Mch Service Program Standards

www.education.vic.gov.au/ecsmanagement/mch/policy/default.htm

Maternal and Child Health Service

Maternal and Child Health Service Program Standards

Maternal and Child H

ealth Service M

aternal 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 http://www.education.vic.gov.au

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.


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


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.


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.


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 principlesThe 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 VisionAll 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 MissionThe 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 GoalsThe 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


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 PrinciplesThe guiding principles for the Maternal and Child Health Service, as stated in the

Maternal and Child Health Service Program Resource Guide7 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.


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 ServiceThe 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 ServiceThe 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.


1.2.2 Enhanced Maternal and Child Health ServiceThe 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.


2.1 An evidence-based frameworkThe 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


2.2 Structure of the Program StandardsThere 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


2.3 Purpose and use of the Program StandardsThe 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 StandardsAs 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.


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.

RationaleThe 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 accessThe Maternal and Child Health Service

provides universal access to its services

for Victorian children from birth to

school age, their mothers and families.


Criteria for Standard 11. 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.


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.


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.


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 Notifications 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 Notification (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




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





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 flexible 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 reflects 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. http://www.eduweb.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




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 identifies 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 identifies 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 notifications made to Child Protection

• evidence of knowledge of staff

• evidence of training





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 confident 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


RationaleThe 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 child21, 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 health4, 5 for each child, mother and family.

Criteria for Standard 21. 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 developmentThe 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.


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.


The Maternal and Child Health Service utilises monitoring, support and intervention

to improve the health and wellbeing of the mother.


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.


The Maternal and Child Health Service recognises and promotes the role of the

family in the health and development of the child.


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.


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.


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 indicators23, 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




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




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





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





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.

• The Maternal and Child Health Service recognises the unique role the father plays in the child’s life and health and development.

• The father is provided with appropriate support in his parenting role by the Maternal and Child Health Service.

• Professional observation and judgment are utilised when supporting the father in their parenting role and in the provision of support.

• The Maternal and Child Health Service promotes and supports groups to bring fathers together for support and to foster social networks (see Standard 3 Criterion 3).

• survey to determine satisfaction of fathers with the Service


The Maternal and Child Health Service recognises and promotes the role of the family in the health and development of the child.

• The Maternal and Child Health Service promotes the role of the family in the health and development of the child.

• The health and wellbeing of the family, in the context of its relationship with the child’s health and wellbeing, is monitored at each contact made with the Maternal and Child Health Service.

• Appropriate referrals to support the health and wellbeing of the family are made in consultation with the family (see Standard 3 Criterion 2).

• The Maternal and Child Health Service promotes and supports groups to bring families together for support and to foster social networks (see Standard 3 Criterion 3).

• health record audit

• audit of referrals for the family

• knowledge of groups within local community

• provision and support of groups within local community





a) The Maternal and Child Health Service delivers evidence-based and/or best practice monitoring, intervention and promotion of health and development.

• The Maternal and Child Health Service implements service delivery in accordance with evidence and recommendations from relevant research.

• In the absence of evidence and/or recommendations from research, service delivery is in line with the acknowledged best practice within Maternal and Child Health.

• The maternal and child health workforce supports the implementation of best practice service delivery.

• evidence of service delivery updated in line with new evidence

• adherence to Key Ages and Stages Framework

• evidence of use of practice guidelines

b) The Maternal and Child Health Service promotes evidence-based service delivery, through the participation in and support of research.

• The Maternal and Child Health Service encourages and supports participation in research to facilitate the development of evidence for maternal and child health.

• Research undertaken in part, or in full, within the Maternal and Child Health Service has received relevant research approvals, including approval by the DEECD Early Childhood Research Committee.

• evidence of participation and contribution to research

• evidence of approval for research from the Early Childhood Research Committee


RationaleTo maximise the child’s health, wellbeing, learning, development and safety,

high levels of family involvement are required. A successful Maternal and Child

Health Service optimises the child’s health, wellbeing, learning, development and

safety, and the wellbeing of the mother and family by adopting a family-centred

approach. This approach involves the Service working in partnership with the child

and family and identifying the strengths of the family. The Service also works with

families to strengthen their capacity, in order to provide the child with a safe and

supportive environment.25

In order to meet the needs of the child the Service collaborates and works in

partnership with early years services, health services, family services, programs,

and organisations. These partnerships support effective linkages and referrals

between the Maternal and Child Health Service and other services, and enable

the provision of cohesive service delivery when more than one service is

involved with the child, mother and family. Working in partnership with other

organisations and services is particularly important when providing a service

for the vulnerable child.17, 26

Criteria for Standard 31. Working with the mother and family

2. Working with other services and organisations

3. Working with the community

1. Working with mothers and families

a) The Maternal and Child Health Service provides child-focused, family-centred

practice, working in partnership with the child and family.

b) The Maternal and Child Health Service provides child-focused, family-centred

practice to strengthen the capacity of families to make informed decisions about

the child’s development and the family’s health, safety and wellbeing.

Standard 3: Partnerships and collaborationThe Maternal and Child Health Service

builds partnerships with families and

communities and collaborates and

integrates with other services and

organisations.



a) The Maternal and Child Health Service facilitates linkages and referrals to

relevant community and professional services in order to meet the identified

needs of the child and family.

b) The Maternal and Child Health Service collaborates with relevant services to

promote and support integrated service delivery when the child and family are

accessing other services.*


The Maternal and Child Health Service works with its local community to strengthen

community capacity.*


Standard 3 – The Maternal and Child Health Service builds partnerships with families and communities and collaborates and integrates with other services and organisations


1. Working with the mother and family

a) The Maternal and Child Health Service provides child-focused, family-centred practice, working in partnership with the child and family.

• The Maternal and Child Health Service has policies and procedures outlining the child-focused, family-centred approach to service delivery.

• Support and training for the maternal and child health workforce facilitates working in partnership with the child, mother and family, in a strength based approach.

• The child, mother and family are included in identifying the approach to service delivery for their child.

• policies and procedures

• evidence of training for maternal and child health workforce

• survey of families

b) The Maternal and Child Health Service provides child-focused, family-centred practice to strengthen the capacity of families to make decisions about the child’s development and the family’s health, safety and wellbeing.

• The maternal and child health workforce works with the mother and family to increase their confidence and capacity to make decisions about the child’s growth and development and the family’s health, safety and wellbeing.

• The maternal and child health workforce considers the capacity of families to make decisions about the child’s development and the family’s health, safety and wellbeing.

• The Maternal and Child Health Service uses a range of strategies to support mothers and families to develop skills and abilities to make decisions about the child’s growth and development and the family’s health, safety and wellbeing.

• evidence of use of health promotion skills and review of change in behaviour






a) The Maternal and Child Health Service facilitates linkages.

• The Maternal and Child Health Service identifies relevant community resources, activities and services in their local community, and information on these resources is available for mothers and families.

• The Maternal and Child Health Service identifies relevant professional resources and services for the child and family to support their health, safety and wellbeing.

• The Maternal and Child Health Service has documented policies and procedures for referral processes.

• Referrals include at a minimum:

– child’s name, date of birth and contact details

– mother’s and other relevant family names,


– relevant health information

– any other information relevant for service delivery by the referred service be typed or written legibly on official paper. *

• community resources on noticeboards, local government or the governing authority website and other locations

• handouts, flyers in waiting area

• documentation availability of community resources for maternal and child health workforce

• range of referral to professional resources and services

• survey of services to whom Maternal and Child Health Service refers




b) The Maternal and Child Health Service collaborates with relevant services to promote and support integrated service delivery when the child and family are accessing other services.*

• The Maternal and Child Health Service collaborates with early years services, health services and local organisations/programs to provide integrated service delivery for the child and family.

• The Maternal and Child Health Service works in collaboration with other services to coordinate services for children with health and/or psycho-social vulnerabilities or risk factors.

• The Maternal and Child Health Service uses a multidisciplinary approach to support collaboration and service coordination.

• The Maternal and Child Health Service acts as an advocate for the child and family when collaborating and integrating with other services.

• Information about the Maternal and Child Health Service, including how to access the service, is provided to local community and professional services.

• The Maternal and Child Health Service is promoted by DEECD, Municipal Association of Victoria (MAV), the local government or the governing authority and other relevant bodies.

• Referrals from/to maternity services conform with the Continuity of Care Protocol.* 27, 28

• Maternal and Child Health Service information on DEECD website and local government or governing authority website

• audit of referrals from other services


The Maternal and Child Health Service works with its local community to strengthen community capacity.*

• The Maternal and Child Health Service strengthens community capacity through assisting the establishment of community programs specific to the health and wellbeing needs of the local community.

• The Maternal and Child Health Service strengthens community capacity and assists with the development of community networks through contributing to established community and volunteer programs.

• evidence of activities to strengthen community capacity

• establishment of liaison meetings and/or networks with community planning staff, and other relevant departments/groups


RationaleA competent and professional maternal and child health workforce is essential for

the optimal delivery of the Maternal and Child Health Service. In order to provide a

safe and quality service, the maternal and child health workforce is required to be

suitably qualified, with relevant knowledge and skills to undertake the position.

New and existing members of the maternal and child health workforce

are supported to learn, develop and strengthen the skills, knowledge and

understanding required to deliver the Maternal and Child Health Service.29

This process is supported by performance review, with the identification of

training and professional development needs.

The Maternal and Child Health Service, through the local government or governing

authority and DEECD, is supported by effective human resource management

and planning. The local government or governing authority complements and

supplements work undertaken by DEECD and other relevant authorities. This

includes the identification of the current and future needs of the workforce and the

Service, implementation of effective strategies to recruit and retain the workforce

and an understanding of the capacity within and requirements of the Maternal and

Child Health Service.30

Criteria for Standard 41. Workforce

2. Human resource management and planning

3. Performance development and continuing education

1. Workforce

a) The Maternal and Child Health Service employs a workforce qualified to meet

the objectives of the Maternal and Child Health Service.

b) The maternal and child health nurses maintain the requirements of

their registration.

c) The maternal and child health workforce has knowledge of, and complies with,

their legislative requirements.

d) The maternal and child health workforce has knowledge of, and complies with,

these Standards and the Maternal and Child Health Program Resource Guide for

their relevant Service.

Standard 4: Competent and professional workforceThe Maternal and Child Health Service

is delivered by a competent and

professional workforce.


2. Human resource management planning

a) Human resource management supports the delivery of the Maternal and Child

Health Service.

b) The recruitment processes for the Maternal and Child Health Service support a

competent and professional maternal and child health workforce.

c) Human resource planning identifies and responds to the current and future

Maternal and Child Health Service workforce’s needs for the Maternal and Child

Health Service.


a) The Maternal and Child Health Service supports performance development of

the maternal and child health workforce.

b) The Maternal and Child Health Service has a learning and development system

to support a competent maternal and child health workforce.


Standard 4 – The Maternal and Child Health Service is delivered by a competent and professional workforce


1. Workforce

a) The Maternal and Child Health Service employs a workforce qualified to meet the objectives of the Maternal and Child Health Service.

• The Maternal and Child Health Service employs nurses who are registered with the Nurses Board of Victoria as Registered Nurses Division 1, registered midwives holding an accredited post-graduate qualification in maternal and child health nursing.

• Where a workforce (support workforce) is employed to support and complement the skills of maternal and child health nurses, they are suitably qualified and experienced to meet the objectives of the Service.* The support workforce may include:

– administration workers

– family support workers

– Aboriginal Health workers

– cultural workers appropriate to local community (see Standard 1 Criterion 3)

– mental health workers

– psychologists

– drug and alcohol workers

– other workers or health professionals as required.

• The support workforce have relevant qualifications and or experience to work in the Maternal and Child Health Service and, where relevant, have professional registration and maintain the requirements of professional registration.

• evidence of current registration

• evidence of qualifications

• position descriptions with selection criteria and key performance indicators for nursing and non-nursing positions




b) The maternal and child health nurses maintain the requirements of their registration.

• The maternal and child health nurses working within the Maternal and Child Health Service comply with and/or practise within the requirements of their registration, including within the following codes, standards and guidelines:

– National competency standards for registered nurses 31

– National competency standards for midwives 32

– Scope of nursing and midwifery practice 33

– Code of ethics for nurses in Australia 34

– Code of ethics for midwives in Australia 35

– Code of professional conduct for nurses in Australia 36

– Code of professional conduct for midwives in Australia 37

– Delegation and supervision for registered nurses 38

– Guidelines for continuing professional development 39

– Professional boundaries 40

– any guidelines, codes or other relevant documents that may be updated or implemented as a result of national registration relating to registered nurses and/or midwives.

• evidence of maintenance of registration, including professional development activities


• evidence of facilitation of professional development, mentoring, support, clinical supervision, peer support and feedback


c) The maternal and child health workforce has knowledge of, and complies with, their legislative requirements.

• The maternal and child health workforce meets the legislative requirements of the following Acts and Regulations:

– Children, Youth and Families Act 2005 16

– Child Wellbeing and Safety Act 2005 41

– Health Records Act 2001 42

– Family Violence Protection Act 2008 43.

• The maternal and child health workforce is trained in their requirements under the:

– Children, Youth and Families Act 2005

– Child Wellbeing and Safety Act 2005

– Health Records Act 2001

– Family Violence Protection Act 2008.

• record of training undertaken

• record of mandatory education provided





d) The maternal and child health workforce has knowledge of, and complies with, these Standards and the Maternal and Child Health Program Resource Guide.

• maternal and child health workforce is aware of, and complies with, these Standards.

• The maternal and child health workforce is aware of, and has the skills and knowledge to comply with, the Maternal and Child Health Program Resource Guide.7

• evidence of compliance with standards

• evidence of training in revised Key Ages and Stages framework

• evidence of compliance with the Maternal and Child Health Program Resource Guide




2. Human resource management and planning

a) Human resource management supports the delivery of the Maternal and Child Health Service.

• The Maternal and Child Health Service, through the local government or governing authority, has documented human resource management policies and procedures.

• The human resource management policies and procedures includes, as a minimum, information on:

– recruitment, selection and appointment processes

– working hours/days

– pay and performance

– leave and illness

– induction, training and education

– workplace relations, including grievance processes

– performance development

– dress code

– management of students, including work experience of university and other students.

• The Service has policies and procedures for relievers within the Service.

• The maternal and child health workforce is aware of, and has access to, the Maternal and Child Health Service human resource management policies and procedures and the position description for their position.

• The human resource management policies and procedures are regularly updated, with input from the maternal and child health workforce.

• The Service has a confidential and secure personal file for each maternal and child health worker containing:

– position description

– performance reviews

– performance development and professional education undertaken

– evidence of qualifications and registration

– other requirements of employment (for example, police check, driver’s licence and evidence of registration with the Nurses Board of Victoria).


• staff survey

• review of staff turnover

• exit interviews

• local government or governing authority strategic plan

• evidence of confidential file




b) The recruitment processes for the Maternal and Child Health Service support a competent and professional maternal and child health workforce.

• The Maternal and Child Health Service recruitment processes are equitable, transparent and in accordance to the legislative requirements of the following Acts:

– Equal Opportunity Act 1995 44

– Racial and Religious Tolerance Act 2001 45

– Information Privacy Act 2000 46

– Public Administration Act 2004.48

• Recruitment is aligned with Maternal and Child Health Service strategic plan and human resource plan (see Standard 5 Criterion 1 and Standard 4 Criterion 2c).

• Each position undergoing recruitment has identified selection criteria.

• Recruitment processes ensure checks are made of the applicant for:

– qualifications and, for maternal and child health nurses and other health professionals, registration

– police check

– evidence of skills, knowledge and abilities.

• The Maternal and Child Health Service has an induction program to support the maternal and child health workforce covering the minimum elements of:

– information about the Service

– information on the duties of the position

– human resource management practices

– education and training relevant to the commencement of the position

– legislative requirements of workforce

– procedures and processes of the Service (see Standard 5 Criterion 2c).

• The Maternal and Child Health Service induction program is updated regularly to ensure the content is relevant and current.

• policies and procedures record of recruitment processes

• evidence of recruitment processes


• selection criteria for advertised positions and within position descriptions

• documentation of attendance/completion of induction program

• evidence of regular review of program

• evidence of orientation policies and procedures

• evaluation of induction program




c) Human resource planning identifies and responds to the current and future maternal and child health service workforce’s needs for the Maternal and Child Health Service.

• The local government or governing authority complements and supplements workforce planning undertaken by DEECD and other authorities.

• In conjunction with work undertaken by DEECD and other relevant authorities, human resource planning considers:

– current and future needs of children, mothers and families

– current and future workforce requirements, including the skills and capabilities currently within the Service and the skills and capabilities required by the Service

– recruitment and retention strategies for the maternal and child health workforce

– career opportunities and pathways

– human resource management procedures

– contingency plans for workforce shortages.

• To assist with human resource planning, the local government or governing authority regularly reviews:

– retention of workforce

– workforce leave accruals

– work–life balance strategies

– organisation performance, including productivity and quality of service delivery

– staff satisfaction.

• evidence of human resource plan

• evidence of linkages between the human resource plan and the strategic plan

• workforce analysis

• workforce survey

• exit interviews

• evidence of staff health–wellness program

• evidence of strategies to support retention (for example, scholarships and mentoring programs)





a) The Maternal and Child Health Service supports performance development of the maternal and child health workforce.

• Each position within the Maternal and Child Health Service has a position description outlining:

– mandatory/recommended qualifications or professional registration (see Standard 4 Criterion 1)

– key performance indicators

– skills and knowledge

– values and personal skills

– lines of accountability

– roles and responsibilities.

• The maternal and child health workforce is aware of, and has access to, their individual position description.

• The maternal and child health workforce (with the exception of administration workers) is provided with appropriate clinical supervision, and supported by experienced and relevant workers and/or mentors.

• The Maternal and Child Health Service has a performance review system that supports each individual staff member to remain competent and accountable and identifies areas for improvement and training needs, in conjunction with that staff member.

• Performance review commences within three months of employment with the Maternal and Child Health Service, with formal reviews occurring at least yearly.

• The performance review:

– is based on the staff members job description

– includes the active participation of the staff member, their manager and, if appropriate, clinical supervisor

– identifies strengths in performance

– involves setting goals

– is an ongoing process and provides opportunities for regular feedback throughout the year

– is documented

– provides opportunities to provide feedback on the Service and the coordinator

– is assessed and documented.

• The maternal and child health workforce has access to career opportunities, including opportunities for leadership and management positions (see Standard 5 Criterion 2a).

• position descriptions

• evidence of access to position description

• models for clinical supervision and evidence of provision of clinical supervision

• documentation of performance development review




b) The Maternal and Child Health Service supports a learning and development system to support a competent maternal and child health workforce (see Standard 2 Criterion 1 and Standard 2 Criterion 1).

• The Maternal and Child Health Service supports training and development of its workforce through a range of strategies, including:

– development of a professional development program

– provision of training and development

– mentoring

– peer review/shadowing and/or

– support to attend external training and development (see Standard 4 Criterion 2b and Standard 4 Criterion 3a).

• The Maternal and Child Health Service has documented policies and procedures on learning and professional development.

• The policies and procedures include:

– process for applying for attend learning and development courses outside of Maternal and Child Health Service

– support provided by the Service.

• The maternal and child health workforce is consulted by the Service regarding its training development requirements.

• The maternal and child health workforce contributes to the supervision and teaching of nursing and other relevant students.

• provision of professional development

• evidence of mandatory training inclusive of maternal and child health training

• evidence of professional development of staff


• survey of workforce on training needs

• annual planning day


RationaleGovernance incorporates the systems by which the Maternal and Child Health

Service is managed, and supports responsive and accountable service provision.

Effective leadership and management are required so as to provide a framework for

governance within the Maternal and Child Health Service and the local government or

governing authority. Lines of accountability and management structures support an

accountable and responsive service.3, 49 Effective management ensures the Maternal

and Child Service and its workforce meet legislative requirements, through clear

understanding of these requirements being communicated to the workforce, and

supported through policies and procedures.

The foundation of corporate governance is supported through development of,

and adherence to, strategic and operational plans, underpinned by effective

communication and change management strategies. Governance is assisted by well

constructed and effective policies and procedures, which are current, appropriate,

relevant, and accessible to the maternal and child health workforce. These plans,

strategies and policies should be integrated within the plans, strategies and policies

of the local government or governing authority, rather than stand alone documents

solely for the Maternal and Child Health Service.50

Criteria for Standard 51. Leadership and direction

2. Accountability

3. Information systems

1. Leadership and direction

a) The Maternal and Child Health Service has a planned approach to service

delivery and development, fostering the delivery of a safe and quality service.

b) The Maternal and Child Health Service, including management and the

workforce, has a shared understanding of the Maternal and Child Health Service

vision and the future service direction and work together to implement the

strategic and operational plans.

2. Accountability

a) The Maternal and Child Health Service (and the local government or governing

authority) has a management structure to support the delivery of a safe and

quality service.

Standard 5: Responsive and accountable service deliveryThe Maternal and Child Health Service,

supported by local government or

the governing authority, provides a

responsive and accountable service for

children, mothers and families through

effective governance and management.


b) The Maternal and Child Health Service complies with, and operates under,

the relevant legislative requirements and by-laws, and in accordance with the

Municipal Association of Victoria/DEECD Memorandum of Understanding.

(The Maternal and Child Health Line is funded by DEECD, and is not subject

to the Memorandum of Understanding.)

c) The Maternal and Child Health Service maintains effective policies and

procedures and other required documents and processes to provide a safe,

quality service and to comply with these Standards.

d) The Maternal and Child Health Service provides clinical and corporate

accountability.


a) The Maternal and Child Health Service maintains accurate and appropriate

health information for the child and family.

b) The Maternal and Child Health Service ensures child, mother and family

information is secure and safe.

c) The Maternal and Child Health Service maintains appropriate information

systems to support data use and accessibility.


Standard 5 – The Maternal and Child Health Service, supported by local government or the governing authority, provides a responsive and accountable service for children, mothers and families through effective governance and management.


1. Leadership and direction

a) The Maternal and Child Health Service has a planned approach to service delivery and development, fostering the delivery of a safe and quality service.

• The Maternal and Child Health Service, supported by the local government or governing authority, has a strategic and operational plan to deliver and develop service delivery and, where applicable, aligns these plans to the Council Plan, Municipal Early Years Plan, Municipal Public Health Plan and DEECD Plan.

• The strategic and operational plans contain a minimum of:

– key service objectives

– strategies for achievement of objectives

– performance indicators.

• The implementation of the strategic and operational plans is supported by change management processes.

• The strategic plan is reviewed and updated at a minimum every three years.

• The operational plan supports the implementation of the strategic plan, is updated yearly and accessible by the maternal and child health workforce.

• strategic plan is aligned with the council plan, Municipal Early Years Plan, Municipal Public Health Plan and DEECD Plan, as applicable

• operational plan aligned with the strategic plan


• evaluation of key performance indicators on operational and strategic plans

• operational plan available to maternal and child health workforce

b) The Maternal and Child Health Service, including management and the workforce, have a shared understanding of the Maternal and Child Health Service vision and the future service direction and work together to implement the strategic and operational plans.

• The maternal and child health workforce is aware of, and supports, the Maternal and Child Health Service vision, mission and goals and its strategic and operational plan.

• The maternal and child health workforce is involved in the development of the Maternal and Child Health Service strategic and operational plan.

• The maternal and child health workforce together implements the operational plan and achieve the objectives within the plan.


• evaluation feedback

• attainment of key performance indicators within organisational and strategic plans




2. Accountability

a) The Maternal and Child Health Service (and the local government or governing authority) has a management structure to support the delivery of a safe and quality service.

• The Maternal and Child Health Service management structure has identified roles within the structure and clear lines of responsibility associated with the roles.

• The Maternal and Child Health Service supports performance development within its management structure (see Standard 4 Criterion 3).

• The management structure of the Maternal and Child Health Service supports career opportunities for maternal and child health nurses (see Standard 4 Criterion 3).

• The management structure and processes associated with this structure are reviewed regularly.

• Meetings of the Maternal and Child Health Service management, and meetings involving the maternal and child health workforce, are goal-orientated and has documented outcomes.

• The management structure supports and advocates for the Maternal and Child Health Service within the local government or governing authority.

• Communication strategies are defined, and demonstrate regular communication and consultation between management and the maternal and child health workforce.

• organisational structure

• outline of role definitions within the structure

• performance development needs identified and met for leadership and management within Maternal and Child Health Service

• leadership and mentoring programs

• evidence of regular team meetings and other forms of communication

• communication policy




b) The Maternal and Child Health Service complies with, and operates under, the relevant legislative requirements and by-laws, and in accordance with the MAV/DEECD Memorandum of Understanding. (The Maternal and Child Health Line is funded by DEECD and not subject to the Memorandum of Understanding.)

• The Maternal and Child Health Service meets the legislative requirements of the following Acts and Regulations:

– Children, Youth and Families Act 2005 16

– Child Wellbeing and Safety Act 2005 41

– Family Violence Protection Act 2008 43

– Health Records Act 2001 42

– Racial and Religious Tolerance Act 2001 45

– Equal Opportunity Act 1995 44

– Health Act 1958 51 and various Regulations made under that Act, including the Health (Infectious Diseases) Regulations

– Freedom of Information Act 1982 47

– Occupational Health and Safety Act 2004 49

– Occupational Health and Safety Regulations 2007 52

– Local Government Act 1989 54.

• The Maternal and Child Health Service is compliant with the by-laws of its local government or governing authority.

• The Maternal and Child Health Service operates in accordance with the MAV/DEECD Memorandum of Understanding and the relevant Maternal and Child Health Program Resource Guide.*

• For the Maternal and Child Health Line only, the Line complies with the Program Resource Guide and other requirements determined by DEECD.

• evidence of legislative requirements within operational and strategic plans

• staff training on legislation




c) The Maternal and Child Health Service maintains effective policies and procedures and other required documents and processes to provide a safe, quality service and to comply with these Standards.

• The Maternal and Child Health Service, supported by the local government or governing authority, has policies and procedures to support safe and quality service delivery, including delivery of service and a process for regular review of the policies and procedures (see Standard 6 Criterion 3).

• Changes to practice, service and evidence are reflected in the policies and procedures.

• The Maternal and Child Health Service has a system for monitoring compliance with its policies and procedures.

• The Maternal and Child Health Service, supported by the local government or governing authority, has systems and processes to support implementation and ongoing review of Maternal and Child Health Program Standards.

• organisational plans

• performance development reviews

• policies and procedures in place, which are regularly reviewed

d) The Maternal and Child Health Service supports clinical and corporate accountability.

• The management structure of the Maternal and Child Health Service work in partnership with the maternal and child health workforce to ensure the delivery of a safe and quality service.

• Lines of responsibility for clinical aspects of the Maternal and Child Health Service are communicated to the maternal and child health workforce and support the partnership between management and the maternal and child health workforce in the delivery of the Maternal and Child Health Service (see Standard 4 Criterion 3).

• evidence of communication of lines of responsibility





a) The Maternal and Child Health Service maintains accurate and appropriate health information for the child, mother and family.

• The Maternal and Child Health Service maintains accurate health information for the child and family information in accordance with the Health Records Act 2001.42

• The minimum information to be included within the health record is:

– the identity of the maternal and child health worker who made the record and had contact with the child and family

– information on assessment, information provided, referrals and recommendations made and other aspects of the consultation

– be legible and dated.

• On becoming aware of a child moving into its service catchment, the Maternal and Child Health Service with the mother’s or family’s consent makes contact with the previous Service for transfer of health record in a timely manner.

• The Maternal and Child Health Service has policies and procedures regarding health information in accordance with the Local Government Records Act 1998, Health Records Act 2001 and Information Privacy Act (2000)

– management of health information

– information privacy

– security of health information

– how the child and family can access their health information

– documentation requirements

– confidentiality and privacy

– transfer of information when the child moves between Maternal and Child Health Services

– destruction of health records.

• In the event of an emergency, management of health information is outlined in the emergency management plan (see Standard 6 Criterion 3).

• The Maternal and Child Health Service encourages mothers and families to bring the Child Health Record when accessing the Maternal and Child Health Service, and when accessing other health services.*

• record maintained for each child in accordance with policies and procedures





b) The Maternal and Child Health Service ensures child and family information is secure and safe.

• Health information is secure and accessible only by relevant and authorised workers.

• Health information is maintained safely and securely:

– until the child is 25 years of age

– for seven years following the last contact with the Maternal and Child Health Service.

Please see Standard 4 Criterion 2 for details on maintaining workforce information in a secure and safe manner.

• electronic records are password controlled

• paper records are locked and in a fire-retardant storage facility

c) The Maternal and Child Health Service maintains appropriate information systems to support data use and accessibility.

• The Maternal and Child Health Service provides access to information systems, which is timely and appropriate.

• Information technology systems are appropriate for the collation of data, and health information.

• Training and development in the use of information technology is available to the maternal and child workforce, and ongoing support is provided.

• For information technology systems, the Maternal and Child Health Service must ensure:

– secure access

– there is backup of the information

– internet connected computers have a hardware/software firewalls

– data integrity

– antivirus software is installed.

• accessibility of computers and printers

• evidence of training

• evidence of information technology support system

• compliant with:

– backup of information

– hardware/software firewalls

– data integrity

– antivirus software.


RationaleQuality improvement is the method through which the effectiveness of activities

within the Maternal and Child Health Service are reviewed, and changes identified

in order to improve service delivery. The process for identification of areas for

improvement, implementation of strategies to support improvement and review

of these strategies is supported through a quality improvement framework.

The framework assists in identification of the process or activity to be improved,

understanding of the issues behind the process or activity to be improved,

implementation of an improvement strategy, evaluation of the strategy and

sustaining the strategy.25 The framework supports the delivery of a quality and

safe service.

The Maternal and Child Health Service delivers a safe service for the child and family

by ensuring the environment in which services are provided supports the health,

safety and wellbeing of the workforce providing the Service and for each child,

mother and family accessing it. The environment is also accessible by each child,

mother and family wishing to engage with the Service. This is provided through

occupational health and safety compliance, emergency management, infection

control, and the provision of suitable equipment and environments for the Service.

Criteria for Standard 61. Improving performance

2. Safe and accessible environment for the child and family

3. Safe practice and environment for the maternal and child health workforce

4. Provision of support for service delivery

1. Improving performance

a) Quality processes within the Maternal and Child Health Service support

improvement in health and wellbeing outcomes for the child and family and in

delivery of the service.

b) The Maternal and Child Health Service has a clinical risk management system to

maintain and enhance the safety and quality of the service provided to the child

and family.

c) The child and family accessing the Maternal and Child Health Service have

opportunities to express their views on the service.

Standard 6: Quality and safetyThe Maternal and Child Health Service

delivers a quality and safe service.


2. Safe and accessible environment for the child, mother and family

a) The environment of the Maternal and Child Health Service is safe

and accessible for the child and family.

b) The Maternal and Child Health Service supports safe practice and a safe

environment for the child and family accessing the service, and its workforce,

through effective infection control guidelines.*


a) The Maternal and Child Health Service provides a safe environment for its

workforce through management of, compliance with, and occupational health

and safety legislative requirements.

b) The Maternal and Child Health Service provides a safe environment for its

workforce through emergency management.

c) The maternal and child health workforce upholds its duty of care to ensure its

work is delivered in a manner that is not harmful to the health and safety of

themselves or others.


The Maternal and Child Health Service supports quality service delivery through

appropriate and maintained equipment and environments.


Standard 6 – The Maternal and Child Health Service delivers a safe and quality service


1. Improving performance

a) Quality processes within the Maternal and Child Health Service support improvement in outcomes for the child and family.

• The Maternal and Child Health Service is supported by a quality improvement framework, which is continuous and supports improvement in the service delivery to, and outcomes for, the child and family.

• The quality improvement framework aligns with local government ‘best value’ processes.

• The quality improvement framework supports the DEECD Service Improvement Plan.

• The quality improvement framework monitors, manages and improves safety, effectiveness, appropriateness, acceptability, access and efficiency of the Maternal and Child Health Service.

• Activities conducted within the quality improvement framework are documented and have an appropriate documented review process.

• The quality improvement framework is applied across the six Maternal and Child Health Standards.

• Maternal and child health workforce contributes to, and participates in, the quality improvement framework.

• quality improvement framework

• quality improvement activities, including outcomes

• incident reports

• data monitoring




b) The Maternal and Child Health Service has a clinical risk management system to maintain and enhance the quality and safety of service provided to the child and family.

• The Maternal and Child Health Service operates through a clinical risk management system that identifies, monitors and reviews clinical risks.

• The clinical risk management system covers potential or actual incidents that may occur within the Maternal and Child Health Service, or which place the child or family at risk in their own environment.

• The elements of the clinical risk management system covers:

– identification of risk

– processes for notification of a ‘near miss’ or incident internally and, where appropriate, externally

– assessment and review of the risk and contributing factors to the risk

– processes for improvement in service delivery as a result of the identification of the risk.

• The clinical risk management system is incorporated into the Maternal and Child Health Service quality improvement framework.

• The clinical risk management system is incorporated into the local government or governing authority’s risk management system.

• clinical risk management system

• review process for clinical risk management system

• child protection protocol




c) The child, mother and family accessing the Maternal and Child Health Service have opportunities to express their views on the service.

• The Maternal and Child Health Service has policies and procedures to allow the child, mother and family to provide feedback regarding the service, which are aligned with Australian Council for Safety and Quality in Healthcare Better Practice Guidelines on complaints management for health services.55, 56

• Policies and procedures include a minimum of:

– processes for the child and family to provide feedback

– processes for Maternal and Child Health Service to assess and respond to feedback, and resolve issues

– escalation process, should the issue not be able to be resolved at a local level.

• The procedure is written in a style and language that is appropriate for the mother and family accessing the Service.

• The feedback process is communicated and accessible to the mother and family utilising the Service.

• The feedback provided by the child and family is incorporated into the Maternal and Child Health Service quality improvement framework.

• policies and procedures for complaints management

• information on feedback process clearly identified to families

• information available on the local government or governing authority website


• feedback from children




2. Safe and accessible environment for the child, mother and family

a) The environment of the Maternal and Child Health Service is safe and accessible for the child and family.

• The Maternal and Child Health Service provides an environment which is:

– compliant with the Occupational Health and Safety Act 2004 52,

53 and Regulations 2007

– managed in accordance to relevant Australian Standards, Victorian legislation, and codes of practice.

• The physical environment of the Maternal and Child Health Service is easily located by the family and has:

– external signage to allow for easy identification

– disability access and facilities in accordance with Commonwealth and Victorian legislation and Australian Standards

– an appropriate waiting area

– appropriate area(s) for consultation.

• The physical environment of the Maternal and Child Health Service for group and other activities within the community are:*

– easily located by the family

– clearly identifiable by the family

– appropriate for the activities to be undertaken by the Service.

Please see Standard 4 Criterion 1c for requirements of maternal and child health workforce to ensure safety for the child and family accessing the Maternal and Child Health Service.

• environment survey

• evidence of updated signage and easily identifiable maternal and child health centre

• maternal and child health centre identified in Melways and on google maps

• access for children and families with a disability




b) The Maternal and Child Health Service supports safe practice and a safe environment for the child and family accessing the service, and its workforce, through an effective infection control system.*

• The Service has documented infection control procedures, aligned with the Commonwealth Government Department of Health and Ageing Infection control guidelines for the prevention of transmission of infectious diseases in the health setting.57

• Within the infection control procedures, the minimum content is:

– hand hygiene

– changeover procedures between visits *

– management of blood or body fluid spills

– management of blood or body fluid exposure

– personal protective equipment *

– management of wastes.*

• The infection control procedures are relevant for each Maternal and Child Health Service setting.

• The infection control procedures are accessible by the maternal and child health workforce in each Maternal and Child Health Service setting.

• The Service provides:

– personal protective equipment for its workforce

– resources for hand hygiene

– other resources as required that are compliant with Commonwealth Government Department of Health and Ageing Infection control guidelines for the prevention of transmission of infectious diseases in the health setting.

• The maternal and child health workforce has its recommended immunisation for Hepatitis B, Influenza, Pertussis, Measles, Mumps, Rubella and Varicella (Chickenpox) if seronegative.24


• number of staff immunised

• Department of Health and Department of Human Services alerts distributed to health and family support workforce





a) The Maternal and Child Health Service provides a safe environment for its workforce through management of, and compliance with, occupational health and safety legislative requirements.

Please note: Environment includes vehicles used within the Maternal and Child Health Service.

• The Maternal and Child Health Service provides an environment that is:

– compliant with the Occupational Health and Safety Act 2004 52, 53 and Regulations 2007

– managed in line with relevant Australian Standards, Victorian legislation, and codes of practice.

• The Service has policies and procedures governing occupational health and safety, compliant with the Occupational Health and Safety Act 2004 and Regulations 2007.

• The Service has policies and procedures governing occupational health and safety, compliant with the Occupational Health and Safety Act 2004 and Regulations 2007.

• Within the policies and procedures, the minimum level of content is:

– management and reporting of incidents, including potential incidents, in relation to occupational health and safety

– risk assessment of the environment

– working environments, including centre areas, waiting areas and office areas

– violence and aggression towards the maternal and child health workforce

– manual handling

– service delivery for the family who may provide a safety risk for the maternal and child health workforce

– home visiting

– working alone in the maternal and child health centre.

• The policies and procedures are relevant for each setting within the Maternal and Child Health Service (see Standard 1 Criterion 2a).

• The Maternal and Child Health Service provides equipment required by the maternal and child health workforce to comply with the policies and procedures governing occupational health and safety.

• The occupational health and safety procedures are accessible by the maternal and child health workforce.

• The Maternal and Child Health Service provides regular training for its workforce in all aspects of occupational health and safety.

• policies and procedures evident

• environment survey

• Occupational Health and Safety incident reporting system

• training of maternal and child health workforce in Occupational Health and Safety requirements of the Service

• occupational health and safety representative

• other evidence of providing safe environment, for example advanced driver training

• occupational health and safety meetings, and/or occupational health and safety as standing agenda item for staff meetings




b) The Maternal and Child Health Service provides a safe environment for its workforce through emergency management.

• The Maternal and Child Health Service has a documented emergency management plan covering a minimum of:

– general emergency within a maternal and child health centre

– fire within the maternal and child health centre

– medical emergency within the facility and, if applicable, within the child’s home

– pandemics within the general community

– bushfire (for Maternal and Child Health Services in settings at risk of bushfire)*

– escalation plan for staff safety issues for sole practitioners.

• The Maternal and Child Health Service provides equipment to the maternal and child health workforce to enable the execution of the emergency management plan.

• The emergency management plan is accessible by the maternal and child health workforce.

• The Maternal and Child Health Service provides regular training for its workforce in the emergency management plan.

• emergency management plan

• evacuation plan

• training of maternal and child health workforce in Emergency Management (for example, fire drill)

• availability/location of Emergency Management plan

• review of issues reported

c) The maternal and child health workforce upholds its duty of care to ensure its work is delivered in a manner that is not harmful to the health and safety of themselves or others.

• Maternal and child health workforce reads and understands the policies and procedures relating to safe practice and environment.

• Maternal and child health workforce understand their rights and responsibilities under the Occupational Health and Safety Act 2004 and Regulations 2007.52, 53

• Maternal and child health workforce implements a range of practices that ensure safe practice within the Maternal and Child Health Service environment.

• evidence of knowledge of safe practice and environment policies and procedures

• policies and procedures accessible by staff





The Maternal and Child Health Service supports quality service delivery through appropriate and maintained equipment and environments.

• The Maternal and Child Health Service provides appropriate equipment to provide a safe and quality service.

• The Maternal and Child Health Service maintains equipment in accordance with manufacturer and other relevant guidelines.

• The maternal and child health centres and venues used for group consultations meet local building standards and recommendations in relation to space and accessibility.

• The maternal and child health centres meet local building standards and recommendations, including:

– Australian Standard 3590.2–1990 Screen-based workstations – Workstation furniture

– Australian Standard 1668.2–2002: The use of ventilation and air-conditioning in buildings – Ventilation design for indoor air contaminant control

– Australian Standard 1680.1–1990: Interior lighting – General principles and recommendations.

• hazard management policy and procedures

• evidence of regular reviews and safety audits of equipment, including electrical equipment

• weights and measures standard within local government policy

• evidence of compliance with Standards


1. Lyth G (2000), ‘Clinical supervision: A concept analysis’, Journal of Advanced

Nursing, 31: 722–9.

2. Bush R, Dower J & Mutch A (2002), Community capacity index, University

of Queensland.

3. Braithwaite J & Travaglia JF (2008), ‘An overview of clinical governance policies,

practices and initiatives’, Australian Health Review, 32(1): 10–22.

4. National Health and Medical Research Council (2005), Cultural competency in

health: A guide for policy, partnership and participation,

Website: http://www.nhmrc.gov.au/publications/synopses/_files/hp19.pdf,

accessed September 2009.

5. Australian Institute of Health and Welfare (2004), Australia’s Health 2004,

Website: http://www.aihw.gov.au/publications/aus/ah04/ah04-c05-040804.pdf,


6. World Health Organisation (2009), The determinants of health,

Website: http://www.who.int/hia/evidence/doh/en/, accessed September 2009.

7. Department of Education and Early Childhood Development (2006), Maternal

and Child Health Program Resource Guide.

8. Scally G & Donaldson LJ (1998), ‘Clinical governance and the drive for quality

improvement in the new NHS in England’, British Medical Journal, 317: 61–5.

9. Office of Safety and Quality in Healthcare (2001), Introduction to clinical

governance – A background paper, Perth, Western Australia Department of Health.

10. World Health Organisation (1948), ‘Preamble to the Constitution of the World

Health Organisation as adopted by the International Health Conference’, New

York, 19–22 June, 1946 signed on 22 July 1946 by the representatives of 61

States (Official Records of the World Health Organisation, no. 2, p. 100) and

entered into force on 7 April 1948.

11. Runciman WB (2006), ‘Shared meaning: preferred terms and definition for safety

and quality’, Medical Journal of Australia, 174:S41–43.

12. Boon H, Verhoef M, O’Hara D & Findlay B (2004), ‘From parallel practice

to integrative health care: A conceptual framework’, BMC Health Services

Research, 4(15).

13. Dixon J, Douglas R & Eckersley R (2000), ‘Making a difference to the socio-

economic determinants of health in Australia: A research and development

strategy’, Medical Journal of Australia, 172(11): 541–4.

References

Victorian Maternal and Child Care Health Service62

14. National Public Health Partnerships (2005), Healthy children – Strengthening

promotion and prevention across Australia, National Public Health Strategic

Framework for Children 2005–2008,

Website: http://www.nphp.gov.au/workprog/chip/documents/StrategicFrame

workpostAHMCApproval.pdf, accessed July 2009.

15. Council of Australian Governments’ National Reform Agenda (2007), Victoria’s

plan to improve outcomes in early childhood,

Website: http://www.dpc.vic.gov.au/CA256D800027B102/Lookup/Victoria’s

Plantoimproveoutcomesinearlychildhood/$file/Victoria’s%20Plan%20to%20

improve%20outcomes%20in%20early%20childhood.pdf,


16. Victorian Government (2005), Children, Youth and Families Act,

Website: www.legislation.vic.gov.au, accessed September 2009.

17. Schmied V, Homer C, Kemp L, Thomas C, Fowler C & Kruske S (2008), ‘The

role and nature of universal health services for pregnant women, children and

families in Australia’, Collaboration for Research into Universal Health Services

for Mothers and Children.

18. Department of Education and Early Childhood Development (2009), Key Ages

and Stages Framework.

19. Vimpani G (2004), ‘Refashioning child and family health services in response to

family, social and political change’, Australian Health Review, 27(2): 13–16.

20. National Scientific Council on the Developing Child, Young Children Develop in

an Environment of Relationships (2004), Working Paper No. 1,

Website: http://www.developingchild.harvard.edu, Accessed September 2009.

21. Lamb M (ed.) (2004), The Role of the Father in Child Development, Fourth

Edition, John Wiley & Sons Inc.

22. Day R & Lamb M (eds.) (2004), Conceptualising and measuring father

involvement, Lawrence Erlbaum Associates.

23. Department of Human Services (2006), National Headline Indicators for

Children’s Health, Development and Wellbeing Report: State-wide Outcomes

for Children, Office for Children, Victorian Government Department of Human

Services, Melbourne, Victoria, Australia.

24. Department of Health and Ageing (2008), Australian Immunisation Handbook,

Website: http://www.health.gov.au/internet/immunise/publishing.nsf/

Content/Handbook-home, accessed September 2009.

Victorian Maternal and Child Care Health Service 63

25. Department of Education and Early Childhood (2008), Blueprint for Education

and Early Childhood Development,

Website: http://www.education.vic.gov.au/about/directions/blueprint2008/

thepaper.htm, accessed September 2008.

26. Centre for Community Child Health (2006), Linking schools and early

years services.

27. Department of Human Services (2004), Continuity of care: A communication

protocol for Victorian public maternity services and the Maternal Child

Health Service,

Website: http://www.eduweb.vic.gov.au/edulibrary/public/earlychildhood/

mch/protocolcontinuitycare.pdf, accessed September 2009.

28. Department of Human Services (2005), Maternity and Maternal

Child Health Services Communication Matrix,

Website: http://www.eduweb.vic.gov.au/edulibrary/public/earlychildhood/

mch/chartcommsmatrix.pdf, accessed September 2009.

29. Maternal and Child Health Special Interest Group (1999), Standards of professional

practice for maternal and child health nurses, Australian Nursing Federation

(Victorian Branch).

30. Armstrong F (2005), ‘Magnet hospitals – What’s the attraction?’, Australian

Nursing Journal, 12(8): 14–17.

31. Australian Nursing and Midwifery Council (2005), National competency

standards for the registered nurse,

Website: http://www.nbv.org.au/c/document_library/get_file?p_l_id

=10327&folderId=13486&name=DLFE-353.pdf, accessed September 2009.

32. Australian Nursing and Midwifery Council (2006), National competency standards

for the midwife,

Website: http://www.nbv.org.au/c/document_library/get_file?p_l_id=10327&fo

lderId=13486&name=DLFE-357.pdf, accessed September 2009.

33. Nurses Board of Victoria (2007), Guidelines: Scope of nursing and

midwifery practice,

Website: http://www.nbv.org.au/c/document_library/get_file?p_l_id=10327&

folderId=13486&name=DLFE-361.pdf, accessed September 2009.

34. Australian Nursing and Midwifery Council (2008), Code of ethics for nurses

in Australia,

Website: http://www.anmc.org.au/docs/Research%20and%20Policy/

Codes%20Project/New%20Code%20of%20Ethics%20for%20Nurses%20

August%202008.pdf, accessed September 2009.


35. Australian Nursing and Midwifery Council (2008), Code of ethics for midwives

in Australia,


Codes%20Project/New%20Code%20of%20Ethics%20fo%20rMidwives%20

August%202008.pdf, accessed May 2009.

36. Australian Nursing and Midwifery Council (2008), Code of professional conduct

for nurses in Australia,


Codes%20Project/New%20Code%20of%20Professional%20Conduct%20

for%20Nurses%20August%202008.pdf, accessed September 2009.

37. Australian Nursing and Midwifery Council (2008), Code of professional conduct

for midwives in Australia,


Codes%20Project/New%20Code%20of%20Professional%20Conduct%20

for%20Midwives%20August%202008.pdf, accessed September 2009.

38. Nurses Board of Victoria (2007), Guidelines: Delegation and supervision for

Registered Nurses and Midwives,



39. Nurses Board of Victoria (2009), Guidelines for nurses and midwives for

continuing professional development,



40. Nurses Board of Victoria (2007), Professional Boundaries: A guide for Registered

Nurses in Victoria,

Website: http://www.nbv.org.au/c/document_library/get_file?p_l_id=10327&fo

lderId=13039&name=DLFE-241.pdf, accessed September 2009.

41. Victorian Government (2005), Child Wellbeing and Safety Act,


42. Victorian Government (2001), Health Records Act,

Website: http://www.health.vic.gov.au/healthrecords/


43. Victorian Government (2008), Family Violence Protection Act,

Website: http://www.vgso.vic.gov.au/resources/publications/enf/thefamilyvio

lenceprotectionact2008.aspx, accessed September 2009.


44. Victorian Government (1995), Equal Opportunity Act,


45. Victorian Government (2001), Racial and Religious Tolerance Act,


46. Victorian Government (2000), Information Privacy Act,


47. Victorian Government (1982), Freedom of Information Act,

Website: www.legislation.vic.gov.au, accessed July 2009.

48. Victorian Government (2004), Public Administration Act,


49. Balding C (2008), ‘From quality assurance to clinical governance’, Australian

Health Review, 32(3): 383–91.

50. Berwick D & Nolan T (1998), ‘Physicians as leaders in improving healthcare:

A new series in the Annals of Internal Medicine’, Annals of Internal Medicine,

128(4): 289–92.

51. Victorian Government (1958), Health Act,


52. Victorian Government (2004), Occupational Health and Safety Act,

Website: http://www.workcover.vic.gov.au/wps/wcm/resources/file/

ebcce5435d77ad2/getting_into_act.pdf, accessed September 2009.

53. Victorian Government (2007), Occupational Health and Safety Regulations,

Website: http://www.ergonomics.com.au/documents/2007OHSregs.pdf,


54. Victorian Government (1989), Local Government Act,


55. Australian Council for Safety and Quality in Healthcare (2004), Better practice

guidelines on complaints management for healthcare services,

Website: http://www.hcscc.sa.gov.au/documents/20_resources/ACSQH%20

Better%20Practice%20Guidelines%20July2004.pdf, accessed September 2009.

56. Australian Council for Safety and Quality in Healthcare (2005), Complaints

management handbook for healthcare services,

Website: http://www.hcscc.sa.gov.au/documents/20_resources/ACSQHC%20

Better%20Practice%20Guidelines%20Complaints%20Handbk.pdf, accessed

September 2009.


57. Department of Health and Ageing (2004), Infection control guidelines for the

prevention of transmission of infectious diseases in the health care setting,

Website: http://www.health.gov.au/internet/main/publishing.nsf/Content/

icg-guidelines-index.htm, accessed September 2009.

58. Department of Education and Early Childhood (2006), Victorian Children’s

Outcomes Framework,

Website: http://www.education.vic.gov.au/ecsmanagement/beststart/

outcomes/default.htm, accessed September 2009.

59. World Health Organisation (1986), Ottawa Charter for Health Promotion, Health

and Welfare Canada and Canadian Public Health Association.

60. World Health Organisation (1997), Jakarta declaration on leading health

promotion into the 21st century’, Health Promotion International, 12(4): 261–4.


KPMG were engaged by DEECD in March 2009 to review and contemporise the

Maternal and Child Health Service Program Standards. Activities undertaken to

review and contemporise the Program Standards included a review of the previous

Program Standard, review of relevant policy documents, literature on Maternal and

Child Health and Program Standards, and extensive consultation throughout the

Maternal and Child Health Service and other key stakeholders. The activities were

overseen by a Project Reference Group appointed by DEECD.

The process for development of the Maternal and Child Health Program Standards is

outlined in Figure 2.

Project initiation Project plan

Desktop review and preliminary consultation

Draft standards

Final Program Standards

Refine draft of Standards

Statewide consultation

Figure 2: Development of the Maternal and Child Health Program Standards

(March–October 2009)

Stage 1

Stage 2

Stage 3

Stage 4

Appendix A: Development of Maternal and Child Health Program Standards

IntroductionProgram Standards for the Maternal

and Child Health Service were initially

developed in 1995. These Standards

consisted of twelve standards and were

developed to provide a Maternal and

Child Health Service with a customer

focus, consistent service delivery,

quality service provision, and to

support evaluation of the Service.


Name Title Organisation

Anne Colahan Manager Maternal and Child Health Service

DEECD

Kerry Connolly Maternal and child health nurse

Victorian Association of maternal and child health nurses

Cheryl Cripps Maternal and child health nurse

City of Frankston

Nicki Doyle Senior Manager KPMG

Irene Ellis Lecture Child Family and Community Nursing

RMIT University

Marcia Gleeson Professional Officer Australian Nursing Federation (ANF)

Sharon Goldfeld Senior Medical Advisor DEECD

Fred Halliday Associate Director KPMG

Ann Hindell Director of Nursing Tweddle Child + Family Health Service

Megan Leuenberger

Research Officer DEECD

Geoff Loftus Manager, Family Services Monash City Council

Karen Mainwaring Acting Manager MCH Line

Alison Nuske Senior Program Policy Advisor DEECD

Sarah Pitney Enhanced Maternal and Child Health Nurse

Port Phillip City Council

Jenny Proimos Senior Medical Advisor DEECD

Anthony Raitman Assistant General Manager DEECD

Lael Ridgway Lecture Child Family and Community Nursing

La Trobe University

Helen Rowe Advisor Municipal Association of Victoria (MAV)

Frances Sheean Regional Lecturer La Trobe University

Anita Siassos Program and Service Advisor Northern Region

Edward Swan Senior Manager KPMG

Helen Watson President MCH Coordinators’ Group

Project Reference GroupA Project Reference Group was

established to support the

development of the Standards.

Members of the reference group

are presented in the following

table.


Consultations to inform development of Program StandardsDuring the development of the Maternal and Child Health Program Standards,

KPMG undertook three phases of consultation. The three phases were preliminary

consultations with identified stakeholders, statewide consultations, and consultations

with key stakeholders, including mothers who have accessed the Service.

Preliminary consultations with stakeholders identified by the DEECD occurred in

April 2009. The stakeholders consulted were:

• Dr Sharon Goldfeld (Senior Medical Advisor Child and Adolescent Health)

and Joyce Cleary (Manager, Statewide Outcomes), DEECD

• Maternal and Child Health Team, DEECD

• Marcia Gleeson (Professional Officer), Australian Nursing Federation

• Lael Ridgway (Lecturer), La Trobe University

• Clare Hargreaves (Senior Policy Manager) and Helen Rowe (Maternal and Child

Health Policy Advisor) Municipal Association of Victoria

• Ann Hindell (Director of Nursing), Tweddle, and involved in the development of

previous Program Standards).

Consultations with the maternal and child health workforce, and managers of the

Maternal and Child Health Service were undertaken in June and August 2009; and

consultations with mothers who have accessed the Maternal and Child Health

Service were undertaken in July 2009. The following consultations occurred:

• Northern Metropolitan Region

• Southern Metropolitan Region

• Eastern Metropolitan Region

• Western Metropolitan Region

• Gippsland Region

• Grampians Region

• Loddon Mallee Region

• Barwon South West Region

• Hume Region


• Enhanced Maternal and Child Health Service

• Maternal and Child Health Line

• Key Ages and Stages Pilot Sites at Yarra Ranges, Wyndham, Wodonga and Bayside

• consultations with mothers who have accessed the Maternal and Child

Health Service.

Documents of relevance to the Program StandardsThe following documents are of relevance to, and used as a resource for the

development of the Maternal and Child Health Program Standards:

Blueprint for Education and Early Childhood Development 25

In 2008, the Department of Education and Early Childhood Development released

the Blueprint for Education and Early Childhood Development, which sets out the

Government’s five year agenda for learning and development from birth to adulthood.

The Blueprint outlines a comprehensive approach to outcomes for children and young

people from birth to adulthood. It identified four priorities:

1. Increase access to high-quality early childhood health,

education and care services

2. Strengthen public confidence in the education system

3. Integrate services for children and families

4. Improve outcomes for disadvantaged young Victorians.

Victoria’s Plan to Improve Outcomes in Early Childhood15

The DEECD released Victoria’s plan to improve outcomes in early childhood, as one

of Victoria’s proposals to the Council of Australian Governments (COAG) under the

National Reform Agenda. Victoria’s plan to improve outcomes in early childhood

is an integrated reform package that will drive sustained improvements in early

childhood outcomes. The plan identified four key policy directions:

• improving antenatal care

• strengthening the health, development and learning of 0–5 year-olds

• enhancing provision of early childhood education and care services

• improving the early years workforce.

A series of actions have been designed in response to each of these four policy

directions to develop an integrated, high-quality and accessible early childhood

service system.


Key Ages and Stages Framework18

The Key Ages and Stages Framework sets out evidence-based activities for the

10 Key Ages and Stages consultations provided by the Universal Maternal and

Child Health Service. The framework includes:

• an emphasis promotion of health and development across a range of domains

• Parents’ Evaluation of Developmental Status (PEDS) as a primary tool to engage

parents in discussion about the development of their child

• Brigance screen as a secondary screen where concerns are identified through

the PEDS

• relevant health information handouts for each Key Ages and Stages consultations

• interventions that include a safe sleeping checklist, Quit smoking intervention,

screening for maternal health and well-being and the presence of family violence.

Victorian Children’s Outcomes Framework58

Has been developed to provide a common basis for setting objectives and planning

across the whole of government. The outcomes framework sets out 35 aspects of

child health and wellbeing, learning and development, and safety that are essential

to all children. This framework also recognises that children do not achieve positive

outcomes in these areas without the support of confident, capable parents,

a strong community and a society which provides the services they need. For this

reason, the outcomes framework relates to both the individual child and their social

and family context. For this reason, the outcomes framework relates to both the

individual child and their social and family context.

National Public Health Strategic Framework for Children 2005–200814

The National Public Health Partnership (NPHP) is a subcommittee of the Australian

Health Ministers’ Advisory Council that provides an opportunity to coordinate public

health activity around Australia. It also ensures a continuing emphasis on public

health priorities and the promotion of public health agendas. One of the public

health priorities of the NPHP is child health, which is being addressed through the

National Public Health Strategic Framework for Children.

The National Public Health Strategic Framework for Children is based on health

promotion and early intervention approaches. It aims to strengthen the capacity

of the health sector and the wider community to respond to a range of public

health issues identified in national strategies for children aged 0 –12 years,

including maternal health and wellbeing during the antenatal period.

The Framework provides a framework for emerging health issues and focuses on


strengthening the capacity of systems to support communities, families, parents

and professionals to support the health of children. The role of health services in

the care of children is also a key focus of the framework.

National Headline Indicators for Children’s Health, Development and

Wellbeing Report23

In 2005, Australian Health Ministers’ Conference and the Community and Disability

Services Ministers’ Conference approved the development of a set of national,

jurisdictionally agreed Headline Indicators. Headline Indicators are a mechanism

to assist policy and planning by measuring progress on a set of indicators that are

potentially amenable to change over time by prevention or early intervention. They

are designed to allow comparison of state and territory data, and data from sub-

populations of children, including:

• children with a disability

• children from culturally and linguistically diverse backgrounds

• children living in disadvantage

• Aboriginal and Torres Strait Islander children.

Ottawa Charter for Health Promotion59

Developed at the first International Conference on Health Promotion held in Ottawa,

Canada in 1986, the Ottawa Charter for Health Promotion identifies the prerequisites

for health, methods to achieve health promotion through advocacy, enabling and

mediation, and five key action areas for health promotion. These areas are:

• building healthy public policy by placing health on the agenda of policy makers

at all levels, including legislative, economic, taxation and organisational change

• creating supportive environments through the provision of living and working

conditions that are safe, stimulating, satisfying, enjoyable and that provide a

positive benefit to health

• strengthening community action by empowering communities to exert ownership,

control and action over their own endeavours and destinies

• developing personal skills through the provision of information and education

related to health and life skills

• reorientating health services to focus on prevention instead of solely treatment

and cure.


Jakarta Declaration on Leading Health Promotion into the 21st Century60

In 1997, the 4th International Conference on Health Promotion was held in Jakarta.

This conference identified new directions for health promotion in the 21st century.

The direction encompasses:

• promotion of social responsibility for health

• increasing investments for health development

• consolidation and expansion of partnerships for health

• increasing community capacity and empowering the individual

• securing an infrastructure for health promotion.

Standards of Professional Practice for maternal and child health nurses29

The Standards of Professional Practice for maternal and child health nurses were

developed by the Maternal and Child Health nurses Special Interest Group. Eight

standards of professional practice have been identified for maternal and child

health nurses. These standards are covering:

• professional role

• child health

• maternal health

• family health

• communication

• primary health care

• health promotion and health education

• nursing research.


A summary of the key performance criteria and examples of evidence within the

Program Standards is listed below. The examples of evidence for each criteria

are examples only, and not mandatory. They do, however, provide guidance on

appropriate evidence to support attainment of the criteria.

Summary of required policies

The following policies and details within the policies are identified within the

Program Standards as required in order to meet the criteria within the Program

Standards. The policies may be standalone policies designed specifically for

the Maternal and Child Health Service, or may be part of policies developed and

applicable to services other than the Maternal and Child Health Service within

the local government or governing authority, or the local government or governing

authority as an organisation-wide policy.

• Service delivery, including:

– service delivery for children and families

– family partnership approach to service delivery.

• Feedback on service delivery, including:

– processes for families to provide feedback

– responsiveness of the Maternal and Child Health Service to feedback

– process for Maternal and Child Health Service to assess and respond to feedback

and resolve issues

– escalation process should the issue not be able to be resolved at a local level.

• Occupational Health and Safety, including:

– risk assessment of the environment

– working environments, including centre areas, waiting areas and office areas

– vehicle safety,

– violence and aggression towards the maternal and child health workforce

– manual handling

– service delivery for mothers and families who may place the safety of the

maternal and child health workforce at risk

– home visiting

– working alone in the clinic setting.

Appendix B: List of evidence


• Emergency Management Plan, including:

– general emergency within the maternal and child health centre

– fire within the maternal and child health centre

– medical emergency within the centre and, if applicable, within a child’s home

– pandemics within the general community

– bushfire (for Maternal and Child Health Service in settings at risk

of bushfire)*

– escalation plan for staff safety issues for sole practitioners.

• Infection control, including:

– hand hygiene

– personal protective equipment

– handling and disposal of ‘sharps’

– management of wastes

– changeover procedures between visits

– management of blood or body fluid spills

– management of blood or body fluid exposure.

• Human resource management policies:

– information about the Maternal and Child Health Service





– procedures and processes of the Maternal and Child Health Service.

• Performance development, including:

– process for applying to attend learning and development courses

– support provided by the Maternal and Child Health Service to attend courses.


Summary of processes, systems and plans

The processes, systems and plans may be designed specifically for the Maternal

and Child Health Service or may be part of processes, systems and plans developed

and applicable to services other than the Maternal and Child Health Service within

the local government or governing authority, or the local council or governing

authority as organisational processes, systems and plans.

The following processes, systems and plans are identified within the Program

Standards as required in order to meet the Program Standards criteria:

• identification, engagement and referrals to associated services for vulnerable

children and families

• strategic plan

• operational plan

• organisational structure

• communication strategy between the maternal and child health management and

the health and family support workforce

• process for regular review of all policies, processes and procedures

• clinical risk management system covering:

– identification of risk

– processes for notification of a ‘near miss’ or incident, internally and, where

appropriate, externally

– assessment and review of the risk and contributing factors to the risk

– processes for improvement in service delivery as a result of the identification

of the risk.

• occupational health and safety incident reporting system

• personal file for each maternal and child health worker, containing:

– information about the Maternal and Child Health Service





– procedures and processes of the Maternal and Child Health Service.

• human resource plan, including:

– current and future workforce requirements, including the skills and capabilities

currently within the Service and the skills and capabilities required by the Service

– recruitment and retention strategies for maternal and child health workforce

– career pathways


– human resource management procedures

– contingency plans for workforce shortages.

• review of human resources management and planning, including:

– retention of workforce

– workforce leave accruals

– work–life balance strategies

– organisation performance, including productivity and quality of service delivery

– staff satisfaction.

• position descriptions for each maternal and child health position, including:

– mandatory/recommended qualifications or professional registration

– key performance indicators

– skills and knowledge

– values and personal skills

– lines of accountability

– roles and responsibilities.

• performance development review system, which:

– is based on the staff member’s job description

– includes the active participation of the staff member, their manager and,

if appropriate, clinical supervisor

– identifies strengths in performance

– involves setting goals

– is an ongoing process and provides opportunities for regular feedback throughout

the year

– is documented

– provides opportunities to provide feedback on the Service and the coordinator

– is assessed and documented.

Examples of data collection

The following data list is an example of data that may be collected and reviewed to

inform the Maternal and Child Health Service on achievement of the criteria of the

Program Standards:

• Maternal and child health attendance rate

• number of outreach services provided for non-attendees of the Maternal and Child

Health Service

• number of referrals to the Enhanced Maternal and Child Health Service

and other services


• utilisation of service, when services are provided outside of traditional working

hours or on weekends

• participation rates for children, mothers and families

• Key Ages and Stages targets versus actual visits

• Headline Indicators, including:

– mortality rate for infants less than one year of age

– proportion of children on the Australian Childhood Immunisation Registrar who

are fully immunised at two years of age

– proportion of infants exclusively breastfed at four months of age.

• number of opportunistic immunisations

• referrals to other agencies, including reason for referral, number of referrals

• activities undertaken and total services hours provided through flexible service

component of the Universal Maternal and Child Health Service

• breastfeeding rates (fully and partial)

• incident reporting

• number of staff immunised.

Examples of audits

The following audits, and content within the audits, are examples that may be used

in order to inform the Maternal and Child Health Service on the achievement of the

criteria within the Program Standards.

• Health record audit, including reviews of:

– maintenance of record for each child accessing the Maternal and

Child Health Service

– outcomes of monitoring, intervention and health promotion

– service delivery based on determinants of health

– health and wellbeing of mother and family monitored with each contact

– information provided to mother and family

– compliance with the Health Records Act 2002.

• Audit of referrals made by the Maternal and Child Health Service, including:


– services to which the child, mother and/or family are referred

– detail contained within the referral.


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 http://www.education.vic.gov.au

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


• Audit of referrals made to Maternal and Child Health Service, including:


– 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.

www.education.vic.gov.au/ecsmanagement/mch/policy/default.htm

Maternal and Child Health Service

Maternal and Child Health Service Program Standards

Maternal and Child H

ealth Service M

aternal and Child Health Service Program

Standards