Nurse-Family Partnership is a decades-old program in which registered nurses visit poor, first-time single mothers, starting early in their pregnancies and continuing until the child turns two. The nurses nudge the mothers to give up smoking and drinking, give them tips on child development, and answer questions about their own health or that of their children.
In the U.S., Nurse-Family partnership is considered “proven” to work. It’s gone through three randomized trials with big sample sizes—400 to 1,189 women—and it has consistently shown to boost the health of the mother, to improve the child’s well-being and safety, and to curb preventable deaths. One recent analysis found that though the program costs only $1.6 billion, it will save the federal government $3 billion in spending on things like Medicaid and food stamps by 2031. It’s already up and running in more than 600 U.S. counties, and a provision of the Affordable Care Act offers the states $1.5 billion to expand home-visiting programs like NFP.
That’s why a new study published in the Lancet is so surprising. The U.K. has a similar program, called, somewhat confusingly, Family-Nurse Partnership. The British government thought it was working so well that in 2013 they expanded it. But the results of a randomized trial involving 1,645 mothers, published last week, found that the program did basically nothing. Just as many moms who were visited by nurses had a second pregnancy within two years. More of the kids who were receiving the nurse visits wound up in the hospital than those in the control condition.