March 2025 Board of Health Meeting - Healthy Babies Healthy Children (HBHC) Program Information Report

PREPARED BY: Healthy Families

DATE: March 20, 2025

SUBJECT: Healthy Babies Healthy Children (HBHC) Program

BACKGROUND/PURPOSE

According to  the Ontario Public Health Standards, the board of health must provide all components of the Healthy Babies Healthy Children (HBHC) Program in compliance with the HBHC Program Protocol (2018).  The HBHC program is a family-centred, voluntary home visiting program fully funded by Ontario’s Ministry of Children, Community and Social Services (MCCSS).  The program aims to optimize the growth and development of children encompassing physical, cognitive, communicative, and psychosocial aspects by providing prevention, early identification, and intervention services to those identified as at risk. This program serves those who are pregnant, their families and families with young children from birth until they transition to school.

Key components of the HBHC program include:

• Screening to identify risks to healthy child development.
• Referrals and connections to appropriate community resources, programs and services.
• A blended home visiting service encompassing Public Health Nurses, Family Home Visitors, Lactation Consultants and Social Workers. 

There are three entry or referral points to the HBHC program: prenatal, postpartum (birth until 6 weeks postpartum), and early childhood (6 weeks of age until transition to school). Most referrals are obtained through the HBHC screening conducted at the time of birth by Family Birthing Centres in local hospitals. Other common referral sources include health care providers (e.g. obstetricians, nurse practitioners, pediatricians), community organizations (e.g. settlement agencies, Children’s Aid Society), and self-referrals. Families must provide consent to participate in the HBHC program and can withdraw at any time. 

DISCUSSION

Early childhood growth and development lay the groundwork for lifelong learning, behaviour, health and well-being (Best Start Resource Centre, 2015).  The HBHC program is provided to families identified with risks that may compromise parental and family health, such as adaptation to parenting, parenting capacity, and child growth and development.  Public Health Nurses visit the families regularly and act as service coordinators to collaborate with Family Home Visitors, Lactation Consultants and, Social Workers to implement evidence-based interventions. These interventions support vulnerable families in achieving their identified family-centered goals. Some of the goals in the program include optimal prenatal health, healthy attachment, optimal growth and development, positive parenting, etc. Early interventions, support families in optimizing their child’s growth and development potential, leading to improved health outcomes throughout the life cycle.

The WECHU’s HBHC team, along with other Health Units, have observed that families participating in the HBHC program are facing heightened vulnerabilities such as:

• Complex mental health needs
• Substance use
• Inability to access a primary health care provider
• Lack of social support
• Food insecurity
• Unaffordable housing.

The number of HBHC screens conducted has been steadily increasing over the past years (see table below). Through HBHC screening, roughly 60% of families are found to have potential factors that can impact growth and development outcomes for children. Top risk factors include complications during labour and birth, previous loss (pregnancy or baby), pregnancy conditions/complications, mental health history, drug use during pregnancy, etc.  (Better Outcomes Registry Network (BORN), 2025). The number of families participating in the HBHC program has also been increasing. This is as a result of an increase in referrals and in-depth assessments; and increased findings of confirmed risk.  

The above information highlights the value and need of the HBHC program for vulnerable families in Windsor-Essex County. BORN has developed an infographic,  “A TALE OF TWO FAMILIES” which illustrates the positive impact that the  HBHC program can have on families  involved in the program.  HBHC is a program designed to help children in Ontario have a healthy start in life by providing families with supports so their children can reach their potential.