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For Healthy Families, Prevention Begins Before Birth


An innovative program in the U.S. state of Virginia supports thousands of new mothers and their potentially at-risk babies every year, even before they are born.

The mission of Healthy Families is to teach new and expectant moms how to raise happy, healthy children by reaching them in the first three years of their lives, when brain development is at its most formative stage.

Setting the foundation

Vijan is a happy baby. He’s curious, sociable and developmentally exactly where he’s supposed to be for a 13 month old.

Part of that can be attributed to Tina Fontaine, a family support worker with Healthy Families, who has visited Vijan and his mother, Bhawana, since before he was born.

Once a week, Fontaine arrives armed with books and everyday objects she uses to teach the first-time mother how to encourage her baby’s development.

With Vijan's mother Bhawana looking on, family support worker Tina Fontaine uses play time to help develop the baby's motor skills. (VOA/J. Taboh)

With Vijan's mother Bhawana looking on, family support worker Tina Fontaine uses play time to help develop the baby's motor skills. (VOA/J. Taboh)

During this visit, she introduces a tin container with a slit on the plastic cover and encourages Vijan to push poker chips through it. But the baby prefers to take the chips out instead, and that’s just fine with Fontaine.

The idea she says, is to use simple activities to promote motor development and problem solving. And if the baby wants to take the lead, she’s all for it.

Building a bond

The main purpose of these sessions, says Fontaine, “is to build a bond between the parent and the child and to help the child get ready for pre-school.”

By helping these children maximize their social and cognitive development during the early years, the program is also setting the foundation for success later in life.

Part of that effort includes reading, and Fontaine appears delighted when Vijan climbs into his mother's lap and becomes absorbed by a book she reads to him.

"Even though they don’t understand it, it’s a feeling, a sense of warmth, that they get from sitting in the parents' lap - whether it’s the mom or the dad - and reading," Fontaine said. "That kind of a child, as they grow up, develops a love for reading."

For Bhawana, a recent immigrant from Nepal, being new in a country without many relatives was overwhelming at first. But she says Fontaine taught her "everything."

“She’s like my sister," Bhawana said. "She’s always coming and plays with us, play[s] with my baby and she’s like my family member.”

Early start

Fontaine's next visit is with Eboni Vaughn. The soon-to-be single mother, 19, is five months pregnant with her first baby and has been seeing Fontaine every two weeks for the past several months.

Fontaine provides pre-natal advice and educational materials and will continue with frequent visits through the baby's third birthday.

Vaughn looks forward to Fontaine’s visits. “I don’t have someone I can come home to and talk to daily about what’s been going on, so with Ms. Fontaine coming, I can express ‘This is what I’m going through, this is how I feel.’ She won’t judge me or the situation. She just gives me the best advice.”

An ounce of prevention

The Healthy Families home visiting program is run by Northern Virginia Family Service, a non-profit organization that serves 30,000 people annually.

“We’re so good at putting money into prisons or into remedial education, into juvenile detention but not into prevention," said Mary Agee, president and CEO of the organization. "We know the factors that go into creating those negative outcomes, so why not avoid those in the first place?”

The home visiting program, which began in the 1990s, has reached more than 7,000 families, according to Agee.

“The majority of all of our children are testing on target when they enter kindergarten," she said. "We can show that over and over and over again that this program, this type of home visiting, works to mitigate any opportunity of a child not succeeding."

Agee says the organization's goal is to ensure that Healthy Families reaches everyone who needs its services at the start of their family's life.

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