UCL Economics researcher Gabriella Conti contributes to vital research on infant and maternal health

A recent study by Schepan et al., published in JAMA Pediatrics, provides new evidence on the long-term benefits of early home visiting programmes for maternal and child well-being. The research examines ‘Pro Kind’, the German adaptation of the Nurse-Family Partnership (NFP), which supports first-time mothers facing financial and social disadvantages through structured home visits. The study followed families for five years and found significant improvements in maternal well-being when all home visits were conducted by midwives. Mothers in this ‘midwife-only’ model reported lower rates of depressive episodes, improved life satisfaction, reduced parenting stress, and fewer instances of abusive parenting.

Comparing Staffing Models

The research evaluated two staffing models within Pro Kind: the ‘Midwife-only model’, in which midwives conducted all home visits throughout the intervention; and the ‘Tandem Model’, in which midwives conducted initial visits, but social workers took over after six months. The findings showed that only the midwife-led model resulted in sustained maternal well-being improvements. Compared to the control group, mothers in this model experienced: 6.6 percentage point reduction in severe depressive symptoms, and a 10.3 percentage point reduction in severe stress symptoms. Children in this model also exhibited fewer externalising behavioural problems. In contrast, the tandem model did not yield comparable maternal benefits, though it did contribute to a reduction in internalising behavioural problems among children. These results underscore the importance of professional continuity in home visiting programmes.

Supporting Evidence from Previous Research

This study builds on earlier work by Conti et al. on the Pro Kind project, which highlighted how home visiting enhances mother-child interactions and maternal investments in early childhood. A 2021 study using video analysis of mother-child play found that home visits significantly improved positive interactions, particularly between mothers and daughters, fostering early socio-emotional development. A 2024 study which used clinical diagnostic interviews for mental health assessment demonstrated that the midwife-only model significantly improved child and maternal mental health years after the intervention. Children in the treatment group had lower rates of hyperkinetic, conduct and emotional disorders (referred to clinically as ICD F-90-98 codes). Mothers had lower prevalence of depression and mood and affective disorders (referred to clinically as ICD F-30-39 codes) and required fewer prescriptions for psychotropic medications. Additionally, the intervention in the midwife-only model helped break the intergenerational transmission of neurotic and stress-related disorders (referred to clinically as ICD F-40-48 codes) between mothers and children, reinforcing the long-term benefits of structured, professional support.

Policy Implications

This research is a product of Gabriella Conti’s five-year collaboration with Malte Sandner and Sören Kliem and contributes to the broader discussion on home visiting and early interventions. The findings have important policy implications for the UK, where universal health visiting services increasingly rely on a mix of professionals, including health visitors, nursery nurses, and community staff. While this approach aims to expand service capacity, the Pro Kind findings suggest that continuity of care and professional background are critical for achieving positive maternal outcomes.  Gabriella noted:

“To design effective early support systems, it is essential that we better understand how different staffing models impact maternal and child well-being. Our future research will further explore how home visiting can be optimised to provide sustainable, long-term benefits for families and inform policies that support family well-being.

Funding:

Funding for the research was provided by the Nuffield Foundation and by the European Research Council.

Links:

• Read the article now.
• Read the 2021 paper now.
• Read the 2024 paper now.
• Learn more about the work of Gabriella Conti.