'not sustainable': public health program to support babies is facing a funding pinch
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ottawa - march 28, 2023 - jessica kiala poses for a photo with her daughter deborah at their home in ottawa tuesday. jessica is a young single mom - a refugee from angola - who has received support from ottawa public health's healthy babies, healthy children program which is having difficulty keeping up with demand. tony caldwell, postmedia.
tony caldwell
/
postmedia
when jessica kiala’s two-month-old daughter became seriously ill with respiratory syncytial virus last winter, the first person she called was emina besic.
besic, a public health nurse, calmed kiala and helped her understand what to watch for and when she should take her baby to the hospital, if things got worse.
they did. kiala took baby deborah to cheo, where she stayed for a week. it was a terrifying time for the young single mother, and she doesn’t know how she would have coped without the support of besic and ottawa public health’s healthy babies, healthy children program.
“it has made a big difference. it gave me a lot of mental support because i deal with anxiety,” said kiala, who is a refugee from angola in central africa. that support continues.
“knowing (besic) is going to come and check on us takes a lot of weight off my shoulders.”
kiala, who doesn’t have a family physician, continues to have regular home visits from besic under the program designed to support new parents and babies’ development.
but ottawa public health is no longer able to offer that kind of support to everyone who needs it, said program manager manar el malmi. that means only those at the highest risk are being seen, leaving some vulnerable parents and babies without support.
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designed as a universal program to promote healthy childhood development, it is now unable to meet growing demand and is facing service cuts.
“we think this program is not sustainable and significant service reductions will be required without an increase in our base funding,” said el malmi, who manages the program. the program is funded through ontario’s ministry of community and children’s services and delivered by ottawa public health and other health units across the province.
it is designed to support new parents and babies’ development through home visits from public health nurses and other services. among other things, nurses screen new mothers for postpartum depression. but provincial funding has not kept up with surging demand, el malmi said, which means its ability to support and reach people in need is increasingly limited.
ottawa public health has asked the ontario government, which provides 100 per cent funding for the program, for a significant increase to meet demand. its $4.5-million annual budget has not changed since 2008 even as staffing and other costs have increased.
demand surged during the covid-19 pandemic, in part because so many people didn’t have family physicians and other risk factors had increased.
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el malmi said services were already being restricted to those deemed to be at highest risk, including parents experiencing poverty, homelessness, social isolation, mental illness and other challenges. some public health nurses now do a significant number of their home visits in shelters.
“we are seeing more and more families with complex needs without an increase in budgeting,” said louise gilbert, a family health specialist with ottawa public health. “it is not sustainable.”
jessica kiala poses for a photo with her daughter deborah at their home in ottawa tuesday. jessica is a young single mom – a refugee from angola – who has received support from ottawa public health’s healthy babies, healthy children program which is having difficulty keeping up with demand.
tony caldwell
/
postmedia
public health nurses often contact clients while they are still in hospital after giving birth, even earlier. but the wait for a first home visit is now longer than program officials would like it to be. home visits through the program used to take place within days of a new baby’s birth. now families are waiting three to four weeks or more.
nor can program staff offer support for as long as they used to, el malmi said. previously, families were in the program for at least six months. now, because of staffing challenges, they are given four or five months.
“we can’t reach the same number of families and we are working with them for a shorter period of time,” she said.
those in the program often describe it as a game-changer. “once in a while a client writes to tell me their nurse was an angel and they don’t know what they would have done without her,” gilbert said.
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a client who arrived in canada as a refugee fleeing abuse said the program gave her information about her baby’s growth and development and also connected her with support in the community: from a food bank to a source of baby equipment and government support programs while she was on maternity leave.
“it was really wonderful to work with her,” public health nurse geneviève rousseau said. “she is an amazing mother. she is easy to work with. she is really resourceful, and, even when days are hard, she is smiling.”
but el malmi said there are many more people with needs who won’t get that kind of support. the cost of that is high. she cites research showing that such interventions can have positive impacts on children’s futures by helping them overcome other stressful or traumatic childhood experiences.
“we are helping to mitigate some of those risk factors and reduce costs to the social and health systems,” she said.
“the potential impact of the budget limitation on families who rely on our service is significant.”
among other things, the program is working on a pilot project with montfort hospital to help people with early signs of post-partum depression get help.
the program has already cut back on some programs, including prenatal classes and pregnancy circles.
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ottawa’s board of health recently heard that funding for the program was not keeping up with population growth and demand, forcing it to adopt a “risk-based approach” and offer services to those with the most complex needs.
“it sounds like vulnerable populations really are impacted,” board member elyse banham said. “it does sound like more funding is needed.”
there was no mention of the program in the ontario government’s recent budget.
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