Integrated Health-Social Hubs for Migrant Women and Infants.

Abstract

Migrant families have reduced access to universal child and family health (CFH) services, including CFH nursing visits, wherein infant and maternal surveillance offers a key opportunity to identify maternal health and child developmental concerns. Evidence is emerging on the effectiveness of integrated health and social care hubs (Hubs) to improve access to CFH services. Our aim was to evaluate the impact of Hubs at 2 sites in Sydney, Australia for migrant women and their infants on attendance to CFH nursing visits until 12 months postpartum for infant and maternal surveillance. We conducted a nonrandomized trial to compare Hubs (intervention) with routine CFH nursing services (control). Pregnant and/or recently birthed migrant women were allocated to Hubs (n = 119) or routine care (n = 120), with allocation based on residential proximity to the Hubs. Mothers and their infants were followed until the child was aged 12 months. Compared with routine care, the Hub group demonstrated a more than 4-fold higher rate of attendance at CFH nursing visits (12-month visit: adjusted relative risk, 4.68; 95% CI, 2.48-8.84) and a 2-fold increase in completion of maternal postnatal depression and psychosocial surveillance at visits. There was no difference in completion of infant surveillance between Hubs and routine care at visits. There was a significant improvement in attendance of CFH nursing visits for migrant women and their infants attending Hubs compared with routine CFH nursing services. Completion of maternal surveillance was higher in Hubs. Hubs are important service models to be considered when addressing disparities in access to CFH nursing services for migrant communities.