Regional Initiatives: Building Health and Wellbeing in the First 1000 Days
Indigenous infants in Australia and Indonesia can benefit from early life health and wellbeing strategies that are culturally protective, place-based and community driven. Approaches that start from the parents’ adolescence and that support and build the roles of both male and female carers, especially in terms of mothers’ mental health, will strengthen foundations for Indigenous children so that they are able to grow and thrive.
This project examined the holistic prevention of non-communicable diseases (NCDs). It focused particularly on a child’s first 1000 days of life – from conception to age two – and on families in the Indigenous communities of Australia and Indonesia.
The University of Melbourne, First 1000 Days Australia, Universitas Indonesia and Universitas Pertanian Bogor were key partners in the study, which brought together 50 health workers, policy makers and government and NGO representatives for two roundtables – one in Indonesia, one in Australia.
Both Indonesia and Australia are home to many different Indigenous groups, speaking hundreds of languages and each valuing their diversity of culture and history. In Indonesia, unlike in Australia, the definition of ‘Indigenous’ is still contested; it remains difficult to define ‘Indigenous’ and simultaneously accept the ethnic and cultural diversity within the different groups and cultures.
Of primary importance within Indigenous communities in both countries are the strengths of community and family. If community and family are valued, strengthened and economically empowered, families will have what they need to bring up strong healthy children.
Participants concluded that the most important factors in a child’s health and wellbeing are their parents having a strong foundation in health and family planning, quality learning opportunities, and empowered families and communities. The project’s recommendations reinforce the need to take different cultural, linguistic, and socioeconomic contexts into account when making decisions on policy, training and service provision for Indigenous infant health.
Greater understanding of communal living scenarios is needed. A broad, non-biological definition of family is crucial, inclusive of any and all immediate carers of a child. Families also need to be economically strengthened so they are able to enact their own agency.
More focus is called for on the mental health conditions faced by mothers before, during and after pregnancy. Also predominantly affecting women, and pregnant women even more so, is domestic violence. These two factors have a substantial influence during and after pregnancy, and need to be considered in any approach to combating NCDs. However, the First 1000 Days model should emphasise the positive impacts that valuing men as fathers, caregivers and role models has on the health and wellbeing of the child. KASIH, a program for supporting soon-to-be fathers in Jakarta, is already showing signs of popularity and success.
Programs for children prior to school and kindergarten have been shown to have immeasurable benefits, and there should be universal access to appropriate early learning resources. One recommendation is for the development of culturally relevant assessment tools to ensure that developmental delays and other conditions are being noticed and responded to.
Increased adolescent education on the requirements for a healthy pregnancy, infancy and childhood, alongside skills, leadership and capacity building, will result in healthier parents and healthier children. There should also be further exploration of the various reasons (cultural, social and economic) for early marriage and sexual debut.
Solutions must be place-based and should strengthen the community through their process. This is, in part, to combat the separation from culture and identity caused by ongoing colonisation and dispossession of Indigenous communities. This includes exploring traditional practices that could help promote healthy practices and prevent NCDs, and employing innovative communication methods for reaching families who struggle with literacy or who live in remote areas.
Professor Kerry Arabena
Chair for Indigenous Health and Director of the Indigenous Health Equity Unit
The University of Melbourne
Dr Indah Widyahening
Lecturer, Faculty of Medicine, Community Medicine Department