Home Visiting Urged to Curb Infant Deaths : Health: U.S. study says the practice could improve well-being of youngsters and reduce instances of child abuse and neglect.

Home visiting--a system used widely in Europe for educating and counseling pregnant women and young mothers--can be effective in reducing many of the conditions and practices that lead to infant mortality, a new federal study has found.

The study, released Monday by the General Accounting Office, found that home-visiting programs can improve the short- and long-term well-being of children and families, enhance birth weight, reduce child abuse and neglect and increase immunization rates.

But not all home-visiting programs work, the study noted. The agency called for better coordination of pilot programs now being tried by federal agencies, and for greater emphasis on designing programs along the lines of past successes.

“These programs are effective because they recognize that infant mortality and many childhood health problems are social as well as medical issues,” said Lawton Chiles, a former U.S. senator who now heads the National Commission to Prevent Infant Mortality.

“Giving a mother a Medicaid card in no way guarantees that she will get the care or information she needs to improve her health or that of her family,” he said. “Home visiting creates a bridge between the family and the services they need.”

The agency recommended that Congress expand the Medicaid health insurance program for the poor to include coverage, where necessary, of prenatal or postpartum home-visiting services for so-called high-risk mothers and high-risk infants up to age 1.

Home visiting is offered free to almost all families with young children in Great Britain and Denmark and is a common part of maternity care throughout Western Europe. In the United States it is not routine; it is offered by some agencies to families with special needs.

Head Start, for example, runs the largest home-visiting program for low-income families in the United States. Surveys suggest that U.S. home-visiting programs have stressed education and social services rather than disease prevention and good health.

Home visiting can be done by nurses, social workers, nutritionists and trained lay workers.