Austria

Background information

Covering the social determinants of health, such as parenting skills and bonding, the “Frühe Hilfen” (Early Childhood Intervention Programme) addresses ECD with a holistic approach in all of the country’s 9 provinces, covering 64 of 117 districts. Frühe Hilfen is an evidence-based comprehensive model for early childhood interventions. The aim is to support families under strain, during pregnancy and the first years of a child's life, in order to promote healthy early childhood development as well as equitable social and health opportunities by overcoming existing shortcomings in service delivery.

The design of the programme was based on a needs assessment to support target groups, such as socially disadvantaged vulnerable groups, with improved access to a wide range of health and social services. In order to effectively support early childhood development, the programme applies the following innovative approaches:

• reaching families actively and systematically by raising awareness among those in a position to identify and refer families in need;
• providing continuous and comprehensive family support (mostly through home visits) throughout a longer time span – to build up mutual trust, provide a model for bonding, and referring families to specific services within the regional network; and
• strengthening general as well as case-related cooperation and networking (i.e. network management to assist in the establishment and maintenance of regional networks) and a multiprofessional support system that offers a wide range of well-coordinated services for parents and children.

The core elements of this Austrian programme are family support (through home visitors), network management and a multiprofessional regional network. The objectives are pursued by setting up regional networks that proactively reach out to families in need, and referring them to family supporters who identify, together with a family, existing needs and resources. Supporters help families to access a wide range of relevant services. A strong focus on networking contributes to better coordination and efficiency of the health and social care system for the target group.

Achievements and challenges

Frühe Hilfen has been evaluated as having progressed significantly in the establishment of networks, despite its short period of implementation. Families who have received support as well as professionals perceive Frühe Hilfen positively. For the families that it supported, Frühe Hilfen has succeeded in improving their well-being, such as social inclusion, self-esteem, positive family climate, parental skills, health literacy, and in reducing their burdens, such as stress, anxiety, economic hardship, mental strain and social isolation. The programme has a positive impact on the bonding, interaction and relationship between a child and its parent(s) as well as on the development of the child. The data shows that target groups – such as socially/socioeconomically disadvantaged groups, especially families – struggling with multiple burdens are being reached. The home visits by trusted family supporters are identified as a central success factor.

The main challenge faced by the programme is establishing a legal basis and regular funding for Frühe Hilfen to be a routine programme.  As the programme is still quite young, cooperation with some regional network partners needs improvement. Additional challenges include ensuring consistency within the whole country, having a unified single name for the programme, defining universal standards, and allowing adaptations to diverse regional structures. Improvements in evaluating a complex programme, such as the Austrian Early Childhood Intervention Networks with its focus on individual needs and long-term objectives, are needed as well.

Gaps and needs for ECD

Addressing health inequalities is a crucial need for ECD. Frühe Hilfen is designed to address health inequalities and identify regional gaps in the health and social sectors. These gaps prevent families in stressful life circumstances from receiving good support and therefore have a negative impact on the health of parents and children.

Ensuring holistic support for all families in Europe should be prioritized. Depending on the regional structures, different models may be needed. However, evaluation and monitoring of the Austrian model shows that it works and that it could be a best practice example for other countries.