Innovative support provided at the right time

20 October 2021, Kikinda, Serbia – Thirty-three-year-old Sandra Obucinski is Stefan’s mother. While getting ready to celebrate his first birthday, she recalls how much Olivera, a visiting nurse, helped and supported her after her miscarriage, but also in her second pregnancy during the COVID-19 pandemic. Since Stefan’s birth, because of COVID-19 prevention measures, Olivera has been supporting Sandra’s parenting journey through video calls.   

“From the first contact with Olja and the visiting nurse service, I had great help. We talked online, did exercises together, we talked about childbirth, we did breathing exercises. We talked about what I should expect when I go to the hospital, and what I should do if my water breaks before that. She prepared a list for me. She really helped,” Sandra recalls.

Olivera, whom everyone calls “our Olja”, has been working in the visiting nurse service for 8 years. Over the years, she has supported hundreds of future parents, but also new parents and babies. The pandemic has led to a sharp increase in the need of families for the continuous support of the visiting nurse service, including how to take care of their own physical and mental health and provide nurturing care to their young children. That is why video counselling during the COVID-19 crisis, when parents were not able to be in contact with other family members or go to a gynaecologist and paediatrician, proved to be extremely important. 

“I think it was the most useful for pregnant women because they were scared the most. These video calls were important because they could contact me. They called me individually and I told them what they can expect during and after childbirth,” explains Olivera.

Video counselling particularly helped parents who were expecting a baby or already had a child to get support from visiting nurses, even when there was a case of a COVID-19 infection in the family. Olivera says the benefit was mutual. 

“With COVID-positive families who had a newborn, we had two visits in person, in full protective gear. The other three visits were organized via video calls. The mom shows us the baby during the video call, we even see the navel and explain what needs to be done. Last year they would very often call us outside of our working hours for advice. It meant a lot to them, but it also meant a lot to us because we could fully keep track of the family. So, the families were not neglected,” explains Olivera.

“I think it was the most useful for pregnant women because they were scared the most. These video calls were important because they could contact me. They called me individually and I told them what they can expect during and after childbirth,” explains Olivera.

Older children also benefitted from video calls. During a Zoom call, two-year-old Jovana is showing Olivera how she can make balls from her and her dad’s socks, which Olivera taught her to do while the family was in quarantine in March last year. Jovana’s mother, Dejana Miletin, says that the family was not neglected in those difficult times. 

“The activities she sends us are very helpful. It’s all the things we can do with children depending on their age. It’s really interesting,” says Dejana

The Obucinski and Miletin families are among the over 30,500 families who, for the first time, worked remotely with 143 visiting nurses in the last 14 months via video calls.

The goal of video counselling is to empower parents during the first days and years of a child’s life, when the brain is developing at a rapid pace, setting the foundations for future health and education outcomes.     

“With parents of newborns, I work on breastfeeding, care, bathing the baby, swaddling, introducing the father and mother to everything that awaits them. And when I work with the family of a child up to one year of age, with an infant, then I have two visits and I follow the growth and development at that age. I follow motor development, fine and gross motor skills, communication. Based on that, together with paediatricians, we can give guidelines on what to work on,” explains Olivera. She says she uses every opportunity, in person and online, to emphasize to moms and dads the importance of early stimulation, play and responsive care for a baby’s development.

“Olja counselled us that the most important thing for our baby, apart from hygiene and food, is cuddling, touching, talking, and involving him in everyday activities. Going to see our friends, for daily walks, going to the store,” says Sandra emphasising that the best toy for a new-born is their parents face and voice, and these interactions can be built during the daily routines.

Visiting nurse services, both before and during the COVID-19 pandemic, encourage fathers to become more involved in all activities and responsibilities around children.

“Olja’s help was invaluable when my wife Sandra went to give birth. She helped her to overcome her fear. Through those online sessions, Olja helped Sandra overcome her fear of giving birth. She helped us a lot, with how to interact with our child, how to help Stefan burp, how to bathe him. She gave us a sense of security. I’ve been bathing Stefan from day one. I just love bathing my child. I enjoy it,” Vladislav explains.

Everyone agrees that visiting nurses provide invaluable, timely, high quality, and focused support, be it online or in person.

“I think video calls are important for our service and I believe we will manage to make them not just a project, but an integral part of our work,” Olivera is hopeful.

The work of the visiting nurse service during the pandemic resulted in the Institute of Public Health of Serbia - Dr Milan Jovanovic Batut issuing the National guidelines for the work of the visiting nurse service during the COVID-19 pandemic. The Guidelines introduced preventive protection measures during the fieldwork, but also prescribe video counselling work, which is the first step towards the institutionalization of this service. It cannot and should not replace home visits, but it is important for ensuring the continuity and efficiency of support in situations when a home visit is not possible. 

Since June 2020, 18 Primary Health Care Centres have received support for quality video counselling with families. The strengthening of the professional capacities of the visiting nurses was led by the Polyvalent Visiting Nurse Service of the Novi Sad Primary Health Care Centre and Harmonija - the Centre to Support Early Childhood Development and Family Relations from Novi Sad in cooperation with UNICEF and the Ministry of Health.

This work was carried out with the generous support of the LEGO Foundation, while the provision of mobile phones and internet was supported by the United States Agency for International Development (USAID) and the European Commission’s Directorate-General for European Neighbourhood Policy and Enlargement Negotiations (DG NEAR).

Written by Ivana Miljković