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First 1000 Days Australia:
NACCHO AGM
Professor Kerry Arabena
@ArabenaKerry @First1000DaysOz
Overview of Presentation
• From the Global to the Local
• Engaging Cultural Protective Factors
• The Australian First 1000 Days Model
• Implementation – Queensland and Victoria (so far)
• International Indigenous First 1000 Days Movement
• Role of the Indigenous Health Equity Unit, The University of Melbourne
From the Global to the Local
• International First 1000 Days Movement established to support maternal and infant nutrition outcomes from a child’s conception through to their second birthday.
• Malnutrition well recognised as causing irreversible damage to a child’s neurological, immune and physical development.
• Supports the UN Sustainable Development Goals.• Taken a broader, holistic view to establish First 1000 Days
Australia – led by Aboriginal and Torres Strait Islander people.
Every mother and father have a story about the beginning of their child’s life…
• First 1000 Days is a period of enormous potential, but also of vulnerability.
• Early interventions are not always available or accessible, particularly for those experiencing vulnerability.
• Some of our children are subject to poorer health and cognitive development to those born to empowered and resilient families with lifelong and wellbeing implications that impact at individual, family, community and societal levels.
Aboriginal and Torres Strait Islander people intrinsically value children, however…
• More of our young children need protection and representation from strong advocates
• A nutritional intervention is not enough – led to a broader articulation of First 1000 Days
• Necessarily involves community leaders, family members, practitioners, policy makers, systems innovators, thought leaders and researchers.
• We need to challenge the status quo – our ‘normal’ is not working anymore.
• A People’s movement and a Nation Building exercise.
• Genesis point – Aboriginal and Torres Strait Islander people.
Culture is THE protective factor for families
We are not born into a society, we are born into an ecosystem. Participating in modernity = Biocide.
“Carried in the wombs of our mothers, born in the wombs of our fathers..”
We are precious, and extraordinary, and powerful and smart and capable beyond words.
Families need to formulate the ways in which health equity is achieved. Not services. Not multinationals.
The Redfern Statement
• We stand here as Aboriginal and Torres Strait Islander peak representative organisations with a deep concern: – that in 2016 First Peoples continue to experience unacceptable
disadvantage; – that the challenges confronting Aboriginal and Torres Strait
Islander people continue to be isolated to the margins of the national debate;
– that Federal Government policies continue to be made for and to, rather than with, Aboriginal and Torres Strait Islander people; and
– that the transformative opportunities for Government action are yet to be grasped.
• Stand with us to let this statement and call for Government action be heard and acted upon by our nation’s leaders.
Redfern Statement: Early Childhood
5. Invest in the First 1000 Days
Provide adequate investment for the launch of the Australian model of the First 1000 Days, an Indigenous-led, holistic initiative which seeks to provide coordinated, comprehensive intervention to address the needs of Aboriginal and Torres Strait Islander children and their families from (pre-) conception to two years of age.
Impetus for First 1000 Days focus
• Chair of NATSIDAG: Importance of Brain growth and development for healthy ageing. ‘…Pregnancy is the new public health intervention for healthy ageing...’
• Understanding policy drivers and decisions made by at-risk populations: S&RH, Adolescents.
• Chairing NATSIHEC – FASD, Abecedarian project.
• Expanding view of an international nutritional intervention for Australian contexts.
• Increase in young women represented in prison populations.
• Invisibility of Aboriginal and Torres Strait Islander men and fathers in policy, interventions, and science.
Protecting Australia’s Children: The First 1000 Days
Catalysing Environment: BMJ Article
• Understanding adolescents are implementers of equity gain in families in the next decade. They need skills to take responsibility.
• Family violence is the main reason for out of home care. Support for identification of disability related violence, gender roles and healthy relationships is required.
• Young people will be thrust into parenthood without knowledge, skills or support.
• New approach needed in health: sexual health, reproductive planning, empowerment, reduction of violence and personal development.
• Need a nested approach (child, family, community) to education and social and emotional well-being.
• Need to draw sectors together – whole of government, whole of community approach.
Protecting Australia’s Children: The First 1000 Days
Sir Michael Marmot: Commenting on Social Standing
and Life Expectancy for Australia’s First Peoples
“Changing the marginal position in society of Aboriginal and Torres Strait Islanders people will need an approach that takes in the whole of life, starting with women of child bearing age, focusing on the care of infants and young children and proceeding through the life course…”
Marmot, M., Status Syndrome - How your social standing directly affects your health and life expectancy, Bloomsbury, London &Henry Holt, New York, 2004.
Protecting Australia’s Children: The First 1000 Days
Additions to Michael Marmot’s Comments:
“Changing the marginal position of Aboriginal and Torres Strait Islander peoples is not only the job of Aboriginal and Torres Strait Islander peoples but for all Australians. We need same opportunity without being made the same. We will need an approach that strengthens culture and takes in the whole of life, starting with women of child bearing age and their partners, extended family, and communities, focusing on infants and young children and proceeding through the life course.…”
Protecting Australia’s Children: The First 1000 Days
Developing First 1000 Days Australia
Over 380 people from more than 100 organisations involved in the design of First 1000 Days.
Linked families, Elders, representative organisations, scientific researchers, geriatric workers, early life educators, front line
workers, policy makers, health economists and NGO sector – revealed consensus for F1000D and need to develop
appropriate, relevant model.
First 1000 Days Australia development
The Australian Model for the First 1000 Days
Family remains the primary and preferred site for developing and protecting culture and identity in Aboriginal and Torres Strait Islander children
The First 1000 Days Australia
First 1000 Days Australia uses this period of time from (pre) conception to age two as a time to:
• Build Resilience
– Support families, organisations and commuities to better prepare for, respond to and transform from disruption in Australia and elsewhere in the world.
• Learn and Innovate
– Generate important new knowledge that addresses some of the most complex issues facing our families, and catalyse innovation through cross-cultural and interdisciplinary exchange
First 1000 Days Australia uses this period of time from (pre) conception to age two as a time to:
• Lead Regional Initiatives– Foster high levels of commitment to and alignment
with the vision, values, resources and infrastructure to support family strengthening before and during the first 1000 days
• Generate and use Evidence for Impact– Produce robust, applicable research evidence about
what works (and what doesn’t), promote the implementation of high impact and cost effective programs and enable the capacity to influence the adoption and scale of such initatives.
Goals of First 1000 Days Work
Protecting Australia’s Children: The First 1000 Days
To provide support to families to better support their children from (pre) conception to two years of age, thereby laying the foundation for their future health and wellbeing.
To use this period of time to radically transform (disrupt) the (Indigenous) service system and support responsible parenthood.
To create a national and international movement of Indigenous conceived of and led early life initiatives that focus on nations building, empowerment and scholarship.
An Indigenous perspective of the First
1000 Days
First 1000 Days Nurturing Care Packages:
1. Capacity building within families, using a strengths-based Indigenous approach
to best parenting, to raise culturally knowing and motivated children
2. Whole-of-family mentoring and healing programs to end family violence
3. Family-based entrepreneurial solutions to welfare dependence, e.g., accessing
micro-business solutions, establishing family-based and local enterprises
4. Early literacy programs using Abecedarian approaches
5. Early nutritional programs for babies and families
6. Preconception family planning (delaying first child by 1 year, long-term
contraception), sex education and health checks
7. The role of fathers and extended family in ensuring the health and wellbeing of
children in the First 1000 Days
8. Improved access to Comprehensive Early-Life Care using a Life-Coaching
approach centred around family empowerment programs
9. A whole-of-service approach
10. A national network of First 1000 Days Australia practitioners
Governance Arrangements
• Memorandums of Understanding and Agreements to engage partners.
• A staged capacity building and implementation program will refocus and realign the current work of early years services while building workforce capacity
• Fostering local, regional and family governance and data generation to support and strengthen our children and their families.
Regional Alliance Sites (RAS)
1. Organisational Advocate
Lead Agency of Regional Alliance Site (RAS):
• Long term commitment RAS
• Manage “Community Capacity Profile and Needs Assessment”
• Facilitate workshops
• Manage relationships with individual organisational advocates/sites
• Coordinate and access relevant data
• Commit resources for engagement (>$20k)
• PD of staff(s) to include UoM engagement
• Support breadth of interventions developed
• Local governance
• Ensure all organisations have RAP
• Ensure Aboriginal and Torres Strait Islander workforce
• Sign Memorandum of Understanding
2. Champion
• Committed to family centred approach delivering interventions during the F1000D:ACCOs; Child protection; Early learning; Education and training; Justice; Legal services; Health; Hospitals; & Local government
• Committed to family-led decision making
• Regional governance in place
• F1000D Workforce
• Commit ‘core’ funds
• Master’s &/or PhD student project(s)
• Peer reviewed publications
3. Alliance Site
• Capacity Profile and Needs Assessment
• Collaborate on Analysis
• Ethics application & publication of papers
• Implement proof of concept
• Recruiting longitudinal pilot study project
• First and primary feature: identification, development and implementation of strategies that focus on health and wellbeing from (pre) conception to age 2, using comprehensive PHC and a life-coaching approach.
• Multigenerational families – family strengthening, country and kin, developing therapeutic cultural supports, undertaking a multigenerational family study supporting entreprenurial activities.
Holistic Strategies for the life course:
• Comprehensive early life services: starting with health, but involving other services and community supports for early life education, householder aspirations and planning, life coaching and mentoring approaches.
• Mixed methods quantitative and qualitative research methodologies to explore scientific themes around family environment, transitions to parenthood and service use and provision to generate evidence to improve policy, practice, family empowerment, business and whole of government services.
Collection must have potential to contribute to health and wellbeing:
– Contribute to the Centre for Indigenous Genomics.
– Assist families document internal, external, social and cultural multi generational narratives.
Possibility of Understanding Impact of:– Microbiome and gastro intestinal conditions and diabetes.
– Environmental toxins including impact of experience of racism
– Infectious diseases
– Chronic inflammation
– Maternal depression on health and wellbeing
– Housing related stress
First 1000 Days Biomedical Roundtable - 21 April 2016
UoM; WEHI; Monash; La Trobe; MCRI; MH
Indigenous Health Equity Unit Collective Impact Facilitators:
Protecting Australia’s Children: The First 1000 Days
Partner Effectively with othersEnsure Effective Governance Academic Convenors: Discuss issues of common concern, facilitate discussions, champion cause, advocacy, coordination. Create scientific evidence to support parents who experience vulnerabilityDesign, implement and evaluate pre conception, early childhood and parental support interventions Implement knowledge exchangeEvaluate new initiatives and service innovations. Facilitate Multigenerational Family Environment Studies (inclusive of fathers and grandparents with mothers and children)
In December 2015, the Australian Human Rights Commission’s Children’s Rights Report 2015 recommended that the Australian Government support the First 1000 Days program, stating that:
Recommendation 14: The Australian Government Department of Social Services support the work of Professor Arabena and the Indigenous Health Equity Unit at the University of Melbourne to progress the early intervention research agenda under the First 1000 Days initiative. (AHRC 2015)
What are we doing now?
• F1000D Council Inaugural Statement
• Mornington Peninsula– Service engagement– Socialising concept and uptake– Presentation at the Lowitja Institute Conference
• Preconception component of multigenerational study with Aboriginal Housing Victoria – Training householders as peer
researchers (TAFE, STC)– Door Knocking and Family Engagement– Ethics Application for HASP
• NHMRC Partnership Application to evaluate First 1000 Days implementation strategy
• Funding Discussion with Queensland Government, Parliamentarians and NGOs
• Scientific Committee– Protocol development
• Short Courses and Curriculum– Regional facilitation and University
based– Accredited training – specialist
certificate, graduate certificate, on-line courses, MPH degree First 1000 Days.
• Publications and Prospectus• Securing funding ($1 950 000)• Developing First 1000 Days
program with partners in Queensland
• Working with Lowitja Institute
2017 Caboolture Implementation strategy:
Activities:• Negotiate regional supports and partners
(agreements)• Short Course in February• Develop survey and train householders and
others to collect data: understand impact of investment (service and household levels)
• Understand aspirations (e.g support for culturally informed parenting, housing stock requirements, business opportunities)
• Design, evaluate and monitor implementation of the roadmap across this and other sites (collective impact)
• Preparation and trials for immediate feedback to communities, government and partners
• Case Study Symposium in October 2017 –preliminary lessons (Victoria and Queensland)
• Identification of First 1000 Days workforce and roll out of cultural programs based on household aspirations, infrastructure and service capacity
• IndigIdeas – business opportunities – link to business development council
We will first establish a baseline to measure impact of your investment, then provide technical support to identify collective impact of your work.
National Benchmark
• Rather than comparing Aboriginal and Torres Strait Islander families to non-Indigenous families, First 1000 Days has been identified as being applicable to, and a benchmark for all families in Australia experiencing vulnerability and disadvantage.
• Federal Opposition developing a position on First 1000 Days.
• NT Government – Special Committee on Early Childhood.
• NACCHO AGM speaker.• Dubbo – 200 people intend to
come to First 1000 Days training.• Family Matters – embedded in 3rd
National Framework.• AHV – Health and Housing
movement• Aboriginal Chamber of Commerce• NGOs and Charities interested in
our work.
NHMRC application Partnership Grant
• Partners:– Aboriginal Housing
Victoria
– QATSICPP
– Centre for Evaluation and Implementation
– Save the Children
– Allannah and Madeline Foundation
– Kinnaway Aboriginal Chamber of Commerce
– SNAICC
Over $900 000 in-kind and cash contribution.
Letters to me by the 22nd November to be included – cash and in kind needed.
Evaluating the implementation of this approach.
Project Proposal covers Queensland and Victoria.
DSS interested but not enough time to get into NHMRC grant – discussing funding separately.
Couldn’t include current QLD investment (media) – others welcome!
International Indigenous and Tribal Peoples First 1000 Days:Australia’s First Peoples, Indonesian Tribal People, Norwegian Sami.
Team, Members and Sponsors
Direct Team– Prof. Kerry Arabena
– Dr. Rebecca Ritte
– Dr. Georgina Sutherland
– Ms. Josie Atkinson
– Dr. Ken Winkel
Site TeamDeb Mellet (Mornington)
Darren Smith (AHV)
TBC (QLD Caboolture Site)
2016 FundersQueensland Government $1.5 million
Department of Social Services
$150 000
University of Melbourne
$200 000
Australia Indonesia Centre
$101 000
2017 Membership –individuals, organisationsubscriptions commence with short course
