A programme supporting minority ethnic women during and after pregnancy is just one of Coventry City Council’s early interventions which are having a positive impact on healthy choices.
The challenge
Child obesity levels in the city are higher than the England average, with around 10 per cent of Reception children and 23.6 per cent of Year 6 children classed as obese. Excess weight levels are higher in areas of greater deprivation and among the BME population. As a Marmot City, addressing health inequalities is a key priority for the city.
While there are many examples of positive engagement and joint working at the operational, front line level, the challenge is supporting the sustainability and resilience of organisations to carry the work forward, which would benefit from a more robust, systems-based approach to a population based, healthy weight ambition.
The approach
Coventry’s 0-19 Family Health and Lifestyles Service includes the Family Nurse Partnership, Health Visiting, Infant feeding, Family Weight management and School Nursing. It went live in September 2018 and aims to create a more seamless service for families.
One element is the ‘MAMTA’ Child and Maternal Health Programme which supports minority ethnic women during and after pregnancy. It is a culturally sensitivity service, to which mothers are referred, offering education and support on, parent education, breast feeding, introduction to solid foods, portion sizes and healthy eating. Universal support on the same issues is provided through eight family hubs offering early help.
As part of the 0-19 service, school nurses have initiated the use of a school health questionnaire to collect data from pupils. This informs the development of health promotion programmes in Year 6 and 9 and there are plans to implement this approach at reception age.
Early work on developing a systems-based approach resulted in an application by the council to become a Childhood Obesity Trailblazer. Although unsuccessful, the bid has led to a local pilot in the Foleshill area of the city, which has contributed to securing Sport England Funding. This involved intensive work with partners such as schools and family hubs. This is now under evaluation.
Over the same period, the Coventry and Warwickshire Year of Wellbeing in 2019 involved a whole programme of work with schools to build a framework around increasing children and young people’s daily activity levels and knowledge.
Other work with a bearing on healthy weight includes a system of regular multi-agency meetings where practitioners, health professionals, children’s services and others come together to discuss how to support children and families’ health needs, including excess weight concerns. This has been established across the city and has been working effectively to help families at a much earlier stage.
The impact
More than 90 per cent of MAMTA users who were tracked during the post-natal period were still breastfeeding at 6 to 8 weeks. Many case studies from the programme provide evidence of a positive impact.
The Year of Wellbeing garnered widespread support and involved six school consortium meetings and face-to-face conversations with more than 90 schools. Some 150 children were trained to help promote physical activity and wellbeing. Other initiatives included Activity Maths, which used physical activity to teach numeracy, a Marathon Kids running programme, increased uptake of the Daily Mile and engagement with wider community and families with numerous events and festivals attended by hundreds of people.
Survey findings revealed that 75 per cent of schools had implemented new activities during 2019 and 93 per cent were keen to have continued engagement. All schools wanted some support to help upskill and develop staff.
Lessons learned
The council undertook a new procurement process for the 0-19 service - ‘dialogue with negotiation’.
“Dialogue sessions between commissioners and potential bidders allowed commissioners to articulate the vision and allowed bidders to test ideas, stimulating innovative solutions and refining ideas before submission of the final proposal,” said Harbir Nagra, Programme Manager in Public Health “It is not the traditional commissioner provider relationship - it really feels like a partnership and continuous improvement is a high priority for the service.”
How will the approach be sustained?
The Children and Young People’s Partnership Board has healthy weight as one of its priorities. Public Health is endeavouring to move forward a systems-based approach and ensure a population based healthy weight ambition is robustly written into policy and strategy across the areas of responsibility of the Council.
This approach will be taken forward by the new Our Healthy City Board.
Councillor Kamran Caan, portfolio holder for Public Health and Sport: “There are lots of proactive initiatives in Coventry working to tackle child obesity, which has been a key area of focus for many years.
“We are working hard alongside our partners including the Family Health and Lifestyle Service and on projects like ‘Coventry on the Move’ in parks, as well as the Year of Wellbeing last year to increase physical activity among children and in families.
“All of these areas of work represent an investment in our city, encouraging and supporting families and children to take steps to live healthier more active lives”.
Contact
Harbir Nagra, Programme Manager, Public Health Coventry City Council