Philanthropic Support as a Path to Government Funding in Politicised Times – A Case Study

As politics polarises, there is a growing need for apolitical funding to trial new ideas and provide independent evidence for government investments in system-changing programs. The right@home sustained nurse home visiting trial demonstrates that philanthropic funding is perfectly placed to fill this role, writes ARACY CEO Penny Dakin.

Anyone working in the for-purpose sector can tell you that money is tight. It’s not a new problem, and it’s not one that’s going to go away. Equally the demands on funds continue to grow in many areas.

For example, a 2016 ACOSS survey found 17.4 per cent of all children in Australia are living in poverty, an increase of two percentage points over the past 10 years. In 2016 the AEDC showed that more than one in five Australian children are considered developmentally vulnerable at the time they enter kindergarten. More recently the 2018 ARACY report card found increasing rates of mental illness among young Australians.

With money scarce and the task growing, we need to ensure every taxpayer dollar has the maximum benefit, not only for those in whom it is invested, but also for those doing the investing. This means developing and trialling programs underpinned by robust research and continuing to monitor the outcomes.

It can be difficult for governments to undertake this work. Tight budgets don’t lend themselves to speculative research and the difficulty of testing in an increasingly hostile political climate cannot be underestimated. In our system of realpolitik, governments have little option but to only back winners.

The right@home trial has become an example not only of good research practice (being featured in the Annals of the New York Academy of Science and the Official Journal of the American Academy of Paediatrics) but also of how philanthropic funding can provide governments with the evidence they need to make important investments in times of growing ideological polarisation.

The right@home sustained nurse home visiting trial is a research collaboration between the Australian Research Alliance for Children and Youth (ARACY); the Translational Research and Social Innovation (TReSI) Group at Western Sydney University; and the Centre for Community Child Health (CCCH), which is a department of The Royal Children’s Hospital and a research group of Murdoch Children’s Research Institute.

The program identifies pregnant women who face an increased likelihood that their babies will be developmentally disadvantaged by the time they start school. The program offers at least 25 home visits beginning before birth and up until the child turns two. Each family receives visits from the same nurse with specialist right@home training. The program gives nurses the time and skills to gain trust and build a strong relationship with the family, and to give personalised support and advice on parenting and child development.

Around 700 families took part in the largest randomised controlled trial (RTC) ever seen in Australia, under which we tested right@home in Tasmania and Victoria, against the standard Community Family Health (CFH) service. The standard service offers six (Tasmania) or nine (Victoria) child wellbeing checks delivered by community‐based nurses in the first two years.

Because of the research-based design work we had put into right@home we were confident it would be more effective than standard programs. But before we asked taxpayers and ministers to invest more in this program than they would in standard programs, we had to test it to be sure. And so the right@home trial was developed.

The right@home trial was funded through grants from the Sabemo Trust, the Ian Potter Foundation, the Sidney Myer Fund and the Vincent Fairfax Family Foundation in conjunction with the Victorian and Tasmanian governments.

In phase one we tested whether right@home makes it easier for parents to learn about things like feeding, parenting and managing their baby’s sleep. When children turned two years old, the study evaluated the impact of the program on parent care, parent attunement and responsivity and supportive home learning environment. Early results are positive. By the time the child reached two, parents receiving the program were more likely to engage in warm parenting, support their child’s learning, maintain a regular bedtime for their child and create a safer and more socially varied home environment. The mothers also felt more confident in their abilities as parents.

In phase two we are looking for long-lasting effects of right@home on children’s early learning and development at the time they start school. From age three onwards we are able to conduct research on child language and development measures. This is an opportunity to follow the impacts of right@home until school entry, as well as to gather important demographic, observational and behavioural data on an engaged and responsive cohort of research participants.

This follow-up research will continue until children turn six. It is supported by the Ian Potter Foundation, the Sidney Myer Fund, the Vincent Fairfax Family Foundation and the NHMRC.

A mountain of evidence tells us that the early years are critical in setting a child’s lifetime trajectory. For example, the Strong Foundations: Getting it Right in the First 1000 Days Partnership led by ARACY, found that children exposed to adverse environments and experiences early are likely to continue to be exposed to such experiences, and that changes or adaptations made during the first 1,000 days can have lifelong effects. Adult conditions such as coronary heart disease, stroke, diabetes, and cancer are now being linked to pathways that originated prior to or during the first 1,000 days.

The evidence is clear that by investing in helping kids get off to a good start, the costs to the community in areas such as healthcare, homelessness and unemployment can be massively reduced. This fact was recently recognised by the UK government which announced the establishment of a cross-government working group to review how to better support families in the period from birth to the age of two.

Responding to this evidence we must seek the most effective means of investment to tackle a particular problem. Our trial is gathering the evidence to prove to governments across Australia that right@home is an effective investment in our children.

These trials have only been possible because of the availability of independent philanthropic funding which has allowed ARACY and our partners to not just develop a new approach, but to test it in an independent and apolitical environment, to build the evidence that will assure governments that this program really does pay dividends for the families involved and for those funding it – the taxpayer.

Philanthropic funding has been central to our ability to do this.

About the author: Penny Dakin was appointed as ARACY CEO in January 2019 having acted in the role since mid-2018. Penny has previously worked as general manager for policy and strategic engagement with ARACY. She has also worked in senior capacities and with organisations including Insight Consulting, the Australian government Department of Health, and A Village for Every Child. Penny also sits on a number of other boards.