Evidenced-based, backed by experience in cities nationwide
The nurse-family partnership (NFP) is effective because it is evidenced-based. NFP is the most rigorously tested program of its kind. Three randomized, controlled trials and follow-ups have been conducted. Consistent program effects found in at least two of the three trials include:
- Improved prenatal health
- Fewer childhood injuries
- Fewer subsequent pregnancies
- Increased intervals between births
- Increased maternal employment
- Improved school readiness
National research statistics can project similar outcomes in the Detroit market:
- The average cost for a Neonatal Intensive Care (NICU) stay is $3,000 per day, with more than 60 percent of the NICU stays greater than four days. The average length of stay for 70 percent of NICU patients is 20 days. (Source: Managed Care Magazine).
- NFP research, stemming back to the establishment of the program in the 1970s, notes a 79 percent reduction in preterm delivery for women who smoke, and reductions in high-risk pregnancies as a result of greater intervals between first and subsequent birth. It is common for “rebound” pregnancies to occur in this population.
- NFP client research has noted a 59 percent reduction in child arrests at the age of 15, related to improved family structure, parenting skills, and single parent economic stability.
- The program notes significant reduction in injuries among its client population:
- 39 percent fewer injuries among client children in general
- 56 percent reduction in emergency room visits for accidents and poisonings
- 48 percent reduction in child abuse and neglect
- Improved school readiness among client children has been demonstrated in a 50 percent improvement in language development delays of children age 21 months; as well as 67 percent reduction in behavioral/intellectual problems at age six.
- For the parent – often a single parent – there are substantial lifestyle improvements that reflect in socioeconomic indicators relevant to the population at large:
- 32 percent drop in unintended subsequent pregnancies
- 82 percent increase in maternal employment
- 20 percent reduction in months on welfare
- 46 percent increase in the father’s presence in the household
- 60 percent fewer arrests of the mother; 72 percent fewer convictions of the mother
NFP has an evaluation component that allows the Health Authority to track progress. Nurse home visitors collect data, which is entered into a clinical information system managed by the NFP national office. Health Authority staff ca review reports regularly to evaluate quality.
The Michigan experience
In 2012, with support from the WK Kellogg Foundation Michigan Medicaid Administrative Match program, and MIECHV Program funding, the Detroit Wayne County Health Authority launched NFP to serve approximately 125 families. With 2,774 first-time Medicaid births in the City of Detroit, the community has the capacity to likely serve 693 clients and support a team of 24 nurse home visitors, supporting communities and population bases in alignment with the configuration of Detroit Medical Center. The Health Authority’s NFP program has contracted with the Wayne State University Physician Group Nurse Midwifery Program for supervision and is closely aligned with Hutzel Hospital in the Detroit Medical Center.
Examples of some of the dramatic outcomes experienced by the Michigan families enrolled in NFP since the first program was established in Berrien County in 2000 include:
- 93 percent of children had all recommended immunizations by 24 months,
- 91 percent of babies were born full term,
- 91 percent of babies had no visits to the ER or hospitalizations due to injury or ingestions by 12 months of age, and
- 49 percent of mothers who completed the program were enrolled in the workforce.