IBSER continues its series of local government best practices: building a system of early support for families: the experience of Andrushivka community in implementing home visiting services

We continue our series of publications highlighting good practices of territorial communities and demonstrating how local policy decisions can help develop services and improve their accessibility for residents. This time, we present the experience of Andrushivka Urban Territorial Community in Zhytomyr Oblast, which is implementing a universal progressive home visiting model — a patronage service for families with children from birth to the age of three.
The first three years of a child's life are particularly important for their physical, cognitive, emotional and social development. During this period, it is essential not only to monitor the child's health but also to identify potential risks at an early stage, support parents and help families access the medical, social and psychological services they need.
The universal progressive home visiting model addresses these needs. In Ukraine, it is being implemented as part of the Care from Birth at Home programme, a joint initiative of the Ministry of Health of Ukraine and the United Nations Children's Fund (UNICEF).
From medical patronage to comprehensive family support
Unlike traditional medical patronage, the universal progressive model takes a broader approach to the needs of children and their families. During home visits, specialists assess not only the child's health and development but also their upbringing environment, home safety, nutrition, breastfeeding, vaccination, the mother's emotional and psychological well-being, and potential social risks.
If a family requires additional assistance, it is referred to the relevant medical, social, psychological or rehabilitation services. In this way, a home visit becomes an entry point to a comprehensive support system rather than simply a form of medical monitoring.
How Andrushivka Community organised the implementation of the model
The good practice developed by Andrushivka Community lies in the local adaptation and institutionalisation of the universal progressive model — creating the organisational, regulatory and human resource conditions necessary for its sustainable operation.
The process began with establishing the required management and regulatory framework. In particular, on 26 February 2024, the Mayor issued an order establishing a multidisciplinary team comprising representatives of the healthcare, social services, psychological support and education sectors. The coordination of the team's work was assigned to the Centre for Social Services.
An important step was the signing of a Memorandum of Cooperation between the Primary Health Care Centre and the Centre for Social Services. The document established the procedures for joint home visits, cooperation between specialists and the allocation of responsibilities.
In addition, the community's executive committee approved a Procedure for Interagency Cooperation in Identifying and Organising Social Services for Children and Families Belonging to Vulnerable Population Groups or Experiencing Difficult Life Circumstances. It sets out procedures for identifying needs, assessing individual situations, forming multidisciplinary teams, referring families to services and coordinating cooperation between the institutions involved.
The model was also incorporated into local programme planning. The Programme for the Development and Support of the Healthcare Sector of Andrushivka Urban Territorial Community for 2025–2027 provides for the implementation of the universal progressive home visiting model as part of the local system for early childhood development.
Trained professionals and coordinated support for families
The next stage focused on preparing the team. Throughout 2024, community specialists took part in UNICEF training on implementing the universal progressive home visiting model and early intervention. In total, the team participated in 21 training sessions.
The specialists also received methodological support and equipment, including tablets, multifunctional devices, power banks, specialised literature and developmental equipment for working with children.
The practical implementation of the model involves joint home visits by healthcare and social service professionals. During these visits, specialists conduct a comprehensive assessment of the needs of the child and family, considering the child's health and development, the mother's health, living conditions, home safety, parenting skills and potential social risks.
Following the assessment, a family needs assessment report is prepared and an individual support pathway is defined. Depending on the family's circumstances, support may include psychosocial assistance, social case management, consultations with a psychologist, speech therapist, doctor or other specialists, as well as referrals to relevant medical, social or educational services.
This approach makes it possible to go beyond simply identifying a problem: it helps ensure that the necessary specialists and services are involved in a timely manner and that support is tailored to each family's specific needs.
Monitoring and planning for the sustainability of the service
Andrushivka Community has also placed particular emphasis on monitoring. The established system includes tracking the number of families reached, the results of needs assessments, referrals, support provided and follow-up assistance.
This data is intended to inform assessments of interagency cooperation, service development planning and management decisions. After all, the number of home visits alone does not demonstrate the effectiveness of the model. It is equally important to understand whether families have received the assistance they need, whether risks have been identified in a timely manner and whether access to services has improved.
Another important aspect is financial sustainability. Implementing the model requires coordination between local targeted programmes, budget programmes and the resources of the institutions involved. Communities need to identify in advance which costs will have to be covered by the local budget once external support ends, and assess their needs in terms of staff, transport, equipment and other resources.
What can other communities learn from this experience?
The experience of Andrushivka Community demonstrates that implementing the universal progressive home visiting model is about much more than introducing a new service. It involves creating a comprehensive local support system for young children and their families.
The following steps may be useful for other communities:
● assess the needs of families with young children and review the available medical, social, psychological and rehabilitation services;● identify the responsible service providers and establish a multidisciplinary team;● formally define interagency cooperation mechanisms, including information exchange, referrals and family follow-up;● provide professional training and the necessary equipment for specialists;● include service funding in local programmes and budgets;● introduce a monitoring system that measures not only the number of visits but also the accessibility and outcomes of support provided to families.
At the same time, it is important not to replicate individual elements of the model without considering local circumstances. Each community should adapt it to its own needs, human resource capacity, infrastructure and financial resources while maintaining its core principles: early identification of risks, basic support for all families with young children, more intensive assistance according to individual needs, and intersectoral cooperation.
For more details on the organisational decisions, implementation stages, monitoring and budget planning behind the universal progressive home visiting model in Andrushivka Community, see the full good practice report.