title: A case study of physical and social barriers to hygiene and child growth in remote Australian Aboriginal communities.
abstract: BACKGROUND
  Despite Australia's wealth, poor growth is common among Aboriginal children living in remote communities. An important underlying factor for poor growth is the unhygienic state of the living environment in these communities. This study explores the physical and social barriers to achieving safe levels of hygiene for these children.
  
  
  METHODS
  A mixed qualitative and quantitative approach included a community level cross-sectional housing infrastructure survey, focus groups, case studies and key informant interviews in one community.
  
  
  RESULTS
  We found that a combination of crowding, non-functioning essential housing infrastructure and poor standards of personal and domestic hygiene underlie the high burden of infection experienced by children in this remote community.
  
  
  CONCLUSIONS
  There is a need to address policy and the management of infrastructure, as well as key parenting and childcare practices that allow the high burden of infection among children to persist. The common characteristics of many remote Aboriginal communities in Australia suggest that these findings may be more widely applicable.
authors.affiliation: Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Australia. liz.mcdonald@menzies.edu.au
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McDonald
authors.forename: Ross
authors.initials: R
authors.lastname: Bailie
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Grace
authors.forename: David
authors.initials: D
authors.lastname: Brewster
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D003441:Crowding; D003466:Cultural Characteristics; D005260:Female; D006266:Health Education / Q000379:methods; D006291:Health Policy; D006301:Health Services Needs and Demand; D006801:Humans; D006920:Hygiene / Q000592:standards*; D008297:Male; D015980:Public Health Practice / Q000592:standards; D012424:Rural Population; D012931:Social Environment; D013021:South Australia