Maternal and Child Health Service Program Standards: Every child, every opportunity doc

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ecsmanagement/mch/policy/default.htm
Maternal and Child
Health Service
Maternal and Child Health Service
Program Standards
Maternal and Child Health Service
Maternal and Child Health Service Program Standards
Victorian Maternal and Child Health Service2
Published by the Programs and Partnerships Division
Office for Children and Portfolio Coordination
Department of Education and Early Childhood Development
Melbourne
Published October 2009
ISBN 978-0-7594-0582-0
© State of Victoria 2009
The copyright in this document is owned by the State of Victoria. No part may be reproduced by any process
except in accordance with the provisions of the Copyright Act 1968, NEALS (see below) or with permission.
An educational institution situated in Australia which is not conducted for profit, or a body responsible
for administering such an institution, may copy and communicate the materials, other than third-party
materials, for the educational purposes of the institution.
Authorised by the Department of Education and Early Childhood Development,
2 Treasury Place, East Melbourne, Victoria 3002.
Also published on
Terms and definitions 3
1 Introduction 6
1.1 Maternal and Child Health Service: Vision, mission, goals and principles
1.2 Overview of Maternal and Child Health Service 8
2 Background 10
2.1 An evidence-based framework
2.2 Structure of the Program Standards 11

2.3 Purpose and use of the Program Standards 12
2.4 Assessment against the Program Standards
3 The Maternal and Child Health Service Program Standards 13
Standard 1: Universal access
Standard 2: Optimal health and development 20
Standard 3: Partnerships and collaboration 28
Standard 4: Competent and professional workforce 33
Standard 5: Responsive and accountable service delivery 43
Standard 6: Quality and safety 51
References 61
Appendix A: Development of Maternal and Child Health Program Standards 67
Appendix B: List of evidence 74
Contents
Victorian Maternal and Child Health Service 79
• Audit of referrals made to Maternal and Child Health Service, including:
– reason for referral
– information on organisation/provider making the referral
– quality of information provided within the referral.
Example surveys
The following are a list of example surveys, and content within the surveys, that
may be utilised in order to inform the Maternal and Child Health Service on the
achievement of the criteria within the Program Standards.
• Survey of families, including views and feedback on:
– Maternal and Child Health Service in general
– access to the Maternal and Child Health Service
– information available on the Maternal and Child Health Service
– culturally competent service delivery for families
– partnership approach to service delivery.
• Survey of services which Maternal and Child Health Service offers referrals to,
including views and feedback on:

– appropriateness of referral
– quality of information within the referral
– other relevant information to improve referrals from the Maternal
and Child Health Service.
• Environmental survey, including:
– review of accessibility of the Maternal and Child Health Service
by children and families
– risk assessment of environment in relation to children and families and the
maternal and child health workforce.
Other suggested evaluations and activities
The following additional evaluations and activities are suggested in order to inform
the Maternal and Child Health Service on the achievement of the criteria within the
Program Standards:
• Evaluation of health promotion activities undertaken by the Maternal and Child
Health Service
• Evaluation of key performance indicators associated with the strategic and
operational plans
• Review of activities to strengthen community capacity.
Victorian Maternal and Child Health Service
3
Within the Maternal and Child Health Program Standards, the following terms and
definitions are used:
Clinical risk management – a method for identifying circumstances within the
Maternal and Child Health Service that place, or potentially place, children and
families at harm or at risk of harm, and addressing these circumstances to prevent
or control the risk.
Clinical supervision – a support mechanism for maternal and child health nurses
within which service delivery, organisational, developmental and emotional
experiences are shared in a secure and confidential environment in order to
enhance skills and knowledge.

1
Collaborate/collaboration – to work together, with other members of the Maternal
and Child Health Service, and/or other services and organisations and/or with the
mother and family to achieve unified goals so as to maximise the child’s health,
wellbeing, learning, development and safety.
Community capacity – the community’s ability to identify and mobilise resources to
address the health and wellbeing issues of young children, and associated health
and wellbeing issues of the mother and family.
2
Corporate risk management – the system by which the Maternal and Child Health
Service is directed, controlled and held to account, encompassing the processes,
policies and responsibilities in relation to accountability, leadership, and direction
of the Service. These activities support the delivery of the Maternal and Child
Health Service.
3
Cultural competence – a set of behaviours, attitudes and policies that come
together to enable the Maternal and Child Health Service to work effectively in
cross-cultural situations, across the spectrum of service delivery from an individual
level, to integrating culture into the delivery of the Service.
4
Determinants of health – factors that determine the health status of individuals and
populations. The determinants of health include:
• general background factors, including culture, social cohesion
• environmental factors
• socioeconomic factors
• knowledge and attitudes
• health behaviours
• psychological effects
• safety factors
• biomedical factors

• individual makeup
• individual and population health.
5, 6
Terms and definitions
Victorian Maternal and Child Health Service4
Family – the family is identified by their emotional attachment with the child and
their concern for the child’s health, growth and development. This may include the
mother, father, adoptive mother, adoptive father, grandparent, step-parent, foster
parent, siblings, partner or carer. Other family members who may also share a
concern for the child are referred to as ‘the extended family’.
Family-centred practice – the approach to identification and management of the
child, mother and family that focuses on the strengths of each individual family.
7
Father – within the Maternal and Child Health Program Standards, refers to the
birth, adoptive father or step father.
Governance – a system through which the Maternal and Child Health Service is
responsible and accountable, and continually improves quality and safety for children
and families accessing the Service. Governance comprises clinical governance;
responsibility for the safe and quality service delivery and corporate governance;
and responsibility for the corporate structures supporting service delivery.
8, 9

Health – a state of complete physical, mental and social wellbeing and not merely
the absence of disease or infirmity.
10
Incident – an event, including an accident, that resulted in, or had the potential to
result in, harm to the child, or family, or a member of the maternal and child health
workforce, including physical or emotional injury, ill-health or other loss.
11
Integration – an approach towards providing a service to the child and family

that involves working with other members of the Maternal and Child Health
Service, and/or other services and organisations. The approach is identified by an
interdisciplinary team approach, with the team having a shared vision of service
delivery, and each team member contributing their knowledge and skills towards a
shared plan of service delivery in order to achieve the goals and outcomes for the
childs family.
12
Intervention – endeavours to promote good health activity and behaviour, and to
prevent or limit poor health activity or behaviour.
Management and leadership – indicates positions and/or roles that do not interface
with the child and family including the team leader, coordinator, and other positions
and structures that provide a line of accountability and reporting for the Maternal
and Child Health Service. These positions have the responsibility to lead and
organise the Service so as to provide a quality and safe service within the resources
available to it.
Victorian Maternal and Child Health Service 5
Maternal and child health workforce – the workforce that provides or assists
and supports the provision of the Maternal and Child Health Service and includes
maternal and child health nurses, coordinators, team leaders, clerical and other
maternal and child health workers of disciplines other than nursing involved in the
delivery of the Service and/or management of it.
Maternal and Child Health Service – a universal health service for children
from birth to school age and their families focusing on promotion of health
and development, prevention, early detection of, and intervention for physical,
emotional and social factors affecting young children and their families. Within
the Program Standards, the Service encompasses the maternal and child health
workforce, including management structures supporting the maternal and child
health workforce (for example, local government or the governing authority), and
areas that may support the delivery of the Service (for example, Human Resources).
Monitoring – the processes of screening and assessment undertaken by the

Maternal and Child Health Service.
Mother – within the Maternal and Child Health Program Standards, refers to the
birth mother or adoptive mother. Aspects of the Program Standards have particular
relevance to physiological and psychological aspects of childbirth and therefore
will be relevant only to birth mothers.
Partnership – the relationship the Maternal and Child Health Service has with
the child’s family or another service/organisation involved with the child. The
relationship is characterised by mutual cooperation, collaboration, respect and
responsibility in order to maximise the child’s development and the family’s health,
safety and wellbeing.
Setting – the surrounds in which the Maternal and Child Health Service is delivered.
This may include, but not be limited to, the centre; within a child’s, mother’s or
other family member’s home; over the telephone; as part of other health services
or organisations; within groups; and in local facilities and buildings.
Support – indicates the provision of information, advice, education, counselling and
other relevant activities by the maternal and child health workforce to the family.
Universal access – the capacity of all children and families to have equal
opportunity to access the Maternal and Child Health Service.
Vulnerable child, mother and family – the child and/or mother and family may be
at risk of adverse health and wellbeing outcomes due to individual, parental or
family circumstances.
Victorian Maternal and Child Health Service6
The Victorian Maternal and Child Health Service is an integral component of a
comprehensive system of child and family services in Victoria. The Service provides
a universal health service for children from birth to school age, focusing on
promotion of health and development, prevention, early detection and intervention
for physical, emotional and social factors affecting young children. The Service
consists of the Universal Maternal and Child Health Service, Enhanced Maternal and
Child Health Service and the Maternal and Child Health Line.
While the Service is primarily for the child, it also focuses on the health and

wellbeing of the mother, and the family, in the context of the child’s health and
wellbeing. The Maternal and Child Health Service is provided in partnership
between local government authorities and the Department of Education and Early
Childhood Development (DEECD). The Maternal and Child Health Line is funded and
provided by DEECD.
1.1 Maternal and Child Health Service:
Vision, mission, goals and principles
The Maternal and Child Health Service Program Standards support the vision,
mission, goals and principles of the Service as stated in the Maternal
and Child Health Service Program Resource Guide.
7
1.1.1 Vision
All Victorian children and their families will have the opportunity to optimise their
health, development and wellbeing during the period of a child’s life from birth to
school age.
1.1.2 Mission
The mission of the Maternal and Child Health Service is to engage with all families
in Victoria with children from birth to school age; to take into account their
strengths and vulnerabilities; and to provide timely contact and ongoing primary
health care in order to improve their health, development and wellbeing.
1.1.3 Goals
The framework for the provision of the Maternal and Child Health Service is guided
by an overarching goal:
To promote healthy outcomes for children and their families, providing a
comprehensive and focused approach to managing the physical, emotional or social
factors affecting families in contemporary communities.
1 Introduction
Victorian Maternal and Child Health Service 7
Two further objectives support this goal. These are to:
•

enhance family capacity to support young children and address physical, emotional,
social and wellbeing issues affecting young children
•
enhance community capacity to support young children and their families to
address physical, emotional, social and wellbeing issues affecting young children.
1.1.4 Principles
The guiding principles for the Maternal and Child Health Service, as stated in the
Maternal and Child Health Service Program Resource Guide
7
are:
1. Consultation and participation – Consultation with, and participation by,
families is integral to the services. Services will be informed by, and seek to
meet, the needs of young children and their families.
2. Access and availability – All families with young children should be able to
readily access the information, services and resources that are appropriate for,
and useful to, them.
3. Primacy of prevention – Prevention of harm or damage is preferable to
repairing it later. Early detection of risk factors is required, and intervention,
where appropriate.
4. Capacity building – Promotion of resilience and capacity is preferable to
allowing problems to undermine health or autonomy.
5. Equity – All children should be able to grow up actively learning, healthy,
sociable and safe – irrespective of their family circumstances and background.
6. Family-centred – The identification and management of child and family needs
requires a family-centred approach that focuses on strengths.
7. Diversity – The diversity of Victorian families should be recognised and valued.
8. Inclusion – Inclusive practices are essential for all children to get the best start,
irrespective of their family circumstances, differing abilities and background.
9. Partnership – Quality services are achieved through integrated service
delivery and partnerships with other early childhood and specialist services,

and with families.
10. Quality – All families with young children must be confident of the quality of
information, services and resources provided to them.
Victorian Maternal and Child Health Service8
11. Evidence and knowledge – Policies, programs and practice are based on the
best evidence and knowledge available.
12. Evolution of services – Programs and services will continue to evolve to meet
needs in a changing environment.
13. Continuously improving and adding value to services – Sustained and
improved services for families and children promote better outcomes for
children and their families.
7
1.2 Overview of Maternal and Child
Health Service
The Maternal and Child Health Service delivers a universal health service through
three service components:
• Universal Maternal and Child Health Service
• Enhanced Maternal and Child Health
• Maternal and Child Health Line.
1.2.1 Universal Maternal and Child Health Service
The Universal Maternal and Child Health Service supports families and their
children in the areas of parenting, development and assessment, promotion of
health and development, wellbeing and safety, social supports, referrals and links
with communities. The Universal Maternal and Child Health Service consists of the
Key Ages and Stages consultations and a flexible service component.
The Key Ages and Stages consultations provide 10 consultations, including an initial
home visit and consultations at 2 weeks, 4 weeks, 8 weeks, 4 months, 8 months,
12 months, 18 months, 2 years and 3.5 years.
The flexible service component allows additional needs of the child and family to
be met through a range of activities, including first-time parent groups, additional

consultations, telephone consultations and community strengthening activities.
Victorian Maternal and Child Health Service 9
1.2.2 Enhanced Maternal and Child Health Service
The Enhanced Maternal and Child Health Service focuses on children, mothers
and families at risk of poor health and wellbeing outcomes, in particular where
multiple risk factors for poor outcomes are present. The Enhanced Maternal and
Child Health Service is provided in addition to the suite of services offered through
the Universal Maternal and Child Health Service. The Enhanced Maternal and Child
Health Service provides a more intensive level of support, including short-term
case management in some circumstances. Support may be provided in a variety of
settings, including the family home, the maternal and child health centre, or other
locations within the community.
1.2.3 Maternal and Child Health Line
The Maternal and Child Health Line is a 24-hour telephone line providing
appropriate information, advice, support, counselling and referral to families with
children from birth to school age. The Line also links families to the Universal
Maternal and Child Health Service and other community, health and support
services required for optimal health and wellbeing of the child, mother and family.
The Line does not provide an emergency service.
Victorian Maternal and Child Health Service10
2.1 An evidence-based framework
The Maternal and Child Health Program Standards provide an evidence-based
framework for the consistent, safe and quality delivery of the Maternal and Child
Health Service. The Program Standards support the provision of clinical and
corporate governance within the Service, and provide a systematic approach to
improving service delivery and safety.
The key elements supported by the Program Standards being:
•
accountability
•

continuous improvement
•
workforce competence
•
performance development
•
clinical effectiveness
•
evidence-based practice
•
risk management
•
child and family safety
•
service delivery
•
performance review
•
dealing with complaints
•
safety of the workforce
•
data and information management
•
leadership and governance
•
community engagement.
3
2 Background
Victorian Maternal and Child Health Service 11

2.2 Structure of the Program Standards
There are six Maternal and Child Health Program Standards. Each Standard has
four components:
1. Statement of rationale – outlines why the Standard has been included.
2. Criteria – each criterion contains a number of elements outlining how the Service
demonstrates compliance with, and performance relevant to, the standard.
3. Performance criteria – strategies, procedures and processes that need to be
in place to meet the criteria.
4. Examples of evidence – examples of how the criteria may be met.
The six standards are not mutually exclusive. Elements of each standard and
the underlying criteria within the standards are closely linked, as demonstrated
in Figure 1.
Figure 1: Relationship between the Maternal and Child Health Program Standards.
Standard Three Standard Four
Standard One
Standard Five
Standard Two
Standard Six
Victorian Maternal and Child Health Service12
2.3 Purpose and use of the Program
Standards
The purpose of the Program Standards is to guide and support the Maternal and
Child Health Service in service delivery. The Program Standards are applicable to,
and recommended for use by the maternal and child health workforce and support
structures for service provision, including local government or the governing
authority and the Department of Education and Early Childhood Development
(DEECD). The evidence for the criteria are examples only, and not mandatory. The
examples provide guidance on appropriate evidence to support attainment of the
criteria. The list of evidence is not exhaustive, and users of the Program Standards
are encouraged to explore other ways of providing evidence to demonstrate

compliance with the Program Standards (in addition to the listed evidence
provided). Examples of good practice, and resources and tools to assist with
implementation of the Program Standards are located in Appendix B.
Note: Due to the operational environment and scope of services provided by
the Maternal and Child Health Line, certain performance criteria or achievement
of performance criteria are not applicable. Where this is the case, an asterisk
(*) has been placed next to the relevant performance criteria or achievement of
performance criteria. When the asterisk (*) appears under a criterion element, all
listed performance criteria are deemed not applicable to the Maternal and Child
Health Line.
2.4 Assessment against the Program
Standards
As described , the Program Standards are designed to support and promote
evidence-based practice or best practice within the Maternal and Child Health
Service. The Program Standards have been developed to encourage and support
the Service to maintain and improve service quality, standardise service delivery
and support measurement to provide feedback on service delivery and service
improvement activities. The Service is encouraged to use the Program Standards
to self-assess in order to improve service quality, and to incorporate review of the
Program Standards as part of routine service review.
Victorian Maternal and Child Health Service 13
1. The Maternal and Child Health Service provides universal access to its services
for Victorian children from birth to school age and their families.
2. The Maternal and Child Health Service promotes optimal health and
development outcomes for children from birth to school age through a focus
on the child, mother and family.
3. The Maternal and Child Health Service builds partnerships with families
and communities and collaborates and integrates with other services and
organisations.
4. The Maternal and Child Health Service is delivered by a competent and

professional workforce.
5. The Maternal and Child Health Service, supported by local government or the
governing authority, provides a responsive and accountable service for the child,
mother and family through effective governance and management.
6. The Maternal and Child Health Service delivers a quality and safe service.
Rationale
The early years of a child’s life provide a critical opportunity to give a child the best
start in life, in order to achieve optimal health, development and wellbeing. There are
a large number of risk factors associated with these years that have negative impacts
on the child’s health, developmental, learning and social outcomes. Conversely,
there are a large number of protective factors in early childhood that are associated
with prevention of adverse events for the child’s health, developmental, learning and
social wellbeing.
13
Evidence suggests that action taken to reduce risk, and to develop
protective factors, provides the foundation for cognitive, coping and emotional skills
that positively affect learning, behaviour and health throughout life.
14
Through the delivery of a universal Maternal and Child Health Service for children in
Victoria, the Service plays a unique and integral part in reducing the risk factors and
increasing the protective factors for adverse outcomes for children. In order to do this,
the Service must provide a flexible service that responds to the needs of all young
children and their families. In addition to providing a universal service, the Service
focuses on approaches to include families not engaged by the Service and those with
the greatest burden of morbidity and risk. The Service actively seeks to identify and
respond to children at risk of poor outcomes, and engage all families regardless of
their cultural and linguistic background.
15
3 The Maternal and Child Health
Service Program Standards

Standard 1:
Universal access
The Maternal and Child Health Service
provides universal access to its services
for Victorian children from birth to
school age, their mothers and families.
Victorian Maternal and Child Health Service14
Criteria for Standard 1
1. Universal access and participation
2. Responsive service delivery
3. Culturally competent service delivery
1. Universal access and participation
a) All Victorian children and families have access to, and are encouraged to engage
with, the Maternal and Child Health Service from the birth of the child until the
child commences school.
b) Service information supports families accessing the Maternal and Child
Health Service.
2. Responsive service delivery
a) The Maternal and Child Health Service is relevant and responsive to the needs
of the child and family in service delivery and setting.
b) The vulnerable child, mother and family are identified and supported to
engage with appropriate services, including the Enhanced Maternal and
Child Health Service.
c) The Maternal and Child Health Service identifies and responds to the child at
risk of, or experiencing, neglect or abuse.
3. Culturally competent service delivery
The Maternal and Child Health Service provides a culturally competent service to
the child and family, including a service appropriate for Aboriginal and Torres Strait
Islander communities.
Victorian Maternal and Child Health Service 15

Standard 1 – The Maternal and Child Health Service provides universal access to its services for Victorian children from
birth to school age, their mothers and families
Criteria element Performance criteria Examples of evidence
1. Universal access and participation
a) All Victorian
children and
families have
access to, and are
encouraged to,
engage with, the
Maternal and Child
Health Service from
the birth of the
child until the child
commences school.
• Victorian children and families have access to:
– the Universal Maternal and Child Health Service,
including the Key Ages and Stages consultations and
the flexible component of the Universal Maternal and
Child Health Service
– Maternal and Child Health Line if required
– Enhanced Maternal and Child Health Service.
• All Birth Notications to the Maternal and Child Health Service
are responded to and families are provided with the opportunity
to engage with the Service.
• The Maternal and Child Health Service provides a welcoming
environment to families to encourage engagement with
the Service.
• The Maternal and Child Health Service promotes regular contact
between the Service and the child and family through the

recommended schedule of contact in the Key Ages and Stages
Framework. The recommended schedule of contact is at*:
– following receipt of the Birth Notication (home visit)
– two weeks
– four weeks
– eight weeks
– four months
– eight months
– twelve months
– eighteen months
– two years
– three-and-a-half years.
• The Maternal and Child Health Service acknowledges the right of
the family to choose not to access the Service.
• Maternal and Child Health
Service participation rates
• survey of families
attending
• processes for contacting
families who do not
engage with the Service
Victorian Maternal and Child Health Service16
Standard 1 – The Maternal and Child Health Service provides universal access to its services for Victorian children from
birth to school age, their mothers and families
Criteria element Performance criteria Examples of evidence
b) Service information
supports families
accessing the
Maternal and Child
Health Service.

• Information on the Maternal and Child Health Service is
available on the DEECD website.
• Information on the Maternal and Child Health Service is
available on the local government website /or the governing
authority website.
• Written information on the Maternal and Child Health Service is
available. The Maternal and Child Health Service has information
available when the Service is telephoned out of hours, which
includes*:
– identification of Maternal and Child Health Service
– hours of operation
– where to access emergency care for the unwell child
– telephone number to access the Maternal and Child
Health Line.
• information on website
• website information
available in multiple
languages
• number of website hits
• posters containing
Maternal and Child Health
Service information
• out-of-hours telephone
message contains hours
of operation, access for
emergency care, and the
MCH Line number
• annual report of the
Maternal and Child Health
Line

Victorian Maternal and Child Health Service 17
Standard 1 – The Maternal and Child Health Service provides universal access to its services for Victorian children from
birth to school age, their mothers and families
Criteria element Performance criteria Examples of evidence
2. Responsive service delivery
a) The Maternal
and Child Health
Service is relevant
and responsive to
the needs of the
child and family in
service delivery and
setting.
• The Maternal and Child Health Service has a exible approach
to meet individual needs of the child and family. This approach
may be through:
– the Universal Maternal and Child Health Service
– Maternal and Child Health Line, or
– Enhanced Maternal and Child Health Service.
• The Maternal and Child Health Service schedules, supports
and promotes availability of services outside traditional
working hours.
• The hours of operation for each service reects the needs of its
community and, where appropriate, includes service delivery
outside of traditional working hours or on weekends.
• A range of settings and models for service delivery are offered to
meet the needs of the child and family.* Examples include, but
are not limited to:
– clinic setting via appointment
– ‘drop in’ services

– within the home of the child, the mother or family
– early childhood services
– family support organisations
– play groups
– telephone.*
• Service delivery is outlined in relevant policies and procedures
and in the Program Resource Guide. web.
vic.gov.au/edulibrary/public/earlychildhood/mch/
guideproviderresource.pdf
• survey of families utilising
service to provide service
feedback
• number of enrolments
from birth notifications
• number of families
utilising the service
outside of traditional
working hours
• policies and procedures
that promote services
outside of traditional
working hours
Victorian Maternal and Child Health Service18
Standard 1 – The Maternal and Child Health Service provides universal access to its services for Victorian children from
birth to school age, their mothers and families
Criteria element Performance criteria Examples of evidence
b) The vulnerable
child, mother and
family are identified
and supported

to engage with
appropriate
services, including
the Enhanced
Maternal and Child
Health Service.
• The Maternal and Child Health Service schedules and promotes
additional support for the vulnerable child, mother and family
through the Enhanced Maternal and Child Health Service (see
Standard 1 Criterion 2b).
• The Maternal and Child Health Service has processes to identify
the vulnerable child, mother and family.
• The Maternal and Child Health Service identies and removes
barriers for access to services by the vulnerable child, mother
and family.
• Service delivery provides opportunities for engagement with the
vulnerable child, mother and family.
• The Maternal and Child Health Service provides, or can refer to,
appropriate services to meet the needs of the vulnerable child,
mother and family.
• number of families
receiving the Enhanced
Maternal and Child Health
Service
• policy/process of
identification; associated
service delivery/referral;
and engagement of
vulnerable children,
mothers and families

• record of identifying
barriers to access and
service response
• number of referrals to
Enhanced Maternal and
Child Health Service and
other services
c) The Maternal
and Child Health
Service identifies
and responds to
the child at risk of,
or experiencing,
neglect and abuse.
• The Maternal and Child Health Service identies the child at risk
of, or experiencing, neglect and abuse and acts on professional
observation and judgement.
• The Maternal and Child Health Service responds to the child
at risk of, or experiencing, abuse and makes notification in
accordance with the Children, Youth and Families Act 2005.
16

• The maternal and child health workforce is supported in forming
the belief about, and responding to, child neglect and abuse by
policies, procedures and training (see Standard 4 Criterion 1c).
• number of notications
made to Child Protection
• evidence of knowledge
of staff
• evidence of training

Victorian Maternal and Child Health Service 19
Standard 1 – The Maternal and Child Health Service provides universal access to its services for Victorian children from
birth to school age, their mothers and families
Criteria element Performance criteria Examples of evidence
3. Culturally competent service delivery
The Maternal and
Child Health Service
provides a culturally
competent service
to the child and
family including a
service appropriate
to Aboriginal and
Torres Strait Islander
communities.
• The Maternal and Child Health Service considers the needs of
individual families and recognises cultural diversity within its
service delivery.
• The Maternal and Child Health Service recognises Aboriginals
and Torres Strait Islanders as the traditional owners of the land
and provides a service respecting their culture.
• The workforce employed at the Maternal and Child Health Service
reflects, where practicable, the cultural diversity of the local
community.
• The maternal and child health workforce is provided with training
in cultural competency, with a focus on training in the cultural
needs of the local community.
• The maternal and child health workforce feels condent in its
knowledge and skills to provide the Service to the child, mother
and family from other cultures.

• The maternal and child health workforce utilises its knowledge
and skills to ensure the child, mother and family feel welcome to
access the Service.
• The maternal and child health workforce understands the
individual interpretation of their own culture for each child,
mother and family accessing the Service.
• The Maternal and Child Health Service ensures access to
interpreters for mothers and families from non-English speaking
backgrounds.
• Materials are developed to provide information in appropriate
languages and for mothers and families who have low literacy
in English and languages other than English.
• models of culturally
competent services
provided
• survey/feedback from
families
• literature and other
information in appropriate
languages
• training undertaken by
maternal and child health
workforce
Victorian Maternal and Child Health Service20
Rationale
The early years of life are critical, and influence learning, health and behaviour
throughout life. Through the use of targeted interventions in the early years, the
Maternal and Child Health Service has the opportunity to influence the health,
wellbeing, learning, development and safety of the child, that in turn will influence
their learning, health and behaviour throughout life.

17
The Service promotes optimal health and development outcomes for children through
targeted service delivery;
18
a flexible approach to meet the needs of the child, mother
and family; professional judgement, and the use of validated tools and evidence-
based interventions. The Service uses promotion of health and development to reduce
health risks, and to increase the capacity of the mother and family, empowering them
to make decisions in order to improve the health, wellbeing, learning, development
and safety of the child.
14, 17, 19
The health and wellbeing of the mother is a key element in influencing the health,
wellbeing, development and safety of the child,
20
and is a core component of the
Maternal and Child Health Service. The unique role of the father is also recognised
in the health and development of the child
21, 22
and the Service supports the father
in his role. In order to optimise outcomes, support and intervention provided by the
Maternal and Child Health Service acknowledges and recognises the determinants
of health
4, 5
for each child, mother and family.
Criteria for Standard 2
1. Health and wellbeing of the child
2. Health and wellbeing of the mother
3. Role of the father
4. Role of the family
5. Service delivery based on evidence

1. Health and wellbeing of the child
a) The Maternal and Child Health Service utilises monitoring, intervention and
promotion of health and development to optimise the child’s health, wellbeing,
learning, development and safety.
b) The Maternal and Child Health Service optimises the child’s health, wellbeing,
learning, development and safety by recognising and acknowledging the
determinants of health.
Standard 2:
Optimal health and
development
The Maternal and Child Health
Service promotes optimal health and
development outcomes for children
from birth to school age through a focus
on the child, mother and family.
Victorian Maternal and Child Health Service 21
c) The Maternal and Child Health Service utilises validated tools and assessments
to optimise the child’s health, wellbeing, learning, development and safety.
d) The Maternal and Child Health Service provides the family with information for
the promotion of health and development of the child.
2. Health and wellbeing of the mother
The Maternal and Child Health Service utilises monitoring, support and intervention
to improve the health and wellbeing of the mother.
3. Role of the father
The Maternal and Child Health Service recognises the unique role of the father in
the health and development of the child and supports him in this role.
4. Role of the family
The Maternal and Child Health Service recognises and promotes the role of the
family in the health and development of the child.
5. Service delivery based on evidence

a) The Maternal and Child Health Service delivers evidence-based and/or best
practice monitoring, intervention and promotion of health and development.
b) The Maternal and Child Health Service promotes evidence-based service delivery
through the participation in and support of research.
Victorian Maternal and Child Health Service22
Standard 2 – The Maternal and Child Health Service promotes optimal health and development outcomes for children from
birth to school age through a focus on the child, mother and family.
Criteria element Performance criteria Examples of evidence
1. Health and wellbeing of the child
a) The Maternal and
Child Health Service
utilises monitoring,
intervention and
promotion of health
and development
to optimise the
child’s health,
wellbeing, learning,
development and
safety.
• The Maternal and Child Health Service utilises the Key Ages and
Stages Framework to optimise the child’s health, wellbeing,
learning, development and safety.
• The Key Ages and Stages Framework consists of three
components, monitoring, evidence-based interventions and
promotion of health and development.
• Professional observation and judgment are utilised and the
mother’s and family’s concerns acted upon.
• Monitoring of the child is inclusive of:
• Family health and wellbeing

– physical assessments, including weight, height, head
circumference, hips and gait
– developmental assessment, including eliciting of parental
concerns , regarding the child’s global/cognitive, social-
emotional, behavioural, motor and language skills
– hearing risk factors
– vision
– oral health.
• Evidence-based interventions to improve outcomes for children:
– smoking cessation
– optimal parental mental health
– free from child exposure to conflict or family violence
– teeth cleaning
– promotion of a healthy weight
– promotion of a healthy BMI.
• Promotion of health and development is targeted at priorities
identified by the Maternal and Child Health Service promotion
of health and development, that may include:
– safe sleeping arrangements – immunisation
– oral health – vision
– nutrition – literacy
– kindergarten enrolment
– child safety and injury prevention
– other health promotion relevant to the community
(see Standard 1 Criterion 2).
• The Maternal and Child Health Service monitors the
immunisation status of the child, and promotes adherence
to the recommended immunisation schedule.
24
• evidence of Key Ages

and Stages activities
undertaken
• Key Ages and Stages
consultations targets
are met
• headline indicators
23
,
including the proportion of
infants exclusively breast
fed at four months of age
• adherence to Maternal
and Child Health Practice
Guidelines
• referrals to other agencies
and services
Victorian Maternal and Child Health Service 23
Standard 2 – The Maternal and Child Health Service promotes optimal health and development outcomes for children from
birth to school age through a focus on the child, mother and family.
Criteria element Performance criteria Examples of evidence
b) The Maternal
and Child Health
Service optimises
the child’s health,
wellbeing, learning,
development
and safety by
recognising and
acknowledging the
determinants of

health.
• The Maternal and Child Health Service recognises and
acknowledges the determinants of health to:
– identify factors that may affect the health and wellbeing
of the child
– target service delivery
– provide social support and appropriate referrals in
consultation with the mother and family (see Standard 3
Criterion 2 and Standard 1 Criterion 2).
• key performance indicators
– count of reasons for
counselling
c) The Maternal
and Child Health
Service utilises
validated tools
and assessments
to optimise the
child’s health,
wellbeing, learning,
development and
safety.
• The Maternal and Child Health Service utilises validated tools
and assessments to monitor the child’s health and wellbeing,
including but not limited to:
– Parents’ Evaluation of Development Status (PEDS)
– Brigance (secondary screening)
– physical assessment
– hearing risk factor assessment
– Melbourne Initial Screening Test

– oral health assessment.
• Appropriate referrals to support the child’s growth and
development are made in consultation with the mother and
family (see Standard 3 Criterion 2).
• key performance indicators
– number of PEDS/
Brigance undertaken
• key performance indicators
– count of number
of Melbourne Initial
Screening Tests completed
• maternal and child health
workforce competence in
undertaken assessments
• number of referrals made
Victorian Maternal and Child Health Service24
Standard 2 – The Maternal and Child Health Service promotes optimal health and development outcomes for children from
birth to school age through a focus on the child, mother and family.
Criteria element Performance criteria Examples of evidence
d) The Maternal and
Child Health Service
provides the family
with information
for the promotion
of health and
development of the
child.
• The Maternal and Child Health Service provides information
in accordance with the Key Ages and Stages Framework.
• Professional observation and judgment are utilised when

providing the mother and family with information for the
promotion of health and development of the child.
• Anticipatory guidance may be provided based on the needs
of the child and family and may include information on:
– attachment and parenting
– recognising serious illness in the child
– play activities
– child development and/or behaviour
– toilet training
– sibling rivalry
– nutrition
– literacy.
• Information and support provided to families are:
– based on evidence and/or best practice (see Standard 2
Criterion 3)
– appropriate and tailored to each mother and family to
maximise their understanding
– provided in a culturally appropriate manner (see Standard 1
Criterion 3)
– see Standard 1 Criterion 2).
• Written information and resources prepared by the Maternal and
Child Health Service are:
– clearly identified as a resource of the Maternal and Child
Health Service
– contains links to websites
– reviewed annually by the Maternal and Child Health Service.
• Written information not prepared by the Maternal and Child
Health Service is provided from recognised organisations or
associations that are clearly identified, and are appropriate for,
the child, their mother or family.

• In consultation with the mother and family, the Maternal and
Child Health Service refers the mother and family to appropriate
services if additional support is required
(see Standard 3 Criterion 2).
• information available on
relevant topics
• information available is
culturally appropriate
• number of referrals for the
mother and family
• review of information
annually
• evidence of information
provision within health
records
Victorian Maternal and Child Health Service 25
Standard 2 – The Maternal and Child Health Service promotes optimal health and development outcomes for children from
birth to school age through a focus on the child, mother and family.
Criteria element Performance criteria Examples of evidence
2. Health and wellbeing of the mother
The Maternal
and Child Health
Service utilises
monitoring, support
and information to
improve the health
and wellbeing of the
mother.
• Maternal health and wellbeing are monitored at each
contact with the Maternal and Child Health Service, and

physical and emotional health issues for the mother are
addressed. This may include:
– breastfeeding
– incontinence
– post-natal depression
– recovery following childbirth
– adjustment to becoming a mother
– family planning
– partnership relationship
– management of tiredness and fatigue
– other women’s health issues.
• The health and wellbeing of the mother are reviewed in relation
to the child’s health and wellbeing
• Professional observation and judgment are utilised when
monitoring and assessing maternal health and wellbeing.
• Appropriate referrals to support the mother’s health and
wellbeing are made in consultation with the mother
(see Standard 3 Criterion 2).
• The Maternal and Child Health Service promotes and supports
groups to bring mothers together for support and to promote
social networks (see Standard 3 Criterion 3).
• key performance indicators
– breastfeeding rates
• key performance indicators
– count of reasons for
referrals
• audit of referrals
• adherence to Maternal
and Child Health Program
Resource Guide

• four week maternal
wellbeing check
• knowledge of groups
within local community
• provision and support
of groups within local
community