MECSH is implemented by the local primary health care service.
Implementing Maternal Early Childhood Sustained Home-Visiting Program (MECSH)
Last updated: April 2018
Prerequisites for Implementation
The MECSH model is implemented by a team of nurses, a nurse coordinator, and a social worker, as well as supervisors, managers, and administrative staff. A program site must be 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). 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 site must be trained to meet their profession’s local registration 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 model. Team supervision should occur monthly.
The ratio of supervisors to home visitors is based on the home visitor team structure and supervisor arrangements for each site.
Staff Ratio Requirements
Full-time nurse home visitors manage a caseload of up to 30 families. 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, model delivery, and client impact. The data system should be established within the administrative data systems of the primary health care service agency implementing the model.
The information contained on this page was last updated in April 2018. 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 Western Sydney University on January 8, 2018. HomVEE reserves the right to edit the profile for clarity and consistency.