title: Delivery of child health services in Indigenous communities: implications for the federal government's emergency intervention in the Northern Territory.
abstract: 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.
authors.affiliation: Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, NT, Australia. rossb@menzies.edu.au
authors.forename: Ross S
authors.initials: RS
authors.lastname: Bailie
authors.forename: Damin
authors.initials: D
authors.lastname: Si
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Dowden
authors.forename: Christine M
authors.initials: CM
authors.lastname: Connors
authors.forename: Lynette
authors.initials: L
authors.lastname: O'Donoghue
authors.forename: Helen E
authors.initials: HE
authors.lastname: Liddle
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Kennedy
authors.forename: Rhonda J
authors.initials: RJ
authors.lastname: Cox
authors.forename: Hugh P
authors.initials: HP
authors.lastname: Burke
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Thompson
authors.forename: Alex D H
authors.initials: AD
authors.lastname: Brown
mesh_terms: 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