Healthy Pregnancy and Early Infancy

Description

Programming in this area relates to the promotion of healthy pregnancies and the health of infants and young children and focuses on prenatal nutrition, maternal and child health and Fetal Alcohol Spectrum Disorder (FASD).

Objectives

Prenatal Nutrition

• Support the improvement of maternal and infant nutritional health. Activities fall under three core elements which include: nutrition screening, education and counselling; maternal nourishment; and, breastfeeding promotion, education and support.

Maternal Child Health

• Implement support services which include: screening and assessment of pregnant women and new parents to assess family needs; reproductive and preconception health promotion; as well as home visiting by nurses and community-based workers to provide follow up, referrals and case management as required.

• Enable home visiting to offer education and support to pregnant women and families with infants with respect to parenting skills and knowledge, healthy child development, positive lifestyle changes, preconception health, improved maternal reproductive health, and access to social supports.

Fetal Alcohol Spectrum Disorder (FASD)

• Support the development of culturally appropriate and evidence-based prevention and early intervention programs related to FASD.

• Support capacity building and training of community workers and professional staff, development of action plans, and prevention, education and awareness activities.

• Implement prevention programs through mentoring projects, using an evidence-based home visitation model. (Mentors help a woman identify her strengths and challenges; link her to appropriate services/supports that can help to reduce her risk of having a baby affected by FASD).

• Implement intervention programs through case management and community coordination to facilitate access to diagnosis, and to help families connect with multi-disciplinary diagnostic teams and other supports and services.


Elements

Home Visiting

Home visiting by community health nurses or community-based workers positively affects the health of mothers, infants, children and families. During the home visit, the nurse or the community-based worker provides information, education and support on: reproductive health; women and families’ mental health needs; children’s mental health; children’s development; breast feeding support and nutrition; healthy habits and lifestyles; healthy parenting skills and knowledge and parent-infant attachment; fathers’ involvement; and, access to health and social supports and services. Regular and consistent home visiting allows home visitors to establish a solid rapport and trusting relationship with families, thereby increasing the receptiveness of families to new information. This results in meeting family needs, improving family functioning and positive family outcomes.

Screening, Education and Counselling

Various screening and assessment tools are used by nurses and community-based workers to identify the needs of families and to determine the level and type of services that will be of most benefit. Comprehensive screening and assessments are crucial for early identification and referral of pregnant women and families with young infants/children who may be at risk of poor health outcomes. Screening may be done prenatally for risk factors such as substance use during pregnancy, sexually transmitted infections, blood glucose level, or postnatally for risk factors such as post partum depression, and developmental delays in children. Once risk factors are identified, the programs can provide education, linkages to support services, as well as resources needed to reduce high-risk behaviours and promote healthy birth outcomes or identify needed services.

Case Management

Case management helps women and families link to services and support they need. Case management includes the coordination of services and access to culturally competent care for women and families, for early intervention and access to early diagnosis. Core activities may include:

• completing the initial individual/family assessment;

• identifying individual/family strengths and assets;

• working with women and families to identify and prioritize their needs and concerns;

• working in partnership with women, the family, home visitors, the community, and other service providers to develop a service plan that reflects the individual/family’s goals and concerns and the individual, family and community strengths;

• identifying the need for special needs services and helping the family access these services;

• facilitating referrals when necessary; and,

• evaluating the individual/family service plan on a regular basis, making adjustments based on the family’s needs and desired outcomes.

Integrating Culture into Care

The prevention components of care can be enhanced for women and families with children by moving beyond the scope of medically-based prenatal and postpartum services to integrate culturally-relevant approaches into all program components. Services delivered at the community level should be designed and delivered in a culturally competent manner that acknowledges and respects cultural differences and the uniqueness of the communities that are served.

Health Promotion

Health promotion strategies improve maternal and child health in communities in many ways. Examples of health promotion interventions include promotion of physical activity and healthy nutrition, problematic substance use prevention, preconception health counselling, parenting including traditional parenting, and injury prevention. Health promotion activities are linked to all programs in this component. This element may include community education awareness events, supplementing the diet and improving the food security of pregnant women, infants and mothers through the use of healthy snacks, food coupons, food vouchers and food baskets. Community kitchens and cooking classes are also supported in an effort to provide women with skills related to food preparation as well as knowledge regarding healthy eating.

Evidence and Capacity Development

A range of evidence-based capacity building activities are supported at the national and regional levels (such as training initiatives for community-based service providers and pilot projects to implement promising practices).

Coordination and Integration

The programs support the coordination and integration of services and the sharing of information including best practices. National and regional activities related to the development, implementation, and evaluation of the programs are also located under this component.

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