Bumps to Babes and Beyond
Knowledge Circle Practice Profiles

Overview

Practice focus

Pre and post-natal support for Indigenous mothers and families; early childhood and parenting education; linking Indigenous families to local services

Delivered by

The Bumps to Babes and Beyond (BBB) program was delivered through a partnership between Mallee District Aboriginal Services (MDAS) and the Queen Elizabeth Centre in Victoria.

Location(s)

MDAS is an Aboriginal Community Controlled Organisation, delivers the program in Mildura and to surrounding regional areas.

Issue being addressed

The program aims to address issues affecting Indigenous maternal and child health. The literature review conducted as part of the BBB program evaluation indicated that:

  • Compared to non-Indigenous babies, Indigenous babies have twice the likelihood of being born with low birth weight and have higher rates of perinatal and infant mortality;
  • Low socio-economic status, low levels of education and literacy, and community attitudes have been associated with low breastfeeding rates in the Indigenous community;
  • Additional areas of concern include the number of early childhood hospitalisations, preventable injury and disease, hearing and dental issues, teenage birth rate and exposure to alcohol and tobacco smoke; and
  • Indigenous maternal health has been flagged as an issue, in particular the low number of antenatal check-ups, and the use of substances during pregnancy.
Service type

Pre and post-natal services for Indigenous mothers and families; health education; community services

Target population

The target population for the program were Indigenous women and families identified by MDAS as experiencing risk factors that may negatively impact their pregnancy, maternal or child health or their parenting capacity.

Aims and objectives

The aim of the program is to enhance and develop strong parent-child relationships, improve child health and development and parenting skills. Specifically, the aims for the program include:

  1. To reduce the number of children placed in out-of-home-care
  2. To enhance the connection between the mother, their child, family and community
  3. To improve parent-child interactions and parenting skills
  4. To increase parental knowledge, enjoyment and confidence in parenting
  5. To develop parents’ professional and personal social networks
  6. To increase parents’ sense of wellbeing
  7. To help Aboriginal children meet key health promotion indicators
Program basis

The BBB Program was adapted from QEC's Tummies-to-Toddlers Program (a similar pre and post natal parenting support program) and provides education and support to mothers and their families from 26 weeks in their pregnancy to when their child is 18 months of age. A key focus of the program is to deliver services that are focused on the child's safety, health, wellbeing and development. The BBB program is delivered either at the MDAS or the clients' homes to suit their needs. The program provides case management, advocacy on behalf of mothers, psychosocial support, parenting education and parent child connection activities through home visits and group programs. The case management involves intensive support to mothers to address their individual needs. The psychosocial support services include improving social skills to build mothers' confidence to participate in group work within the MDAS and other community settings. The parenting skills activities were provided to clients through a structured program and on an as needs basis.

Cultural relevance

Local community context

Within the Mildura Local Government Area, Indigenous people represent 4.40% of the population, with 30.95% of the Indigenous population aged between 0-9 years (ABS 2011). This is significantly higher than Victoria’s Indigenous population of 0.7% which includes an Indigenous child population of 23.61% aged between 0-9 years(ABS, 2011).

In the Mildura LGA, rates of unemployment, single parent families, psychiatric admissions, and childhood accidents within the general population are also higher than the Victorian State average. Mildura’s teenage birth rate is 27.0 for every 1000 adolescent women, compared to Victoria’s average of 10.6 (Aarons & Glossop, 2008; DEECD, 2010b; DEECD, 2010c).

Despite this, Mildura has limited long term early parenting support services available for Indigeous families. It was in response to this need, that the QEC and MDAS developed the BBB program.

Involvement of Aboriginal and Torres Strait Islanders

MDAS and QEC previously collaborated to deliver an earlier program, so a positive working relationship existed when they partnered to develop the BBB program. Indigenous people were involved in developing the BBB program in various ways including:

  • regular knowledge sharing between MDAS and QEC staff;
  • adapting and tailoring the QEC Tummies to Toddlers program to the local Indigenous community to ensure it was culturally appropriate;
  • representation on stakeholder meetings; and
  • MDAS Indigenous staff were responsible for delivering the service
Cultural practices and materials

The BBB program content was discussed with members of the Aboriginal community and MDAS prior to the program commencing. Culturally appropriate toys and games were chosen for parent-child activities. These included Aboriginal books, songs and musical instruments. Groups were held in culturally safe areas. Mothers were encouraged to attend MDAS or any other place that felt safe to them. Aboriginal art was also part of the research and the mothers were involved in choosing paintings that depicted the themes from their experience of pregnancy, birth and mothering. The mothers were linked to Aboriginal workers and members of the community who were mothers and could provide support and advice.

Evaluation

Evaluation status

An independent evaluation of the program was completed in December 2014

Link to evaluation

The evaluation can be access here: http://www.qec.org.au/sites/default/files/news_pdf/Evaluation%20of%20the%20Bumps%20to%20Babes%20and%20Beyond%20Program.pdf

Evaluation details

The evaluation aimed to gather the experiences of mothers and analyse these to identify any emerging issues and whether the program was achieving its objectives. The evaluation used an action research design approach, which is a culturally respectful approach that involves the participants in shaping the overall evaluation direction. The approach involves an ongoing cycle of planning, acting, observing, reflecting and then adapting the evaluation as it progresses so that it can better suit the needs of the particular context.

The methods used to complete the evaluation included qualitative and quantitative data including a literature review, interviews with clients and community members, and demographic data from clients and families. Nine program participants completed at least one of the six program interviews that were scheduled through the evaluation duration (April 2013-April 2014).

The evaluation acknowledged there had been some limitations to its methodology (e.g. access to participants at planned intervals) and suggested that further program development and research needs to occur to refine the program to ensure it meets families and communities needs.

As the evaluation adopted an action research approach, Indigenous people were involved in evaluation through client and staff interviews and in helping shape the direction the of research as it progressed.

Effectiveness

Most effective aspect

The most effective aspect of the program was that mothers were partnered to a social worker and thus had someone to go for information, support with parenting, social issues or referrals to another service. If mothers disengaged, the worker reiterated that they were welcome to come back into the program. The length of the program also enabled trusting professional relationships which supported the building of parenting and communication skills, particularly over difficult issues such as if a child was identified at risk.

Demonstrated outcomes

In relation to the aims of the program (see above), the evaluation found:

  • Aim 1: For participating mothers, all of the children had remained in their family's care and had not been placed in out of home care, despite some degree of child protection involvement in some cases.
  • Aim 2: Anecdotal evidence suggested the program had brought together the community and services to create a 'safe space' for mothers and families. The evaluation found mothers had grown their connection with their babies, family members and community.
  • Aim 3: The evaluation found there were numerous cases of mothers demonstrating positive and responsive behaviour towards their child.
  • Aim 4: The mothers described varying levels of enjoyment and confidence in parenting, including increased skills in learning to read their baby's cues and understanding their development. The program's group work with other mothers allowed them to share knowledge and build relationships.
  • Aim 5: Evidence from mothers suggested they had increased their relations with community and heath service professionals. However their development of social networks varied, with complex personal and social issues making it difficult for some mothers to form friendships and social groups.
  • Aim 6: Anecdotal evidence from the mothers indicated that parenting knowledge and confidence improved their self-efficacy. They reported that the sense of being 'cared for' improved their sense of wellbeing.
  • Aim 7: The program was considered instrumental in supporting mothers to meet health promotion indicators. The services that assisted this included: Indigenous midwives and staff, consistent health staff, transport, co-located groups, individual and group services and a flexible delivery mode.
Resourcing

The BBB program was resourced by MDAS, QEC and from funding provided by the Department of Health (VIC OR COMMONWEALTH?) under the Vulnerable Aboriginal Children and Families Strategy.

Evidence base and opportunities

The evaluation includes a literature review outlining the importance of pre and post natal support for mothers and programs designed for Indigenous families.

Other information about pre and post-natal support for Indigenous mothers and families can be found here:
https://apps.aifs.gov.au/ipppregister/projects/anunipima-baby-basket-program
http://www.aihw.gov.au/uploadedFiles/ClosingTheGap/Content/Our_publications/2014/ctgc-ip08.pdf
http://www.aihw.gov.au/uploadedFiles/ClosingTheGap/Content/Publications/2012/ctgc-rs16.pdf

 

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