Health Care for ECD
Thematic Area :
Home Visiting For Early Child Development

Home visiting is a long-standing strategy to support the healthy development and well-being of young children and families worldwide. Through one-on-one contact between home visitors and families, home visiting provides individually tailored support and education, assessment of family needs, counselling on various relevant topics — including positive parenting practices, and referral of families to required services in the community. Parenting education and counselling within home visiting services often use didactic and experiential approaches.

Evidence-based home visiting services have been proven to improve maternal and child health outcomes in the early years of a child’s life. Early childhood home visiting programmes, in general, aim to improve outcomes related to prenatal care and birth, maternal and child health, child development, maltreatment prevention, and family economic self-sufficiency. 

Home visiting programmes around the world

The best summary of home visiting research based on American models is the Home Visiting Evidence of Effectiveness (HomVEE) clearinghouse maintained by the federal government of the United States. HomVEE provides an assessment of the evidence of effectiveness for early childhood home visiting models that serve families with pregnant women and children from birth up through age 5, the kindergarten entry age. 

One of the most successful home visiting programmes implemented and tested in developed countries is the Nurse-Family Partnership (NFP), envisioned by Dr David Olds in the United States. The NFP consists of an intensive and comprehensive home visiting programme run by nurses during pregnancy and the first two years of a child’s life. The programme is designed for first-time, low-income mothers, to help them better care of themselves and their babies. Adopted by the government of the United Kingdom as the Family-Nurse Partnership (FNP) programme, it showed minimal positive results in initial outcome evaluations, but there are some suggestions of longer-term outcomes. In Europe, the Ireland intervention Preparing for Life (PFL) and Orla Doyle’s summative evaluation of the results are encouraging. The study finds that PFL continues to impact children’s cognitive skills and achievement tests up to five years after the families have finished the home visiting programme. The specific focus of the PFL is on improving parenting behaviour and the quality of the home environment.

Reach Up and Learn programme 

Several recent evaluations of the Reach Up and Learn programme have been conducted, including in Brazil, India, Bangladesh, and China. Reach Up has been formulated with the benefit of over 30 years’ worth of research on effective early childhood intervention programmes. It provides agencies with a comprehensive set of materials to support parents in providing a more stimulating environment for their children — improving quality interaction, and facilitating learning. Additionally, there is evidence that it is possible to teach home visitors to support responsive caregiving which is a key component of the nurturing care that  children need to survive and thrive. There have also been some home-visiting evaluations conducted in South Africa

From the sample of studies cited above, it is possible to conclude that home visiting programmes are a widespread and effective public health strategy for promoting parent and child well-being, including in low- and middle-income countries, where the majority of the world’s children live.



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