By Jo Casebourne, Chief Executive at EIF, and Viv Bennett, Chief Nurse at Public Health England. This blog was also published at vivbennett.blog.gov.uk.
A new report published this week by the Early Intervention Foundation provides valuable information about the evidence for approaches to early intervention for mothers and infants, which are commissioned and delivered locally as part of the Healthy Child Programme.
There is compelling evidence that the early years are a critical opportunity for building healthy, resilient children, with positive early experiences shaping outcomes throughout the life-course and contributing to a healthy, thriving society. Conversely, decades of research and data analysis has identified many early childhood factors which adversely impact on outcomes for children. Whilst there have been sustained improvements in public health outcomes for children since records began, there remain persistent inequalities that start early in life. These inequalities result in poorer physical emotional and mental health, academic achievement and employment prospects at all stages of life. However, inequality is not inevitable and across the public sector we continue to strive to ensure that every child has the best start in life. To make a positive difference we need to know what works for whom and why.
The importance of getting it right for all our children through early intervention cannot be over-emphasised. This new report underlines the continued case for early intervention and strengthens the evidence of what works within the Healthy Child Programme (HCP) to improve outcomes for children and their families, adding to the growing suite of ‘what works’ resources published by EIF. As the evidence continues to grow, we gain a greater understanding of the individual factors that influence why certain interventions work for some people in some circumstances and not others. And as this report emphasises, evidence of past impact in one situation is not a guarantee of effectiveness in other places and different local conditions.
EIF’s report provides a comprehensive update of the evidence for key interventions during pregnancy and the first 12 months of a child’s life, from the transition to parenthood, smoking cessation and maternal mental health, through to breastfeeding, sleep training and early language development.
The report highlights areas of practice that are underpinned by strong evidence, and identifies areas where there are significant gaps. Examples of common health visiting practice which are strongly supported by evidence include the advice provided to parents on infant sleeping positions, which has strong evidence of reducing the occurrence of sudden infant death syndrome (SIDS). Areas of practice where there remain significant gaps include evidence informing when and how to intervene when parents misuse drugs or alcohol.
Crucially, the review also highlights the key role that the health visiting service plays in leading the delivery of the HCP (0-5 years), in partnership with a wide range of other agencies. Although many of the most effective interventions require specialist teams to set up or deliver, the good news is that the majority could be delivered as part of the HCP with minimal additional training for midwives, nurses and health visitors. The universal reach of the HCP is central to its success and provides an invaluable opportunity to support all families, whilst also enabling early identification and support for children and families who are most at risk of poor outcomes.
This publication will help policy-makers, commissioners, providers and practitioners to use high-quality evidence in their decision-making. EIF and PHE continue to work together to develop evidence and support the application of evidence into practice, to achieve the ‘triple aim’ of improving health in defined populations, enhancing people’s experience of the service and achieving this at best taxpayer value, which in turn contribute to our shared ambition for every child to have the best start in life.