TO: Chair and Members of the Board of Health
FROM: Graham L. Pollett, MD, FRCPC, Medical Officer of Health
DATE: 2012 January 19

Smart Start for Babies: Time for Renewal

Recommendation

It is recommended that Report No. 011-12 re Smart Start for Babies: Time for Renewal be received for information.

Background

Smart Start for Babies (SSB) is a Canada Prenatal Nutrition Program (CPNP) designed for women at risk of poor birth outcomes due to factors such as poverty, domestic abuse, recent arrival in Canada as a refugee and teen pregnancies.  The local SSB program receives $152,430 annually from the Public Health Agency of Canada.  As the program sponsor for the past 7 years, the Health Unit has applied for another 2 year extension which would ensure funding until March 2014.  The program receives significant in-kind personnel support from London Health Sciences Centre, Merrymount Children’s Centre and the Health Unit.  The mainstay of the program is to provide food supplements, nutritional counseling, support, education, referrals to other services and counseling for ‘at risk’ pregnant women.

The CPNP priorities for funding are for local programs that address:

• Pregnant women living in poverty
• Pregnant teens
• Pregnant women who drink alcohol or use drugs
• Pregnant women diagnosed with gestational diabetes
• Refugees
• Pregnant women living in isolation or with poor access to services

Program Renewal at the Local Level

Since the inception of the SSB program 16 years ago, many of the services provided for the target groups in London and Middlesex have evolved.  Over the past six months, SSB staff has collaborated with community partners about how best to support organizations working with high risk women to help them have healthier pregnancies and connect with services and supports.   Community consultations took place on October 27^th and November 30^th to explore new operational structure and to consider ways to deliver services to the target population.  Particular attention has been paid to new staffing structures, reallocating financial resources for program resources and strengthening partnerships within the communities/ neighbourhoods where the clients live.

As a result of the community consultations, four major goals have been identified:

1.   To enhance the health and well being of pregnant women including teens who have limited resources and supports

2.   To set the stage for healthy growth and development of infants in the first 2 years of life

3.   To integrate SSB services with appropriate community agencies in the London and Middlesex to enhance and sustain learning opportunities for a greater number of pregnant women.

4.   To establish multiple ways to reach out to high risk pregnant women and invite them to learn about healthy nutrition and positive lifestyle choices.

In 2012, the plan is to implement a number of new activities and strategies that will support the above goals.  Specifically, each program location will have a site coordinator who is familiar with all services and resources within that community and who will facilitate connections with and for the clients.  There are also plans to develop nutrition resources and train-the-trainer sessions for all community service providers to support clients who are not directly involved in SSB but whom would benefit from learning about nutrition and pregnancy.  Throughout London, there are some community health service agencies who may be interested in delivering SSB to their clients.  In January 2012, the plan will include conversations with such service providers to determine how SSB can best meet clients’ needs.

For many of these pregnant women, the SSB program provides an opportunity for social support and networking.  The program provides skill building and education and also has a number of strategies to support a healthy environment such as free prenatal vitamins, food gift certificates, provision of kitchen supplies and a healthy snack for those attending.  The program will continue to provide hands-on food demonstrations about how to cook nutritious meals, providing an awareness of cost and nutritious content. Clients who are interested may be enrolled in the new e-learning prenatal program and much of the teaching will be integrated with the many internet resources available on-line and social media.    

Conclusion

SSB has a long history in London and Middlesex County.  For the past seven years, the Health Unit has also been the program’s sponsor, i.e., been responsible for the program budget. This Health Unit has played a major role in its implementation since the program’s inception 16 years ago, including being the employer for the full time staff coordinator and secretarial support.  Experienced staff members facilitate the sessions, incorporate public health messages in the curriculum and link clients to appropriate services and resources.  Through partnerships with other community service agencies, the SSB program will be enriched and ‘at risk’ clients will receive the support, education and skills needed to care for their growing families.

This report was prepared by Ms. Nancy Summers, Manager, Family Health Services. 

Graham L. Pollett, MD, FRCPC
Medical Officer of Health

This report addresses the following requirement(s) of the Mandatory Health Programs and Services Guidelines:  Reproductive Health Program, to support healthy pregnancies.