Supporting early family life: the importance of public health programmes

25 Jun 2018

Globally, women are generally offered maternity-specific care during their pregnancy through obstetricians, gynaecologists, nurses and/or midwives. While this care extends into the postpartum period, guidelines currently do not recommend visits to the mother beyond 6 weeks (World Health Organisation, 2014). However, in the Fair Society, Healthy Lives report, it is emphasised that the two first years of life represent a critical time point in which the obstacles to healthy brain development can lead to long-term disadvantages, and that interventions are required to prevent the emergence of health inequalities and to improve children’s life-chances (Marmot et al, 2010). In attempts to prevent ill health in infants, a number of countries provide services that traverse both the antenatal period and the early years of life. Examples of such services include the Healthy Child Programme in the UK, the Maternal and Child Health Service in Australia, and the Comprehensive Child Development Service in Hong Kong. While these services differ, they are structurally similar in that they provide a universal preventative service with a programme of care that encompasses screening, immunisation, health and development reviews, supplemented by advice around health, wellbeing and parenting. In accordance with the principle of ‘proportionate universalism’, the scale and intensity of intervention is proportionate to the level of disadvantage to ensure more vulnerable families receive increased care and that safeguarding takes place for children at increased risk (Marmot et al, 2010).