Extended prenatal and postnatal home visits in a vulnerable area in Sweden-a pilot study

ObjectiveDespite close to all-embracing access to child healthcare, health divides exist among children in Sweden. Home visits to families with new-born babies are a cost-effective way to identify and strengthen vulnerable families. An extended postnatal home visiting programme has been implemented in a disadvantaged suburb in Stockholm with positive results.DesignLongitudinal, prospective study and register study from medical records.SettingA vulnerable rural area in Sweden.InterventionA parent advisor from the social services and a midwife performed an extended home visiting programme during the end of pregnancy to mothers of children born between 1 May 2018 and 31 May 2019. During these children's first 15 months, three additional home visits were made by a parent advisor and a child healthcare nurse. The aim of the study is to evaluate the effect of the intervention on the health of the children and the mothers.SubjectsAll firstborn children at the study site (N = 30 study, N = 55 control group).Main outcome measuresThe proportion participating in visits to the child and maternal healthcare services, children being breastfed and receiving childhood vaccinations.ResultsThere were fewer absentees in the study group during routine check-up visits (93 vs. 84%). More mothers in the study group attended the check-up with the midwives (90 vs. 80%). More children in the study group were breastfed (90 vs. 67%) and received all vaccinations (100 vs. 96%).ConclusionSupplementing the extended home visiting programme with a visit at the end of pregnancy seems to contribute to fewer absentees at routine visits for both mothers and children; furthermore, more children were breastfed and vaccinated compared with the control group. Evaluation of four additional home visits to all firstborn children by parent advisors and healthcare professionals during the end-of-pregnancy period and early childhood in a vulnerable area showed the following benefits:More children in the study were breastfed and received all vaccinations compared with the control group.There were fewer absentees at the routine check-up visits to the child healthcare centre in the study compared with the control group.More mothers in the study group attended the check-up visits to the midwife 2 months after delivery compared with the controls.