Peer-reviewed article
A better start for health equity? Qualitative content analysis of implementation of extended postnatal home visiting in a disadvantaged area in Sweden
Madelene Barboza, Asli Kulane, Bo Burström, Anneli Marttila ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined what happens during extended postnatal home visits to families in a disadvantaged area of Sweden between 2013 and 2016. Nurses visited 98 families six times each, documenting 501 visits in total. The analysis found that visits covered child health and development, family relationships, and support from the broader community, with families facing greater challenges receiving additional attention to their specific needs.
Key points
- Home visits addressed three main areas: child health/care/development, family roles and relationships, and external support systems
- The content model remained stable across all six visits per child
- Families with extra needs received continuous attention to their additional issues alongside standard programme content
- The intervention covered all domains of nurturing care recommended by the WHO Commission on Social Determinants of Health
- The approach represents proportionate universalism in practice
Limitations
This is a qualitative content analysis of documented visits without a comparison group, so it cannot demonstrate whether the intervention actually improved child health outcomes or reduced health inequities. The study describes what was delivered but does not measure whether families' situations or children's well-being actually improved.
Abstract
BACKGROUND: Health inequities among children in Sweden persist despite the country's well-developed welfare system and near universal access to the national child health care programme. A multisectoral extended home visiting intervention, based on the principles of proportionate universalism, has been carried out in a disadvantaged area since 2013. The present study investigates the content of the meetings between families and professionals during the home visits to gain a deeper understanding of how it relates to a health equity perspective on early childhood development. METHODS: Three child health care nurses documented 501 visits to the families of 98 children between 2013 and 2016. A qualitative data-driven conventional content analysis was performed on all data from the cycle of six visits per child, and a general content model was developed. Additional content analysis was carried out on the data from visits to families who experienced adverse situations or greater needs. RESULTS: The analysis revealed that the home visits covered three main categories of content related to the health, care and development of the child; the strengthening of roles and relations within the new family unit; and the influence and support located in the broader external context around the family. The model of categories and sub-categories proved stable over all six visits. Families with extra needs received continuous attention to their additional issues during the visits, as well as the standard content described in the content model. CONCLUSIONS: This study on home visiting implementation indicates that the participating families received programme content which covered all the domains of nurturing care as recommended by the WHO Commission on Social Determinants of Health and recent research. The content of the home visits can be understood to create enabling conditions for health equity effects. The intervention can be seen to represent a practical example of proportionate universalism.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Extended multisectoral postnatal home visiting based on proportionate universalism principles, with six visits per child delivered by child health care nurses
- Population
- 98 families with newborns in a disadvantaged area of Sweden
Key finding
Visits covered child health/care/development, family relationships, and external support systems