Delivery of child health services in indigenous communities

Implications for the federal government's emergency intervention in the Northern Territory

Ross Stewart Bailie, Damin Si, Michelle Dowden, Christine Connors, L O'DONOGHUE, Helen Liddle, Catherine Kennedy, R COX, Hugh Burke, Sandra Thompson, A Brown

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objectives: To describe delivery of child health services in Australian Aboriginal communities, and to identify gaps in services required to improve the health of Aboriginal children. Design: Cross-sectional baseline audit for a quality improvement intervention. Setting and participants: 297 children aged at least 3 months and under 5 years in 11 Aboriginal communities in the Northern Territory, Far West New South Wales and Western Australia in 2006. Main outcome measures: Adherence to guideline-scheduled services including clinical examinations, brief interventions or advice on health-related behaviour and risks, and enquiry regarding social conditions; and recorded follow-up of identified problems. Results: Documentation of delivery of specific clinical examinations (26%-80%) was relatively good, but was poorer for brief interventions or advice on health-related behaviour and risks (5%-36%) and enquiry regarding social conditions (3%-11%). Compared with children in Far West NSW and WA, those attending NT centres were significantly more likely to have a record of growth faltering, underweight, chronic ear disease, anaemia, or chronic respiratory disease (P < 0.005). Only 11%-13% of children with identified social problems had an assessment report on file. An action plan was documented for 22% of children with growth faltering and 13% with chronic ear disease; 43% of children with chronic respiratory disease and 31% with developmental delay had an assessment report on file. Conclusion: Existing systems are not providing for adequate follow-up of identified medical and social problems for children living in remote Aboriginal communities; development of systems for immediate and longer-term sustainable responses to these problems should be a priority. Without effective systems for follow-up, screening children for disease and adverse social circumstances will result in little or no benefit.
Original languageEnglish
Pages (from-to)615-618
Number of pages4
JournalMedical Journal of Australia
Volume188
Issue number10
Publication statusPublished - 2008

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Northern Territory
Child Health Services
Federal Government
Emergencies
Chronic Disease
Ear Diseases
Social Conditions
Social Problems
Guideline Adherence
Western Australia
South Australia
New South Wales
Thinness
Health
Growth
Risk-Taking
Quality Improvement
Documentation
Anemia
Outcome Assessment (Health Care)

Cite this

Bailie, R. S., Si, D., Dowden, M., Connors, C., O'DONOGHUE, L., Liddle, H., ... Brown, A. (2008). Delivery of child health services in indigenous communities: Implications for the federal government's emergency intervention in the Northern Territory. Medical Journal of Australia, 188(10), 615-618.
Bailie, Ross Stewart ; Si, Damin ; Dowden, Michelle ; Connors, Christine ; O'DONOGHUE, L ; Liddle, Helen ; Kennedy, Catherine ; COX, R ; Burke, Hugh ; Thompson, Sandra ; Brown, A. / Delivery of child health services in indigenous communities : Implications for the federal government's emergency intervention in the Northern Territory. In: Medical Journal of Australia. 2008 ; Vol. 188, No. 10. pp. 615-618.
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abstract = "Objectives: To describe delivery of child health services in Australian Aboriginal communities, and to identify gaps in services required to improve the health of Aboriginal children. Design: Cross-sectional baseline audit for a quality improvement intervention. Setting and participants: 297 children aged at least 3 months and under 5 years in 11 Aboriginal communities in the Northern Territory, Far West New South Wales and Western Australia in 2006. Main outcome measures: Adherence to guideline-scheduled services including clinical examinations, brief interventions or advice on health-related behaviour and risks, and enquiry regarding social conditions; and recorded follow-up of identified problems. Results: Documentation of delivery of specific clinical examinations (26{\%}-80{\%}) was relatively good, but was poorer for brief interventions or advice on health-related behaviour and risks (5{\%}-36{\%}) and enquiry regarding social conditions (3{\%}-11{\%}). Compared with children in Far West NSW and WA, those attending NT centres were significantly more likely to have a record of growth faltering, underweight, chronic ear disease, anaemia, or chronic respiratory disease (P < 0.005). Only 11{\%}-13{\%} of children with identified social problems had an assessment report on file. An action plan was documented for 22{\%} of children with growth faltering and 13{\%} with chronic ear disease; 43{\%} of children with chronic respiratory disease and 31{\%} with developmental delay had an assessment report on file. Conclusion: Existing systems are not providing for adequate follow-up of identified medical and social problems for children living in remote Aboriginal communities; development of systems for immediate and longer-term sustainable responses to these problems should be a priority. Without effective systems for follow-up, screening children for disease and adverse social circumstances will result in little or no benefit.",
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Bailie, RS, Si, D, Dowden, M, Connors, C, O'DONOGHUE, L, Liddle, H, Kennedy, C, COX, R, Burke, H, Thompson, S & Brown, A 2008, 'Delivery of child health services in indigenous communities: Implications for the federal government's emergency intervention in the Northern Territory', Medical Journal of Australia, vol. 188, no. 10, pp. 615-618.

Delivery of child health services in indigenous communities : Implications for the federal government's emergency intervention in the Northern Territory. / Bailie, Ross Stewart; Si, Damin; Dowden, Michelle; Connors, Christine; O'DONOGHUE, L; Liddle, Helen; Kennedy, Catherine; COX, R; Burke, Hugh; Thompson, Sandra; Brown, A.

In: Medical Journal of Australia, Vol. 188, No. 10, 2008, p. 615-618.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Delivery of child health services in indigenous communities

T2 - Implications for the federal government's emergency intervention in the Northern Territory

AU - Bailie, Ross Stewart

AU - Si, Damin

AU - Dowden, Michelle

AU - Connors, Christine

AU - O'DONOGHUE, L

AU - Liddle, Helen

AU - Kennedy, Catherine

AU - COX, R

AU - Burke, Hugh

AU - Thompson, Sandra

AU - Brown, A

PY - 2008

Y1 - 2008

N2 - Objectives: To describe delivery of child health services in Australian Aboriginal communities, and to identify gaps in services required to improve the health of Aboriginal children. Design: Cross-sectional baseline audit for a quality improvement intervention. Setting and participants: 297 children aged at least 3 months and under 5 years in 11 Aboriginal communities in the Northern Territory, Far West New South Wales and Western Australia in 2006. Main outcome measures: Adherence to guideline-scheduled services including clinical examinations, brief interventions or advice on health-related behaviour and risks, and enquiry regarding social conditions; and recorded follow-up of identified problems. Results: Documentation of delivery of specific clinical examinations (26%-80%) was relatively good, but was poorer for brief interventions or advice on health-related behaviour and risks (5%-36%) and enquiry regarding social conditions (3%-11%). Compared with children in Far West NSW and WA, those attending NT centres were significantly more likely to have a record of growth faltering, underweight, chronic ear disease, anaemia, or chronic respiratory disease (P < 0.005). Only 11%-13% of children with identified social problems had an assessment report on file. An action plan was documented for 22% of children with growth faltering and 13% with chronic ear disease; 43% of children with chronic respiratory disease and 31% with developmental delay had an assessment report on file. Conclusion: Existing systems are not providing for adequate follow-up of identified medical and social problems for children living in remote Aboriginal communities; development of systems for immediate and longer-term sustainable responses to these problems should be a priority. Without effective systems for follow-up, screening children for disease and adverse social circumstances will result in little or no benefit.

AB - Objectives: To describe delivery of child health services in Australian Aboriginal communities, and to identify gaps in services required to improve the health of Aboriginal children. Design: Cross-sectional baseline audit for a quality improvement intervention. Setting and participants: 297 children aged at least 3 months and under 5 years in 11 Aboriginal communities in the Northern Territory, Far West New South Wales and Western Australia in 2006. Main outcome measures: Adherence to guideline-scheduled services including clinical examinations, brief interventions or advice on health-related behaviour and risks, and enquiry regarding social conditions; and recorded follow-up of identified problems. Results: Documentation of delivery of specific clinical examinations (26%-80%) was relatively good, but was poorer for brief interventions or advice on health-related behaviour and risks (5%-36%) and enquiry regarding social conditions (3%-11%). Compared with children in Far West NSW and WA, those attending NT centres were significantly more likely to have a record of growth faltering, underweight, chronic ear disease, anaemia, or chronic respiratory disease (P < 0.005). Only 11%-13% of children with identified social problems had an assessment report on file. An action plan was documented for 22% of children with growth faltering and 13% with chronic ear disease; 43% of children with chronic respiratory disease and 31% with developmental delay had an assessment report on file. Conclusion: Existing systems are not providing for adequate follow-up of identified medical and social problems for children living in remote Aboriginal communities; development of systems for immediate and longer-term sustainable responses to these problems should be a priority. Without effective systems for follow-up, screening children for disease and adverse social circumstances will result in little or no benefit.

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