About Bulundidi Gudaga

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The Bulundidi Gudaga program is an important initiative within the South Western Sydney Local Health District (SWSLHD). It has been developed to address both the local needs of Aboriginal families and children, and as a clinical trial that will inform service development in other locations.

Aboriginal children do not have the same opportunities for optimal health and development as non-Aboriginal children. Analysis of data for Campbelltown collected by the Obstetrics Data Package (2002) demonstrated that birth outcomes for Aboriginal infants born in Campbelltown were similar to the outcomes of the most vulnerable of the general population. Poorer outcomes for Aboriginal infants were present even among families who were not socioeconomically disadvantaged and did not have specific individual risks for poorer child health or development outcomes. Aboriginal infants living in poorer suburbs compared to non-Aboriginal infants living in these suburbs had worse birth outcomes.

The Bulundidi Gudaga program builds on key results from the Gudaga Study, in particular the short duration of breastfeeding, concerns around early child development and the higher than expected number of SIDS deaths and removal of children to out of home care.

In parallel to the Gudaga research, a sustained nurse home visiting program had been developed and trialled by CHETRE with positive results for disadvantaged families in the region.

Bulundidi Gudaga is an adaptation of this home visiting program to meet the needs of vulnerable women and their babies within the local Aboriginal community.

Implementation of the Bulundidi Gudaga program comprises a major redistribution of Child and Family Nursing Services in the region and is a key strategy of the health services’ response to ‘Close the Gap’ initiatives. Nurses will visit expectant mothers antenatally and continue to visit them until the infant is 2 years of age.

A key aim of the program is to build strong partnerships between Aboriginal and mainstream services to ensure that Aboriginal infants, children, and their mothers have access to appropriate health services. The program works closely with Tharawal Aboriginal Corporation.

Bulundidi Gudaga Clinical Trial

The Bulundidi Gudaga project is built on a partnership between the South Western Sydney Local Health District (SWSLHD) and researchers from CHETRE. This Sustained Home Visiting Program has been developed as an important part of the SWSLHD's intention to 'Close the Gap' by improving child health and development outcomes for Aboriginal infants in Campbelltown. Another key stakeholder and collaborator is the Tharawal Aboriginal Corporation.

According to the best international evidence, the Maternal Early Childhood Sustained Home-visiting (MECSH) program, a review of PANOC services, and the draft NSW Health Home Visiting Guidelines, the appropriate service responses for families changes as their level of vulnerability changes. Results of the MECSH trial in Miller indicate that antenatal home visiting significantly improves early parenting confidence. Study of the activities undertaken by the nurses in the home visits demonstrates that all women with at least one risk factor for poor child health and development outcomes benefit from a comprehensive intervention dealing with the child, mother, family and environment.

In response to local need and the existing evidence base, the Bulundidi Gudaga research program is based on the MECSH program. We are running a clinical trial to examine whether or not this Sustained Home Visiting program is as effective in improving outcomes for Aboriginal children and their families as it has been shown to be for a non-Aboriginal cohort.