VoorZorg (NFP in the Netherlands)

Child abuse and neglect in early life have severe and lifetime consequences for the physical and mental development. We adapted the Nurse Family Partnership (NFP) program, developed by David Olds (US), in the Dutch version... [ view full abstract ]

Child abuse and neglect in early life have severe and lifetime consequences for the physical and mental development. We adapted the Nurse Family Partnership (NFP) program, developed by David Olds (US), in the Dutch version called VoorZorg. This is an early intervention targeting by potentially high risk young women, from early pregnancy until the child becomes two years old.

Target:

The target of the program is to prevent or reduce childabuse.

RCT

A randomized controlled trial was conducted in 460 eligible women with several risk factors for child abuse. The intervention group (I; n=237) received the programm while the control group (C; n=223) received usual care, during pregnancy until the child’s second birthday.

Results:

(1) 98% have four or more risk factors: 76% single, 74% poverty, 68% violence in the past and/or present, 19% depression and 25% substance abuse.

(2) smoking is reduced (number of women and number of cigarettes) during and after pregnancy AND they don’t smoke near the baby.

(3) significantly more breastfeeding (14%) at 6 months, usual care group (6%).

(4) domestic violence has declined both during pregnancy and two years later (psychological and physical violence).

(5) child abuse reports were significantly less in the VoorZorg group (11%); usual care (19%).

(6) cost effectiveness analysis showed a positive effect with a gain of around 20%

Conclusions:

VoorZorg appears to be able to actually improve the lives and situation of high risk mothers and their children in many areas. It is breaking the intergenerational transmission, supports positive parenting; and supports both the families and the therapists and supporting organisations to work together. Specially for those young women not able to organise participation themselves. 

VoorZorg is a good investment in the municipal preventive youth health care policy. And gives unborn children at risk ànd the whole family better opportunities.