The Australian Model of the First 1000 Days

Written by Kerry Arabena, Rebecca Ritte and Stacey Panozzo, The University of Melbourne

From the Indigenous Health Equity Unit, Onemda VicHealth Group, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne

The Australian Model of the First 1000 DaysThe Australian Model of the First 1000 Days is an Indigenous-led initiative which seeks to provide a coordinated, comprehensive intervention to address the needs of Aboriginal and Torres Strait Islander children from (pre)conception to two years of age and their families.1 It is an engaging model that assists parents to achieve health outcomes for their children by strengthening their extended family and community to realise the potential of all children. It also supports service providers to act on evidence and build service and regional level capacities to respond.

Internationally, the First 1000 Days movement focuses on reducing under-nutrition for the period from conception to a child’s second birthday, with early life interventions showing demonstrable and far-reaching outcomes.2 These outcomes include reducing the human and economic burden of communicable diseases and risk of developing some non-communicable and chronic diseases, as well as improving educational achievement and earning potential.

To ensure Australian Aboriginal and Torres Strait Islander families benefit from the First 1000 Days movement, an Australian Model of the First 1000 Days has now been developed. The Model has been informed through a year-long and continuing, nation-wide engagement process. This has involved four national Symposia linking 323 participants from 107 different organisations, including early-life researchers, research institutions, policy-makers, professional associations and human rights activists with Aboriginal and Torres Strait Islander service delivery organisations, peak bodies and families.3-6

Through this engagement process, the Australian Model of the First 1000 Days broadened beyond the international emphasis of improving nutrition and maternal and child health to include an Indigenous-led holistic and ecological framework focusing on comprehensive primary health care with a case management style of approach. It includes strong community governance processes and interventions that focus on the family environment, increasing antenatal and early years’ engagement, service use and provision.3-6 A pre-birth longitudinal study will be carried out to measure the impacts and health benefits of the implemented interventions.

What will it look like? Who is involved?

The Model will be under the auspice of regional and local governance arrangements between The University of Melbourne, early learning centres, Aboriginal community health organisations and government and non-government organisations. The University of Melbourne will coordinate the design, implementation and evaluation of the First 1000 Days interventions and build knowledge exchange strategies. The University will also help support and develop the capacity of partners and end users, and provide seed money for First 1000 Days initiatives with hospitals, government departments and industry partners.

The next step for the Australian Model of the First 1000 Days is a proof-of-concept strategy that will be followed by the roll out of the First 1000 Days program across local sites and organisations around Australia. This foundation project aims to establish the process of providing a coordinated and comprehensive suite of interventions that address the needs of Aboriginal and Torres Strait Islander children and families. Initially, three sites will be engaged located in urban, rural and remote areas.

Further information

For individuals or organisations interested in becoming involved in the Australian Model of the First 1000 Days, 2-day courses provided by the School of Population and Global Health, The University of Melbourne explore how the Model can be established and implemented across different Aboriginal and Torres Strait Islander communities Australia-wide in partnership with the University of Melbourne and Aboriginal Community Controlled Health Organisations. For further information about the 2-day courses please refer to our website or contact the Indigenous Health Equity Unit.

References

  1. Ritte R, Panozzo S, Johnston L, Agerholm J, Kvernmo SE, Rowley K, Arabena K. An Australian Model of the First 1000 Days: An Indigenous led process to turn an international initiative into an early life stratgey benefiting Aboriginal and Torres Strait Islander families. Global Health, Epidemiology and Genomics. Under review.
  2. 1000 Days. Why 1000 Days? 2014 [cited 2015 12 July]. Available from: http://www.thousanddays.org/about/.
  3. Arabena K, Howell-Muers S, Ritte R, Munro-Harrison E. Making the World of Difference: The First 1000 Days Scientific Symposium Report. Onemda VicHealth Group, The University of Melbourne, Melbourne, 2015.
  4. Arabena K, Panozzo S, Ritte R. The First 1000 Days Researchers' Forum Report. Onemda VicHealth Group, The University of Melbourne, Melbourne, 2015.
  5. Arabena K, Panozzo S, Ritte R, Johnston L, Lyons J. Strengthening Families through the First 1000 Days Community Governance Symposium: Report. Onemda VicHealth Group, The University of Melbourne, Melbourne, 2015.
  6. Arabena K, Panozzo, S. And Ritte, R.,. The First 1000 Days Policy and Implementers' Symposium Report. Onemda VicHealth Group, The University of Melbourne, Melbourne, 2016. 
Artwork by Mandy Nicholson.
 

Comments (2)

How does this model fit with, or differ from, the Australian Nurse Family Partnership Program that also targets pre-birth to 2 years and that has already been rolled out for a number of Indigenous communities?
Hi Caroline, The First 1000 Days Australia differs from the Australian Nurse Family Partnership Program in that it includes: (1) A multigenerational approach, focusing on infants, young people, mothers and fathers, carers and grandparents; (2) An intentional engagement of fathers and young men during their transition to becoming fathers; (3) Holistic family-focused interventions for the life-course that address areas of: (a) Family environment, including families using strengths-based approaches in raising resilient children, effective information and support for families to enhance relationships between children and parents, addressing family violence, in addition to a case management approach and the identification of growth and cognitive milestones; (b) Antenatal and early years engagement, which includes preconception and family planning, and a whole-of-service approach including nutritional programs, counselling, early learning, education, correctional services, housing, drug and alcohol services, and family empowerment programs; and (c) Service use and provision focusing on capacity building with Aboriginal and Torres Strait Islander parents, families and the workforce during the First 1000 Days. In addition to the holistic interventions and to ensure we are able to measure their impact, the Model will include the first Indigenous-led and governed Aboriginal and Torres Strait Islander Pre-birth Longitudinal Cohort Study. This aspect of the Model will employ rigorous measurements of the cognitive and educational development, and health and cultural wellbeing of Aboriginal and Torres Strait Islander children and families. We are more than happy to provide further information upon request. - Kerry Arabena, Rebecca Ritte and Stacey Panozzo