Improving child and family health services for families most in need and building positive relationships with families

1 Jul 2012

While most families of young children are well supported socially and make good use of services, some do not. Children from families that have poor social supports and that make limited or no use of early child and family services are at increased risk of poor health and developmental outcomes.

Research confirms what many professionals working with children and families already know – that the families most in need are the least likely to access support.

An evaluation of the Victorian Maternal and Child Health Service in 2006 found that mothers from three groups were not receiving the same level of service as the rest of the population: culturally and linguistically diverse (CALD) mothers; single mothers; and/or young mothers. The evaluation also found that mothers under 21 years of age (and single mothers to a lesser degree) disengage from services the most rapidly, followed by mothers from CALD communities. Parents with greater levels of socio-economic disadvantage who live in non-metropolitan areas are also less likely to participate in services. These three groups are prominent among those who we think of when we refer to vulnerable families.


Many child and family health services continue to struggle to engage and retain families; the reasons why vary. Many of these families are referred to as ‘hard to reach’ or labelled ‘non-compliant’ for failing to attend a visit, listen to practitioner advice, or follow-up on directions.

However, research shows that the way services are delivered is just as important as what is delivered. ‘... If services are not delivered in ways that engage parents and respond to their needs, then [services] will struggle to attract and retain them and their effectiveness will be compromised’. This article focuses on the importance of building positive relationships with families and offers ideas to help nurses reflect on their own relationship building knowledge and skills.

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