A comprehensive program evaluation was undertaken to improve the evidence base around what contributes to successful outcomes in Aboriginal and Torres Strait Islander maternal and child health. The Baby Basket program developed by Apunipima Cape York Health Council (ACYHC) was selected at the child and maternal health roundtable organised by the Institute in March 2012 for that purpose.
The aims of the evaluations were to:
- Assess what has been achieved, whether it is making a difference and why
- Understand the contextual factors which have impacted on the implementation of the program in the community settings
- Provide feedback to service providers to improve service delivery
- Identify elements of best practice in maternal and child health service delivery
- Identify what will be required to replicate and expand the Program across other settings.
The Baby Basket program was introduced in 2009. The program is an initiative focused on Indigenous women who are expecting a baby and/or have recently given birth. The program aims to engage Indigenous women with the health system through encouraging early and frequent clinic attendance during the antenatal period and regular postnatal check-ups. Engagement is facilitated by the delivery of three Baby Baskets including five food vouchers to mothers. The baskets are delivered in the first trimester, immediately prior to birth and post birth. The program also attempts to improve knowledge about issues that affect the growing baby such as healthy choices around smoking, alcohol and diet. Through enhanced engagement, the hypothesised impact of the Baby Basket program is better maternal health, reduced complications during and after pregnancy, an increased proportion of normal weight babies, and thriving infants. Ultimately, a healthy start to life should help reduce the gap in life expectancy between Indigenous and non-Indigenous Australians.
Considering the evidence available to this study, and acknowledging the important limitations with the quantitative data, it is not possible to specifically attribute the improvements in many of the indicators examined in this evaluation to the Baby Basket program. It is likely that a combination of factors, including routine maternal health services have played a role. However, given the aims of the Baby Basket program, its activities and the specific focus on improving attendance at antenatal and postnatal clinics, it is both feasible and likely that the Baby Basket program has contributed to the trend improvements in these measures since 2009. The qualitative findings support this view. If the chain of events from the Baby Basket program lead to increased clinic visits, and the provision of scheduled services to infants is a component in reducing faltering growth, then the Baby Basket program is likely to have also been a contributor to this recorded outcome at ACYHC. However, this evaluation is not able to identify the extent to which the Baby Basket program contributed to this outcome. The study also highlighted the importance of the relationship established between the health care team and the mothers, and that the baskets were part of assisting the building of trust between them. The findings of the evaluation have already been incorporated into the program and more robust evaluation frameworks and ongoing research partnerships will assist this to become a stronger program in the future.