Funders:
  • Northern Territory Government Department of Health
Collaborators:
  • Katherine West Health Board
  • Sunrise Health Service
  • Miwatj Health Aboriginal Corporation
  • Charles Darwin University
  • Murdoch Children’s Research Institute (MCRI)
Chief investigator:
Project coordinator:
Researchers
HDR Students

For more information about the project, please email.

Aim:
To evaluate the implementation and outcomes of the Maternal and Early Childhood Sustained Home-visiting (MECSH) program in the Northern Territory.  
 
Summary:
Sustained home visiting starting in pregnancy and continuing into early childhood is an evidence-based model of care for improving life course trajectories infants and young children at risk of adverse development outcomes. Home visiting programs have positive impact on mothers’ psychosocial health and wellbeing, children’s health and development, parenting practices and school readiness. 

Between 2019 and 2024, three Aboriginal Community Controlled Health Services – Miwatj Health Aboriginal Corporation, Katherine West Health Board and Sunrise Health Service - implemented the Maternal and Early Childhood Sustained Home-visiting (MECSH) program in East Arnhem and Katherine regions of the Northern Territory. MECSH is an Australian nurse-led home visiting program developed in Sydney that was licensed to the Northern Territory Government for implementation in the NT. Implementation support was provided by Western Sydney University.
 
Using mixed-methods research, the Centre for Child Development and Education at Menzies undertook an evaluation of the first five years of implementation. The evaluation of implementation involved quantitative analysis of de-identified client level primary health care records together with qualitative interviews and surveys with parents in remote communities to understand their needs and responses to the program. Interviews with health service providers and health service providers aimed to understand the challenges and achievements of delivering this model of care.
 
A final stage of evaluation of outcomes linking data from de-identified primary health care, hospital and child protection datasets is planned for completion by end of 2026. 
 
Implications for policy and practice:
The decision to adopt MECSH established the possibility of implementing an intensive program of sustained home visiting available to all women in very remote communities serviced by ACCHS, regardless of age and parity. The evaluation established that with further adaptation and contextualisation, a home visiting model like MECSH could provide vital support to women facing significant and often intersecting health and social challenges. 

The ‘NT MECSH’ model of care that emerged during the 5-year period of implementation and adaptation was valued by many parents. From parents’ perspectives, MESCH practitioners provided three areas of valued care: Emotional support, Information and educational support, and Practical care. These elements occurred within a trusting relationship between skilled practitioners and mothers. Based on parent interviews, MECSH helped to build maternal capacity and self-efficacy, to strengthen family relationships and to reduce barriers to engagement in health and social services. 
 
This model of care differs from standard health services in its reliance on continuity of care, on assertive engagement, on practitioner responsiveness and adaptability to client needs, and on sensitivity to the client’s family context with provision of social care based on collaboration between nurse and social care practitioner. Further work to consolidated and strengthen these potential outcomes of the program was recommended by the evaluators.  
 
A summary of the evaluation 2019-2024 can be downloaded here.
To request the full report please contact danielle.aquino@menzies.edu.au
Click here to access resources developed to support home visiting models of care
 
Project dates:

Implementation evaluation: completed in November 2024
Impact evaluation: due for completion December 2026

Journal articles:
 
  • Gregory A, Aquino D, Caudwell KM, Wild K, Maypilama L, Robinson G. Survey to story: exploring mixed methods administration of surveys in remote First Nations communities of the Northern Territory. Australian Psychologist 2025 (under review)
  • Gregory A, Wild K, Aquino D, Robinson G. ‘They got my back’: Thematic analysis of relationship building in nurse home visiting in Aboriginal communities. Aust J Rural Health. 2024; 32: 1227–1238. https://doi.org/10.1111/ajr.13199
  • Gregory A, Aquino D, Wild K, Robinson G (2023). Looking to the future: aspirations of women with young children. Partyline, Issue 85. Available at: www.ruralhealth.org.au/partyline/article/looking-future-aspirations-women-young-children
Parenting resources: Supporting partnerships with families
 
Drawing on learnings during the MECSH evaluation, additional funding was sought to extend the collaboration with partner health services and communities to design, test and refine new contextually appropriate resources to enhance home visiting programs. The resources produced from this project can be found here
 
What is MECSH? Animation:

‘What is MECSH?’ is an animation to provide information to pregnant women, families, and communities about the Maternal and Early Childhood Sustained Home visiting (MECSH) program in the Northern Territory. MECSH is delivered in three remote regions of the Northern Territory by Miwatj Health Service, Katherine West Health Board, and Sunrise Health Service with funding from the Northern Territory Government. MECSH is a licensed program of Western Sydney University. The animation is also available in Yolngu Matha and Kriol for use by health services in the East Arnhem and Katherine regions.

Watch the 'What is MECSH' animation here or via the clip below.

This project received grant funding from the Australian Government.