Providing a Healthy and Safe Start: Multidisciplinary, integrated practice and community-led practice for health equity

Background: Healthy and Safe Start (HSS) is an integrated and multidisciplinary response program delivered by a not-for-profit organisation in Australia developed in response to increasing numbers of pregnant women and families presenting to homelessness and domestic violence services. It provides perinatal support for vulnerable pregnant women and their families.

 

Approach: The research used an exploratory multi-method approach, involving a rapid review of relevant literature, descriptive analysis of administrative data, semi-interviews with staff and families engaged with the services, and survey feedback from stakeholders who interacted with the program. The administrative data for 106 current and previous program participants was provided by the not-for-profit organisation in a deidentified format.

 

It included demographic data as well as data related to service provision, including antenatal appointments and birthing outcomes. Semi-structured interviews were held with 5 practitioners involved in the delivery and management of the program and 13 program participants. The interviews were audio recorded then transcribed, and deidentified transcripts were analysed using thematic analysis.

 

Results: The findings indicate that the program’s success is grounded in its features of a multidisciplinary model of care, its outreach approach, its practical approach, its whole-of-service system approach, and the relationship-based, Continuity of Care, and trauma-informed models of care underpinning practice.

Prior to entering the program, families were often highly isolated from both formal and informal networks. The multidisciplinary, relationship-based, and trauma-informed model improved access to essential health and social services. Having a multidisciplinary and integrated team working closely together was central to the success of the HSS program and improved outcomes for both mother and child.

 

Implications: Community-based, multidisciplinary teams are pivotal to improving access to coordinated health and social care for pregnant and parenting women and their families experiencing adversity.