Experiences from the Pilot Project: Visiting Professionals Have Become Welcome in Families and the Benefits Are Undeniable

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“I don’t know what I would have done without you” – reactions like these from new mothers are greatly rewarding and encouraging for Lithuania’s pioneering family visiting specialists. 

For several families participating in the pilot project, the specially trained nurses and midwives who regularly visited them became invaluable advisors. They provided a wide range of services from antenatal preparation and newborn care to breastfeeding advice and psychological support to help prevent postnatal depression. The goal is to expand this service, which has demonstrated its value across 12 municipalities, to a national level.

Many Lithuanian families with children need help, especially families with social needs or socio-economic exclusion, who lack childcare knowledge and skills.

According to statistics, the number of cases of physical violence against young children in Lithuania has doubled in five years, 2018-2021. During this period, around 3,000 children of all ages were subjected to violence, half of them in the home environment. Around 1,500 children lose parental care in Lithuania every year for various reasons.

Drawing on the experience of Western countries, a pilot project on family visits for early intervention services has been carried out in twelve Lithuanian municipalities over the last three years: 22 trained specialists have been visiting and counselling families on a regular basis – from the birth of the baby until he or she turns 2 years old.    

Experience from foreign countries shows that such a counselling service for families leads to a 48% reduction in child neglect, a 67% reduction in behavioural and intellectual problems, a 72% reduction in maternal criminality, an 82% increase in women’s participation in the labour market, and a 35% reduction in the incidence of hypertension in pregnancy.

Advisers, assistants, helpers

Professor Aurelija Blaževičienė, Head of the Department of Nursing at the Faculty of Nursing of the Lithuanian University of Health Sciences (LSMU), emphasises that home visitation specialists are not social workers.

A. Blaževičienė, I, Stražinskaitė Glinskienė, A. Šimkus
A. Blaževičienė, I, Stražinskaitė Glinskienė, A. Šimkus.

“These are nurses or midwives who have a nursing or midwifery background, with additional post-graduate certificate in the Family Visiting Early Intervention. Their function is to provide comprehensive family counselling, help create a safe environment for the baby, teach attachment, and how to avoid toxic relationships within the family. Sometimes they had to teach basic skills such as cooking baby’s meals or chopping firewood.  

We have trained 22 family visitation specialists, and we plan to train 85 more next year. In total, 325 families have been provided with home visitation in the context of early intervention services. The Ministry of Health has envisaged that next year the service could already become routine, financed by the Compulsory Health Insurance Fund, and available to all families in the country who need it,” said Prof. A. Blaževičienė.

Currently, families from Telšiai, Gargždai, Klaipėda, Pakruojis, Kaunas, Vilnius, Elektrėnai, Ukmergė, Marijampolė – a total of 12 municipalities – are participating in the pilot project. One of the biggest challenges faced by the new service providers is how to engage the families and win their trust to let them into the home. They actively cooperate with obstetrics and gynaecology departments, family doctors, and social workers.

Midwife Irena Stražinskaitė-Glinskienė visits 26 families in Plungė. “My strength is being a midwife. The women I consult come back from the maternity ward with a smile, because I explain to them in detail what will be happening to their bodies every second. I see my mission as helping families to navigate in the ocean of information, to understand what motherhood and parenthood are. In order to be able to come to a family, a professional must earn trust, be a personality, and an authority at the same time.

Greater flexibility is a prerequisite for the success of this project. Because families don’t need us on a set schedule – they need us when a question arises, or when they actually need specific help. In three out of 26 cases, the mother’s situation could have resulted in postnatal depression. So, in a nutshell, we are the family’s, the woman’s, medical assistants,” the specialist noted.

The future: specialists in the family doctor’s team

According to Artūras Šimkus, Head of the Nursing and Long-Term Care Division of the Ministry of Health, the Home Visitation for Early Intervention service is included in the activities of the health care centres as part of the family doctor’s team. A legal act describing the service is being drafted and a special commission will assess the appropriateness of the service.

Professor Rasa Tamelienė, Head of the Department of Neonatology at the LSMU Faculty of Medicine, noted that the whole world has recently been taking the shift towards the family, which means that from the very first hours the newborn is no longer separated from his/her mother, and more recently from his/her father. Neonatologists and other professionals working in the hospital are learning to work closely with the family.

“But when a child goes home, families have many questions. It is good to see the emergence of a much-needed service where a visiting specialist who is familiar with the family can be contacted at any time if needed,” said the professor.

The project “Model of Home Visitation for Provision of Early Intervention Services” has been funded with more than €1.4 million and is expected to provide services to 750 families in at least ten municipalities by specially trained nursing professionals. The service will not be discontinued: the participating municipalities have committed themselves to providing the service for another five years, and some for as long as eight years.