Setting
adversity
DISEASE
Australia’s universal Child and Family Health (CFH) services offer free, community-based healthcare to families with children from birth to school entry. Available in all Australian jurisdictions, CFH services are delivered by nurses, often in partnership with allied health providers and working with interpreters as needed. The services are mostly clinic-based and offer broad ranging support for children’s health, development and parental well-being. In some jurisdictions, CFH services offer higher intensity support (more, longer and home-based appointments) for families experiencing increased health risks and social adversity. These service streams are differentiated with the labels ‘universal’ and ‘higher intensity’ throughout.Australian CFH services already identify and respond to adverse experiences such as poor parental mental health and family violence. While the service frameworks recognise financial hardship as a social adversity affecting child and family outcomes, there is a gap in practice in systematically identifying and responding to this need. The HWF pilot was tested with CFH services in lower socioeconomic communities in Australia’s two most populous states, Victoria and New South Wales. The study was planned before the COVID-19 pandemic, but implementation and evaluation occurred during the pandemic and were deeply impacted by Australia’s public health restrictions and economic responses. In brief, stay-at-home orders (lockdown) were Australia’s main measure of disease control until November 2021, when vaccination levels reached 70%–80%. This required CFH and financial counselling services to shift to telehealth within weeks, and saw many CFH services seconded to other pandemic-related duties. To offset the economic fallout of lockdown, the government implemented a range of financial supplements and supports in April 2020. By September 2020, this financial response had reduced poverty and housing stress beyond prepandemic levels; however, financial hardship had rebounded a year later after financial supports were withdrawn.
