A program offering First Nations women in two regional NSW communities a plaster cast of their bellies towards the end of their pregnancies has transformed health outcomes for children and mothers.

When Child and Family Health Nurse Nicki Callan began working in  the  central  NSW communities of Warren and Trangie, she found they had been without a child and family nurse for 12 months and 18 months respectively.

“A child family health nurse in a rural and remote community is often the first point of call for assessment and appropriate referral pathways,” says Nicki.

However, she noticed many families were not accessing services and many children were falling behind on immunisation schedules and other health measures.

To help build a positive relationship with new mothers, and create trust in health services, Nicki and her colleagues came up with the creative idea to offer mothers in their final weeks of pregnancy a session taking a plaster cast of their pregnant belly.

Working closely with Mary Small, an Aboriginal Health Worker, and Emma Howard, an outreach midwife, Nicki began meeting with mothers who took up the offer of a belly cast in their final trimester.

Making the belly cast takes around half an hour, explains Nicki, who would normally only see mothers and babies after birth. “It’s a really amazing positive tool where you can engage with the mother, who now feels more comfortable and supported to come back to you and use our services.”

INVOLVING COMMUNITY IS WOMEN’S BUSINESS

The first group of women who took part in the program were led by Wayilwan elders in painting classes. The mothers-to-be decorated their casts with stories that are meaningful to them. “While they painted their casts, they were discussing women’s health and traditional women’s health knowledge and women’s business,” Nicki explains.

The first group met over a two-month period, and the project culminated in an exhibition of casts at Warren Art Gallery and Museum that was launched with Indigenous dancers and celebration in language.

“Mothers and the families are coming back to use our services, and they are bringing their babies to be immunised,” Nicki says. “And they are reaching out with concerns they may have about their little ones.”

In mid-2023 the Warren LGA achieved a 100 per cent immunisation rate. When new mothers return to use her service, Nicki will talk to them about any health concerns and make GP referrals for issues such as post birth infections in mum and baby or poor baby weight gain.

However, Nicki still faces an uphill battle working in a regional area that lacks services and specialists who can work with children who need extra support.

When she began working in the Warren area, the local paediatric unit told her due to staffing levels, they were unable to see any child with a developmental or behavioural delay.

Nicki contacted two local preschools to identify children with speech delays and any other needs for extra supports. And working with the local NDIS provider and other funders, she has been since been able to access speech and occupational therapy for children that had previously not received any services.

She is now working with the Royal Flying Doctor Service on a plan she hopes will see a paediatrician servicing the Warren community each month.

DOLLY PARTON BOOK PROGRAM

When she saw many children in the community who needed support to improve their reading and literacy levels, Nicki came up with another creative solution: bringing the Dolly Parton Imagination Program to the community.

“It’s an amazing program where children get a book every month of their life until they turn five, and it’s a great initiative to get kids reading,” explains Nicki.

Nicki, working with Mary and with her manager’s approval, contacted the local council and the local library to establish a branch of Dolly Parton Imagination Library in Warren.

Children in the community now receive books from the program, and any child that comes into the hospital for any reason are offered a book.

“In October 2024 we celebrate our first-year anniversary of the program.”

Nicki and Mary didn’t stop there. Working with the Indigenous Literacy Foundation, they have also organised book deliveries to all children 0 to 18 years that access the Warren Multi-Purpose Services (MPS).

“Working in a rural and remote community we constantly need to look outside the box to provide a referral pathway for a child. We do not have the services of the big cities, but all children should have the right to access health care, no matter where they live.”

The Bellies and New Life project was recognised as a finalist in the Western NSW Local Health District Awards 2023, but Nicki is quick to emphasise that she is not working alone.

“Working within a team, we are strong”, she says. “Working within a community, we are stronger. And working in partnerships is where magic happens.”