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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 Global, carried out a program to provide additional support to Indigenous mothers and young families.
  • The program 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.

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?”

The Approach

This question led to the creation of the Australian Nurse-Family Partnership Program (ANFPP) in 2008, with Abt Global selected as its managing implementer. ANFPP was an innovative, nurse-led home visiting program that targeted 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 led 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 supported 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 conducted both quantitative and qualitative reporting and evaluation, overseeing collection and analysis of 1,000 data points for every participant every three to six months during the project.

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

In 2018, ANFPP, which operated in five sites, expanded to eight additional sites.

The Results

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

  • Preterm births – or those before 37 weeks – for ANFPP clients declined 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 were very low.

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

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