Bulundidi Gudaga: The Impact of Epidemiological and Intervention Research on Maternal and Child Health Service Policy and Program Delivery for Australian Aboriginal Families in an Urban Community and Beyond

The Gudaga study, a longitudinal birth cohort study of urban Aboriginal children, commenced in 2004 and continues to follow the health and development of 149 Aboriginal children born in the local area. This study was initiated by the elders of an Aboriginal community in South West Sydney who approached the researchers with a concern for the number of SIDS deaths and other poor early childhood outcomes evident within their community. They hoped that research data would support their appeals for Aboriginal specific and culturally sensitive maternal and child health services. The Gudaga study confirmed their concerns, documenting high rates of SIDS (2.01), birth prematurity (13.4%), small babies for gestational age (11.4%), and high hospital/emergency service use (35%). Low rates of breastfeeding at hospital discharge following birth was also documented (53%).

In response to this data, a culturally appropriate sustained nurse home visiting program was developed and trialled with vulnerable and at risk Aboriginal mothers and infants within the local community. This program, known as Bulundidi Gudaga (healthy pregnancy, healthy baby), is based on the MECSH (Maternal Early Childhood Sustained Home Visiting) model, which commences antenatally and continues until the child is 2 years old. The research trial employed a quasi-experimental design, comparing Bulundidi Gudaga families with the Gudaga data (historical control), and non-Aboriginal families receiving the same program. Birth outcome data from this trial demonstrates significant improvement in maternal and child outcomes, with less premature births (7.1%), less low birth weight babies (5%), and higher rates of breastfeeding at hospital discharge (68.9%).

Bulundidi Gudaga is being delivered by child and family nurses and Aboriginal health workers employed within the local area health service. This program is now embedded in the publically provided range of services available to families by the government funded health service. The strength of the research has prompted change in the health service system to accommodate this model of working with families. The research has also significantly influenced area health policy in relation to the engagement and support of Aboriginal families within the health service. The Gudaga/Bulundidi Gudaga research journey provides an excellent example of the way in which Indigenous community – research partnerships can significantly influence public health policy.