Child and family health nursing services in Australia : current state and future directions from the CHoRUS study

Australia has a well-accepted system of universal child and family health (CFH) services to meet the needs of pregnant women, children and families at multiple contact points from pregnancy through to five years of age. However, in Australia these services are fragmented across sectors and professions and inconsistent between states and territories. The CHoRUS (Child Health: Researching Universal Services) study aimed to investigate the feasibility of implementing a national approach to universal CFH services. The study was conducted in three phases. In phase one, consultations were held with members of professional associations representing midwives, CFH nurses, general practitioners (GPs) and practice nurses. Allied health, early childhood education and consumer representatives also participated in focus groups. In phase two, midwives and CFH nurses completed surveys and in phase three we examined innovations in practice across 21 sites in Australia. The study identified concerns related to communication processes and information transfer, resourcing of services, limited collaboration between professionals and services and tensions around professional roles and responsibilities. Change will require organisations and services to place the family at the centre of care, to be flexible in service delivery, to facilitate collaboration between professionals and to provide ongoing education and support for CFH professionals.