Nurse-Family Partnership: A Benefit to Families–and Society

by Michael Colgan

A Denver-based social program called the Nurse-Family Partnership (NFP) has shown that improving the health, well-being, and self-sufficiency of low-income, first-time parents can having a startling impact on keeping disadvantaged mothers and their children out of trouble with the law.

Specifically, follow-up research, collected when the children involved in the program reach the age of 15, shows that the NFP provides long-standing benefits to children, including

• 48 percent reduction in child abuse and neglect
• 59 percent reduction in arrests
• 90 percent reduction in adjudications as PINS (person in need of supervision) for incorrigible behavior

The NFP’s data also indicate significant benefits for mothers, including

• 61 percent fewer arrests
• 72 percent fewer convictions
• 98 percent fewer days in jail

The Nurse-Family Partnership provides many services to disadvantaged, first-time parents. Many new, low-income parents must raise their child alone. The only monetary benefit that they receive is a welfare check. But money does not solve every problem. It doesn’t improve prenatal health; it doesn’t teach necessary child-rearing skills for first-time, expectant mothers; and it certainly doesn’t reduce child abuse and neglect. Reliance on welfare can also breed dependency with no return to society. Fortunately, the Nurse-Family Partnership aims to help remedy these issues.

The NFP is a voluntary, nonprofit, visitation program. NFP nurses begin their work with the mother in pregnancy and continue to meet regularly until the child’s second year of life. Its goals are to

• Instill good health practices in new mothers, such as keeping in contact with healthcare providers, eating well, and reducing or eliminating the use of drugs and alcohol
• Help parents to improve their child’s health and development with responsible and competent care
• Improve economic self-sufficiency by helping parents plan for the future, continue their education, and find work

These goals can often not be achieved without visits and instruction by capable nursing practitioners. With this in mind, the NFP employs over 750 nurses, more than 75 percent of whom have a bachelor of science or higher degree. All have also received face-to-face education at the NFP National Service Office in Denver, as well as regional training. They commit two and one-half years to each client, including 14 planned visits during pregnancy, 28 visits during infancy, and 22 visits when the child is a toddler. To avoid health risks to the families served, a nurse home visitor’s caseload does not exceed 25 families. Further to the services provided by its caregivers, the program also offers

• Guidelines focused on the mother’s personal health, quality of living, and life-course development
• Inclusion of the mother’s support system including family members, the child’s father (if willing and able), friends, and the assistance of other health and human service organizations, if necessary
• The NFP data collection system, which is designed to record and report family characteristics, needs, services, and progress toward accomplishing its goals

Few other social programs have collected as much substantial scientific data as the Nurse-Family Partnership. It has demonstrated its long-term social and economic advantages over the last 30 years with consistent results that include improved prenatal health, fewer childhood injuries, increased maternal employment, and improved school readiness.

In addition to producing the behavioral changes cited at the beginning of this story, other aspects of crime prevention are present in the NFP’s work.

Obviously, an employed and responsible parent pays taxes and reduces costs in criminal justice and child protection services. Also, a child that is healthy due to having healthy parents during pregnancy reduces health care and special education costs and cuts down on juvenile delinquency. The Washington State Institute for Public Policy carried out an independent study to determine the economic benefits of the NFP. In 2003, the program produced $26,298 in savings per family while costing only $9,118 per family, leaving a $17,180 return per family served. This is a $2.88 return per family on every dollar invested. These numbers do not include savings related to reductions in preterm births, subsequent pregnancies, the cost of welfare, or child injury and immunizations. Given this information, it’s likely that the savings are even larger than estimated. Along with the shown reduction in crime rates, society has realized a significant economic benefit from the work of this organization.

The Nurse-Family Partnership is at work in 280 counties in 22 states across the country.  It has plans to eventually become available to all low-income, first-time families. It strongly draws resources from the Pennsylvania Department of Welfare; Public/Private Ventures (in Pennsylvania); Invest in Kids (in Colorado); and the Louisiana Office of Public Health. For more information visit www.nursefamilypartnership.org.