VoorZorg: home visiting program for pregnant high risk women effective at reducing child maltreatment

Date published: November 26th, 2014

VoorZorg: home visiting program for pregnant high risk women effective at reducing child maltreatment

The VoorZorg program, an intensive nurse home visiting program for young pregnant women with a low socioeconomic status, is effective at reducing g child maltreatment and domestic violence. In addition, women smoke less and breastfeed longer. This appears from PhD research of EMGO+ researcher Jamila Mejdoubi (VUmc department of Public & Occupational Health). November 5, she successfully defended her PhD thesis entitled ‘The primary prevention of child maltreatment in early life: Study on the effectiveness of VoorZorg’.

Children who grow up in families with low socioeconomic status combined with other risk factors are exposed to several negative environmental risk factors, like stress and substance abuse, that compromise fetal and early child development. Furthermore, these children are at increased risk of child maltreatment and witnessing intimate partner violence, itself a form of child maltreatment. Child maltreatment has many consequences on the mental and physical health of the young child with repercussions throughout the whole lifespan. Child maltreatment is, for example, an important determinant for risky health behavior, for criminal behavior and for intimate partner violence.

Further validation of an American based program

VoorZorg is originally an American program (Nurse-Family Partnership, NFP) that addresses risk factors among high risk pregnant women for the primary prevention of child maltreatment. Although NFP has been proven to be an evidence-based intervention for this, the program was never been studied outside the United States. Because of the many positive results of NFP in the US, Mejdoubi and her colleagues translated and culturally adapted this program in the Netherlands into VoorZorg. The Netherlands are the first country outside the US where the effectiveness of the program is determined.

High risk women receive 40 to 60 home visits from trained nurses during pregnancy and the first two years of life of the child. Visits are well-structured and described in two manuals, but nurses are able to improvise when needed. It is important that nurses develop and maintain a trusting relationship with the mother throughout the program.

Specialized nurses accompany the poorly educated pregnant women under age 25 in their first pregnancy until the child is 2 years. They get 40 to 60 structured home visits. This intensive supervision is the number of cases of child abuse 11%, while 19% is in a similar group of young mothers who received no VoorZorg.

Less child maltreatment

Mejdoubi’s study showed that children of mothers receiving VoorZorg had significantly less child protective services reports dyuring pregnancy and the first years of life of the child. This indicates that there is less child maltreatment in this group. Also, the home environment of this group appeared to be more enriched and more supportive. At 24 months after birth.

Important step

In late November, the International Convention for the Rights of the Child (once adopted by the United Nations) has its 25th anniversary. This Convention allows children to be protected against any form of abuse. Mejdoubi: "With the deployment of VoorZorg, the Netherlands can take an important step to achieve this important goal." From 1 January 2015, the VoorZorg program will be available in the Netherlands.


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