cases, provided within group sessions and consultations, with slightly fewer organisations providing health promotion and education via written information.
Health promotion and education for mothers and children up to the age of five is most commonly provided within consultations, with 51% or fewer organisations providing education within group sessions or via written material.
BARRIERS AND CHALLENGES TO SERVICE DELIVERYThe most common barriers described by NDMB organisations included recruitment and retention of qualified staff (experienced by almost half the respondents), lack of transport for clients, capacity issues, limited funding, difficulties associated with remote service delivery, and difficulties engaging and maintaining contact with clients (Figure 7).
Figure 7: Barriers and challenges to service delivery experienced by NDMB organisations
Text alternative of Figure 7: Barriers and challenges to service delivery experienced by NDMB organisations
Services were also specifically asked about the barriers and challenges in the collection and monitoring of data. The most common barrier or challenge that organisations reported was difficulties with IT and data collection systems (incompatible systems, IT connectivity, etc), experienced by 40% of organisations (Figure 8).
Figure 8: Barriers and challenges experienced in the collection and monitoring of data
Text alternative of Figure 8: Barriers and challenges experienced in the collection and monitoring of data
DEMAND AND CAPACITYOver half the organisations reported some difficulty in meeting demand and an additional seven per cent are experiencing significant difficulty in meeting demand. One quarter of organisations indicated that they had the capacity to meet current demand (Figure 9).
Figure 9: Capacity of NDMB services to meet demand
Text alternative of Figure 9: Capacity of NDMB services to meet demand
PARTNERSHIPS, REFERRALS AND LINKAGESThe most common agreement/partnership developed across NDMB sites has been with the hospital, allied health providers and community health services (Figure 10).
Figure 10: NDMB services - Formal and informal partnerships
Text alternative of Figure 10: NDMB services - Formal and informal partnerships