Long-term improvement in child and maternal health through home visiting programs
Home visiting programs can improve both child health and maternal well-being in the long term.
Young mothers who find themselves in difficult social and financial circumstances often experience enormous pressure. Without adequate support, psychosocial stress can quickly lead to overwhelming – with serious consequences for both mother and child. Scientific studies show that these stresses can increase the risk of neglect, child abuse and mental health issues for both mothers and children. In this context, preventive programs that provide early support to families in difficult circumstances are becoming increasingly important.
A new study published in the renowned journal “JAMA Pediatrics” shows that home visiting programs can improve both child health and maternal well-being in the long term. Particularly significant effects were achieved when care was provided exclusively by midwives.
The largest randomized study in Germany on this topic
The “Pro-Child Follow-Up” study is the largest randomized controlled study in Germany to evaluate the long-term effects of a home visitation program for disadvantaged families. Between 2006 and 2009, 755 first-time mothers with low incomes and psychosocial stressors were divided into three groups: Two intervention groups received regular home visits from midwives or from a tandem team of midwives and social workers. The control group had access to standard welfare services. The aim was to compare the effectiveness of the different models.
After seven years, the participating families were examined again. The results are clear: children from families who received support from midwives were less likely to show behavioral problems such as anxiety disorders or depressive symptoms. The frequency of child abuse and neglect was also lower. At the same time, mothers in this group reported less parenting stress and improved mental health.
“Long-term relationships are key”
“Our results show that early interventions not only help in the short term, but also have lasting positive effects years after the programs have ended,” explains Dr. Tilman Brand, head of the Social Epidemiology group at BIPS. Particularly interesting: the intervention group that was cared for exclusively by midwives performed better than the group in which a tandem team of midwives and social workers was used. “We would have expected that the combination of both professional groups would have offered additional added value. But apparently, the long-standing relationship with a single caregiver is crucial,” Brand continues.
A reduction of 13 percentage points in behavioral problems
The study was able to show unusually clear effects: Compared to the group without special intervention, the rate of behavioral problems in the group with family support decreased by 13 percentage points, and mothers' depressive symptoms were reduced by 7 percentage points – which corresponds to a relative risk reduction of about 50 percent. “These results underscore the importance of involving midwives in supporting disadvantaged families at an early stage,” emphasizes Brand.
A model for the future?
Despite the positive results, the home visiting program is currently only being implemented in a few regions. Bremen and Braunschweig have adopted the model, but the program has not yet been introduced in other federal states. The study authors make it clear: “A nationwide program could help to sustainably reduce social inequality and improve the health of children and parents,” emphasizes Brand.
The paper, written by a team of researchers from Germany and the UK, provides important impetus for health and social policy. The team hopes that the results will help to expand and sustain early support services for families in difficult circumstances in Germany.
The paper is the result of a collaboration between the Ernst Abbe University of Applied Sciences Jena, the Nuremberg Institute of Technology, the Institute for Employment Research (IAB) and University College London and the Leibniz Institute for Prevention Research and Epidemiology - BIPS. It was funded by the German Federal Ministry of Education and Research.
Original publication
Schepan ML, Sandner M, Conti G, Kliem S, Brand T. Maternal and child health following 2 home visiting interventions vs. control: Five-year follow-up of a randomized clinical trial. JAMA Pediatrics. 2025 https://doi.org/10.1001/jamapediatrics.2024.5929
BIPS – Health research for the benefit of mankind
The population is at the center of our research. As an epidemiological research institute, we see our mission as identifying the causes of health disorders and developing new concepts for the prevention of diseases. Our research provides a basis for societal decisions. It informs the population about health risks and contributes to a healthy living environment.
BIPS is a member of the Leibniz Association, which comprises 96 independent research institutions. The orientation of the Leibniz Institutes ranges from the natural, engineering and environmental sciences to economics, spatial and social sciences and the humanities. Leibniz Institutes address issues of social, economic and ecological relevance.Due to their national importance, the institutes of the Leibniz Association are jointly funded by the federal government and the federal states. The Leibniz Institutes employ around 20,000 people, including 10,000 scientists. The institutes' total budget is 2 billion euros.