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Implementing Maternal Early Childhood Sustained Home-Visiting Program (MECSH)

Meets DHHS criteria for an evidenced based model

Prerequisites for Implementation

Last Updated

May 2014


Type of Implementing Agency

MECSH is implemented by the local primary health care service.


Staffing Requirements

The MECSH program employs a team of nurses, a nurse coordinator, and a social worker, as well as supervisors, managers, and administrative staff. The program is supported by health and child welfare professionals, including perinatal psychiatrists, dieticians, and drug and alcohol counselors.


Staff Education and Experience

Home visits are provided by registered nurses with a bachelor's degree (or equivalent) and postgraduate training and experience in child and family health nursing (or equivalent). Nurses are expected to practice at an advanced level of nursing. Supervisors should be formally trained and skilled in reflective clinical practice, a process of contemplating experiences while they are happening and retrospectively. Health and child welfare professionals who support the program must be trained to meet their profession’s local registration requirements. 


Supervision Requirements

The developer recommends individual and team supervision to support reflection on clinical practices that the nurses deliver in the home. Clinical supervisors should oversee the home visitors and managers should provide supervision related to program management. Individual supervision sessions should occur at least monthly, with more frequent sessions for staff new to the MECSH program. Team supervision should occur monthly.

No information is available about the ratio of supervisors to home visitors.


Staff Ratio Requirements

Full-time nurse home visitors manage a caseload of up to 30 families per year. Part-time home visitors and those with a higher proportion of families with very complex needs or families in rural areas that require additional travel time have smaller caseloads. Caseloads should include a mix of families at varying program stages. The developer suggests 6 antenatal families, 6 families with children 0 to 6 months old, 6 families with children 6 to 12 months old, and 12 families with children older than 1 year.


Data Systems/Technology Requirements

MECSH requires a data system to record key fidelity measures, including client eligibility, recruitment, retention, program delivery and client impact. The data system should be established within the administrative data systems of the primary health care service agency implementing the program.



The information contained on this page was last updated in May 2014. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by Dr. Lynn Kemp at the University of New South Wales on May 11, 2014. HomVEE reserves the right to edit the profile for clarity and consistency.