title: Addressing the well-being of Aboriginal children in out-of-home care: are we there yet?
abstract: OBJECTIVE
  Children in out-of-home care (OOHC) have well-documented health and developmental needs. In Australia, Aboriginal children have significantly worse health outcomes than non-Aboriginal children. We wanted to identify the health and well-being of Aboriginal children entering OOHC, placed with an Aboriginal organisation, who accessed a specialised multidisciplinary clinic in south-western Sydney. We wanted to identify children entering care who were doing well and who improved in care. We also wanted to identify enablers and barriers to care.
  
  
  METHODS
  We analysed records of the first 100 children attending the OOHC clinic in south-western Sydney. Measures included clinical outcomes and recommendations at first and subsequent visits. Descriptive statistics were calculated using SPSS 16.0 for Windows (SPSS Inc., Chicago, IL, USA). Key stakeholders from the relevant agencies were interviewed about enablers and barriers to care by independent evaluators.
  
  
  RESULTS
  A significant proportion of children had health needs identified including speech delay (54%), under-immunisation (50%), behaviour problems (45%), hearing problems (44%), visual problems (35%) and dental problems (36%). Sixteen per cent of the children were doing well at first visit; a third improved in care, and a third remained stable. Significant differences were identified in health and educational needs between the under-5 year olds and the 5-13 year olds. Key barriers identified were systemic issues and lack of resources for intervention.
  
  
  CONCLUSIONS
  Children attending this clinic had similar rates of problems identified as other studies. School-age children appear to have significant additional health needs. Targeted developmentally and culturally appropriate interventions need to be provided to address the identified barriers to care.
authors: Department of Community Paediatrics, Sydney South West Area Health Service, Sydney, New South Wales, Australia. shanti.raman@sswahs.nsw.gov.au
authors: Shanti
authors: S
authors: Raman
authors: Sandra
authors: S
authors: Reynolds
authors: Rabia
authors: R
authors: Khan
mesh_terms: D002648:Child; D002675:Child, Preschool; D006699:Home Care Services; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008485:Medical Audit; D009517:New South Wales; D017063:Outcome Assessment, Health Care; D010549:Personal Satisfaction