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ANFPP: Giving Aboriginal and Torres Strait Islander Children a Better Start in Life


  • A life expectancy gap exists between Indigenous and non-Indigenous Australians.
  • The Australian government, with Abt Associates, is carrying out a program to provide additional health care services and support to Indigenous mothers and young families.
  • The program has reduced the number of preterm births and increased immunization rates and birth weights.
The Challenge

The life expectancy gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians remains approximately 10 years – a gap Australia aims to eliminate by 2030.

The Approach

In the mid-2000s, the Australian government was grappling with the question, “Can long-term gains be achieved in the health status of Aboriginal and Torres Strait Islander people by investing in the early years of life?”

This question led to the creation of the Australian Nurse-Family Partnership Program (ANFPP) in 2008, with Abt Associates selected as its managing implementer. ANFPP is an innovative, nurse-led home visiting program targeted at delivery of home services to Indigenous children and their mothers. Strong evidence suggests that ANFPP’s support of children and their families at this early point in the life cycle leads to long-term gains in their health status, with ANFPP highlighted as contributing to Aboriginal and Torres Strait Islander maternal and child health programmes in the Closing the Gap Prime Minister’s Report 2016

As the implementing partner, Abt supports health services across Australia to deliver the program, providing educational resources and training, mentoring and support to nurse supervisors, nurse home visitors, family partnership workers, and administration staff. To ensure the program’s success, Abt conducts both quantitative and qualitative reporting and evaluation, overseeing collection and analysis of 1,000 data points for every participant every three to six months.

Analysis and reflection has led to innovations such as the inclusion of Family Partnership Workers –individuals of Aboriginal or Torres Strait Islander descent who facilitate a cultural bridge between Nurse Home Visitors, the mothers and families of the Program – and the Communities of Practice Conference, which brings together representatives of all sites to share program learning and insight.

In 2017, the Australian Government announced that ANFPP, which has operated in five sites, is expanding to eight additional sites in 2018.

The Results

Evidence from three randomised control trials conducted over three decades shows the program is working, particularly for reducing premature births and low birth weights. For example:

  • Preterm births – or those before 37 weeks – for ANFPP clients have been declining since 2012;
  • Babies born to program participants also had higher-than-average birth weights;
  • Immunization rates for infants in the program exceeded the national average for Indigenous children at 24 months;
  • In 2015-16, 50 percent of infants in the program continued to breastfeed at six months of age, compared to the Australian average of only 15 percent; and
  • The alcohol consumption rates of pregnant women in the program are very low.

While the program is based on the success of similar programs in the U.S. and Canada, using it to help Australia’s most disadvantaged people is groundbreaking.

Learn more about ANFPP on the project’s web site.