Child Development Parent Education Program

The MECSH program includes delivery of a child development parent education program. The use of a formal child development program supports the structure of the MECSH program and is critical for supporting mothers to be future oriented and aspirational.

The chosen program should support families to foster the development of their child and must provide anticipatory guidance of normal development in all developmental domains - cognitive, social, emotional and physical. Training in and support for delivery of the program by the MECSH nurse must be provided, including the provision of any support materials required by the chosen program.

The original MECSH program used the Learning to Communicate child development parent education program. The major aim of Learning to Communicate is to enhance the ability of parents to provide appropriate stimulation for their babies, which will facilitate their baby’s communication development.

Learning to Communicate is delivered by the MECSH nurse during the home visit. Delivery of Learning to Communicate is supported by a DVD and Parent Handbook provided to each mother in the MECSH program. The nurse is provided with a facilitator’s guide.

The Learning to Communicate parent materials are given to parents during the antenatal period, with structured sessions commencing postnatally.

The objectives of Learning to Communicate are to provide parents with:

  • information on the normal development of communication
  • information on ways that they can encourage their baby’s development
  • information on the types of toys and play materials that are appropriate at each stage of their baby’s development
  • the opportunity to practise and discuss the above.

Learning to Communicate aims to teach parents how to communicate more effectively with their infants and to stimulate their infant’s communication development through natural daily activities. Each Learning to Communicate session has three sections:

  • Development - See what I can do!
  • Mum and Dad help baby to learn; and
  • Things that make learning fun. 

 ChildDev SuitableRequire

 Web MECSH Separator Child Dev Progr

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LtC Book Cover Web







MECSH Research Publications

  1. Kemp L. Adaptation and fidelity: A recipe analogy for achieving both in population scale implementation. Prevention Science 2016;17(4):429-38. DOI: 10.1007/s11121-016-0642-7.
  2. Zapart S, Knight J, Kemp L. ‘It was easier because I had help’: Mothers’ reflections on the long-term impact of sustained nurse home visiting. Maternal and Child Health Journal 2016;20(1):196-204. DOI: 10.1007/s10995-015-1819-6.
  3. Kemp L, Harris E, McMahon C, Matthey S, Vimpani G, Anderson T, Schmied V, Aslam H. Benefits of psychosocial intervention and continuity of care by child and family health nurses in the pre- and postnatal period: Process evaluation. Journal of Advanced Nursing 2013;69(8):1850-61.
  4. Kemp L, Harris E. The challenges of establishing and researching a sustained nurse home visiting programme within the universal child and family health service system Journal of Research in Nursing 2012;17(2):127-38.
  5. Kemp L, Harris E, McMahon C, Matthey S, Vimpani G, Anderson T, Schmied V, Aslam H, Zapart S. Child and family outcomes of a long-term nurse home visitation program: a randomised controlled trial. Archives of Disease in Childhood 2011;96(6):533-40.
  6. Kervin B, Kemp L, Jackson Pulver L. Types and timing of breastfeeding support and its impact on mothers’ behaviour. Journal of Paediatrics and Child Health 2010;46(3):85-91.
  7. Kardamanidis K, Kemp L, Schmied V. Uncovering psychosocial needs: perspectives of Australian child and family health nurses in a sustained home visiting trial. Contemporary Nurse 2009;33(1):50-8.
  8. Aslam H, Kemp L, Harris E, Gilbert E. Socio-cultural perceptions of SIDS among migrant Indian mothers. Journal of Paediatrics and Child Health 2009;45(11):670-5.
  9. Kemp L, Harris E, McMahon C, Matthey S, Vimpani G, Anderson T, Schmied V. Miller Early Childhood Sustained Home-visiting (MECSH) trial: design, method and sample description. BMC Public Health 2008;8:424.
  10. Kemp L, Eisbacher L, McIntyre L, O’Sullivan K, Taylor J, Clark T, Harris E. Working in partnership in the antenatal period: what do child and family health nurses do? Contemporary Nurse 2006;23(2):312-20.
  11. Kemp L, Anderson T, Travaglia J, Harris E. Sustained nurse home visiting in early childhood: exploring Australian nursing competencies. Public Health Nursing 2005;22(3):254-9.


MECSH Trial Outcomes

The randomised trial of the MECSH program demonstrated that children, mothers and their families who received the program achieved the following impacts and outcomes:

New mothers

  • tended to be more likely to experience a normal, unassisted vaginal birth;
  • felt significantly more enabled and confident to care for themselves and their baby;
  • had significantly better self rated health;
  • could name two or more measures to reduce cot death risk.


  • were breastfed for longer;
  • had improved cognitive development, particularly for children of mothers who were recorded as having psychosocial distress antenatally;
  • were more engaged with their mother.

Mothers of infants and toddlers

  • tended to have a better experience of being a mother, particularly for mothers who were recorded as having psychosocial distress antenatally and mothers who were born overseas;
  • provided a home environment that was supportive of their child’s development through improved verbal and emotional responsiveness, providing a more organised environment, providing developmentally appropriate play materials and greater parental involvement.

Drawing by a child of the MECSH Trial aged 4 years

 Drawing by a child of the MECSH Trial aged 4 years









MECSH Best Fit Checklist

Service System Requirements 

The MECSH program requires that the maternal and child health services in the area served by the MECSH program have the following five system requirements:

  1. A universal population-based system for identifying pregnant women
    • Identify before 20 weeks gestation (preferably)
    • Hospital booking-in system enables early book-in
    • Work with community and health care providers (eg GPs)
  2. A universal population-based system for assessing psychosocial risks of each family expecting an infant
    • Psychosocial risk questions
    • Edinburgh Depression Scale
  3. A process for reviewing families’ psychosocial risks to identify those families who would benefit from participation in the MECSH program
    • Facility to “flag” files of potential eligible families
    • Case discussion meetings to review families psychosocial risks
    • System generate a list of families to be offered the Program
  4. A process for contacting eligible families who would benefit from participation in the MECSH program in order to offer them the program
    • Initial contact to be made by Program Nurse
  5. A process for monitoring the identification of eligible families and uptake of the Program by families
    • Ongoing monitoring of requirements 1 to 3
    • Ongoing monitoring of requirement 4

The MECSH program is licensed by the University of NSW. Child and family service providers implementing MECSH in their communities are provided with support through the license and a three-year implementation support package. Granting of a license signifies a commitment by the licensed child and family service to delivery of a quality intervention and service systems to meet the needs of vulnerable families in their community.

If you are considering implementing the MECSH program, please contact CHETRE for more information.

MECSH Checklist

MECSH Program Goals

The program goals are:

  • Improve transition to parenting by supporting mothers through pregnancy. This includes providing support with the mother’s and family’s psychosocial and environmental issues, supporting the health and development of the family including older children, providing opportunity for discussion, clarification and reinforcement of clinical antenatal care provided by usual antenatal midwifery and obstetric services, and preparation for parenting.
  • Improve maternal health and wellbeing by helping mothers to care for themselves. Guided by a strengths-based approach, the nurse will support and enable the mother and the family to enhance their coping skills, problem solving skills and ability to mobilise resources; foster positive parenting skills; support the family to establish supportive relationships in their community; mentor maternal-infant bonding and attachment; and provide primary health care and health education.
  • Improve child health and development by helping parents to interact with their children in developmentally supportive ways. This includes supporting and modelling positive parent-infant interaction and delivery of a standardised, structured child development parent education program.
  • Develop and promote parents’ aspirations for themselves and their children. This includes supporting parents to be future oriented for themselves and their children, modelling and supporting effective skills in solving day to day problems and promoting parents’ capacities to parent effectively despite the difficulties they face in their lives.
  • Improve family and social relationship and networks by helping parents to foster relationships within the family and with other families and services. This includes modelling and supporting family problem solving skills, supporting families to access family and formal and informal community resources and providing opportunities for families to interact with other local families.

MECSH program model