Delivery of child health services in Indigenous communities: implications for the federal government's emergency intervention in the Northern Territory.
OBJECTIVE
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.


METHODS
Cross-sectional baseline audit for a quality improvement intervention.


METHODS
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.


METHODS
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.


CONCLUSIONS
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.
Bailie
Ross S
RS
Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, NT, Australia. rossb@menzies.edu.au
Si
Damin
D
Dowden
Michelle C
MC
Connors
Christine M
CM
O'Donoghue
Lynette
L
Liddle
Helen E
HE
Kennedy
Catherine M
CM
Cox
Rhonda J
RJ
Burke
Hugh P
HP
Thompson
Sandra C
SC
Brown
Alex D H
AD
D002662:Child Health Services / Q000331:legislation & jurisprudence*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration*; D035082:Federal Government; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015876:Northern Territory; D011785:Quality Assurance, Health Care / Q000331:legislation & jurisprudence*; D012959:Socioeconomic Factors