Relevant bibliographies by topics / Children Institutional care Australia

Academic literature on the topic 'Children Institutional care Australia'

Author: Grafiati
Published: 10 December 2022
Last updated: 29 January 2023

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Journal articles on the topic "Children Institutional care Australia"

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Hil, Richard, Joanna Penglase, and Gregory Smith. "Closed worlds. Reflections on institutional care and child slavery in Australia." Children Australia 33, no. 1 (2008): 12–17. http://dx.doi.org/10.1017/s1035077200000067.

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This article deals with various implications arising from evidence of slavery experienced by children placed in orphanages and children's homes between 1910 and 1974. Slavery was an integral part of the day-to-day realities of many of these children who also experienced forms of sexual, physical and emotional abuse in institutions that were supposedly responsible for their care. It is argued that slave labour in care settings contravened various provisions contained in welfare legislation of the period and was used to supplement the incomes of care institutions. The end result was that children were often compelled to work rather than receive the education to which they were entitled, rendering them ill-prepared to deal with various challenges in later life. This largely hidden story of slavery among the ‘Forgotten Australians’ is one of crude exercise of self-serving authority over children – authority aimed at serving the interests of institutions rather than the children they were meant to help.
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Doore, Kathryn E. van. "Regulating Australia’s Participation in the Orphanage Industry." Institutionalised Children Explorations and Beyond 7, no. 1 (March 2020): 74–82. http://dx.doi.org/10.1177/2349300319894498.

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Orphanages harness the goodwill of volunteers, visitors and donors to generate funding. However, in recent years, evidence has emerged that in some cases children are being recruited or trafficked into orphanages in order to generate profit from this goodwill. This is known as the ‘orphanage industry’, and the recruitment of children into orphanages for the purpose of profit and exploitation is ‘orphanage trafficking’. Australia is reported to be the largest funder of residential care for children in South East Asia. In 2017, Australia became the first government in the world to consider orphanage trafficking as a form of modern slavery. This article traces the evolution of the recognition of orphanage trafficking broadly, and then focusses on recommendations made by the Australian government following the release of its 2017 Hidden in Plain Sight Report. This article analyses the emerging policy and legislative reforms that are being undertaken by the Australian government and recommends further development to ensure that funding and finances are appropriately directed to divest from orphanages and instead support burgeoning care reform in the South Asian region. Finally, the article responds to critiques of the Australian government’s standpoint on orphanage trafficking as it relates to the over-reliance on institutional care and provides clarification on why a criminal justice response to orphanage trafficking is appropriate.
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Scarvelis, Beverly, Beth R. Crisp, and Sophie Goldingay. "From institutional care to life in an Australian family: The experiences of intercountry adoptees." International Social Work 60, no. 2 (July 10, 2016): 423–34. http://dx.doi.org/10.1177/0020872815580048.

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Intercountry adoption programmes have brought children from racially and culturally diverse backgrounds to live as Australians, including 30 Thai children from Rangsit Children’s Home who arrived in the late 1980s and early 1990s. This article provides insight into the experiences of intercountry adoptees at four key stages of the adoption process: leaving the orphanage, arrival in Australia, becoming a member of a family and reconnecting with Thai culture. As this study demonstrates, each of these phases can be challenging for both the adoptees and the families who adopt them and supports may be required long after adoptees become adults.
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Laurence, Jennifer, and David McCallum. "On Innocence Lost: How Children Are Made Dangerous." International Journal for Crime, Justice and Social Democracy 7, no. 4 (November 19, 2018): 148–64. http://dx.doi.org/10.5204/ijcjsd.v7i4.930.

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This article explores continuities of despotism within liberal governance. It introduces recent government investments in the need to protect children from institutional and organisational abuse in the context of which loss of innocence is conceptualised as a moment in a biography, following exposure to violence. The article contrasts those investments with contemporaneous claims by the state that as other-than-innocent, certain children in its care are legitimately exempted from moral-ethical norms embedded elsewhere in the logic of governing childhood proper. The article turns to historical understandings of the welfare of children in the state of Victoria, Australia, to explore the conditions and the means by which children in state care came to be figured as other-than-innocent exceptions, rightly exposed to forms of authoritarian violence. Loss of innocence is explored as an enduring achievement of government in the context of aspirations to do with population, territory and national security.
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Wüstenberg, Jenny. "Dark Pedagogies in Comparative Perspective: Remembering Institutional Child Abuse." Jeunesse: Young People, Texts, Cultures 13, no. 2 (March 1, 2022): 55–80. http://dx.doi.org/10.3138/jeunesse.13.2.55.

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This article sketches three cases of institutional child abuse in different historical contexts and places—St. Michael’s Residential School in Alert Bay (Canada), Parramatta Girls’ Home in Sydney (Australia), and the Closed Juvenile Detention Center in Torgau (German Democratic Republic). I propose Katharina Rutschky’s concept of “dark pedagogy” to analyze the striking similarities in the methods and justification of treatment of children, in the experiences that survivors describe, and in the nature of commemoration. This concept can help us see how the extremes of violence and the techniques of control in “care” facilities that were common across the profiled cases are immersed in similar norms governing the social roles of children and adults. My core argument is that institutional child abuse—because of its systemic nature, its embeddedness in the modernist project, and the resulting stigmas—has lead to similar challenges and practices in confronting and memorializing these histories.
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Mendes, Philip. "Remembering the ‘forgotten’ Australians: The Care Leavers of Australia Network and the Senate Inquiry into Institutional and Out-of-home Care." Children Australia 30, no. 1 (2005): 4–10. http://dx.doi.org/10.1017/s103507720001052x.

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This study examines the findings of the recent Community Affairs Reference Committee report into institutional and out-of-home care. Attention is drawn to the key role played by the Care Leavers of Australia Network (CLAN) in pushing the concerns of older care leavers onto the public agenda, successfully lobbying for the Senate Inquiry, and providing services and supports to care leavers.The report highlighted the historical failure of state authorities to protect the well-being of children and young people placed in alternative care. Many of those children have subsequently experienced significant emotional and psychological problems, the results of which include psychiatric illness, depression, suicide, substance abuse, illiteracy, impaired relationship skills and marriage breakdown, and incarceration.The report also has contemporary implications. In order to achieve better outcomes for care leavers in the future, we need to ensure that child welfare services are adequately funded, employ properly trained and qualified professional staff, promote a gradual and functional transition from dependence to independence, and ensure accountability to external bodies including consumer groups.
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McPhillips, Kathleen. "Religion after the Royal Commission: Challenges to Religion–State Relations." Religions 11, no. 1 (January 15, 2020): 44. http://dx.doi.org/10.3390/rel11010044.

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The findings and recommendations emanating from the Australian Royal Commission into Institutional Responses to Child Sexual Abuse (2012–2017) have advised religious organisations that they need to undertake significant changes to legal, governance and cultural/theological practices. The reason for urgency in enacting these changes is that religious organisations were the least child safe institutions across all Australian organisations, with poor practices of transparency, accountability and responsibility coupled with a tendency to protect the reputation of the institution above the safety of children in their care. In Australia, new state laws have been enacted and are impacting on the internal governance systems of religious organisations, including removing the secrecy of the Catholic confessional, instituting mandatory reporting of child abuse by clerics and criminalising the failure to report child sexual abuse. Religious organisations have moved to adopt many of the recommendations regarding their troubled governance including the professionalisation of religious ministry; adoption of professional standards; and appropriate redress for survivors and changes to religious laws. However, these changes signal significant challenges to current church–state relations, which have been characterised by positioning religious organisations as special institutions that enjoy exemptions from certain human rights legislation, on the basis of protecting religious freedom. This article examines and evaluates the nexus between state and religion in Australian public life as it is emerging in a post-Royal Commission environment, and in particular contested claims around the meaning and value of religious freedom versus the necessity of institutional reform to ensure that religious organisations can demonstrate safety for children and other vulnerable groups.
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Kaufman, Keith L., Marcus Erooga, Benjamin Mathews, and Erin McConnell. "Recommendations for Preventing Child Sexual Abuse in Youth-Serving Organizations: Implications From an Australian Royal Commission Review of the Literature." Journal of Interpersonal Violence 34, no. 20 (September 5, 2019): 4199–224. http://dx.doi.org/10.1177/0886260519869239.

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Evidence suggests that tens of millions of children and adolescents are involved in youth-serving organizations (YSOs) outside of their homes on a daily basis. Children’s involvement with YSOs clearly offers a broad array of emotional, social, and personal development benefits. This involvement can, however, also be associated with a variety of safety risks, including the potential for child sexual abuse (CSA) victimization and the myriad short- and long-term consequences to its victims and their families. Recognizing the significance of CSA within YSOs, the Australian Royal Commission into Institutional Responses to Child Sexual Abuse funded a comprehensive review of the literature on risk and protective factors related to CSA in institutions. This yielded more than 400 primarily research articles from the United States, United Kingdom, and Australia, examining institutional CSA victims, perpetrators, and settings. Findings were provided regarding six specific types of institutional settings, including faith-based, early childhood education, childcare and schools, health care, out-of-home/foster care, and sport. This article is based on the findings of Kaufman and Erooga’s comprehensive literature review and Royal Commission findings. It provides a brief review of critical risks associated with CSA victims, perpetrators, and organizational settings, as well as highlights risks particular to specific types of YSOs and risks that are present across these organizations. Optimal prevention directions and strategies are outlined in response to identified patterns of organizational risk. Recommendations for YSO policy enhancements are also provided to complement the article’s prevention focus. Finally, suggestions are offered for future research directions to foster the development of an evidence-based foundation for work in this area.
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Adamson, Elizabeth, and James A. Smith. "Exploring the Links between Fathering, Masculinities and Health and Well-Being for Migrant Fathers: Implications for Policy and Practice." International Journal of Mens Social and Community Health 3, no. 2 (September 8, 2020): e58-e65. http://dx.doi.org/10.22374/ijmsch.v3i2.36.

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Fathers’ uptake of paternity leave and care of children is shaped by various factors, including structuralbarriers and gender norms, which influence masculine identity formation. Such barriers to accessing leave and caring for children are thus influenced by a complex intersection of individual and institutional factors. Focusing on Australia, this article looks at migrant fathers’ decisions about parental leave and caregiving, and its intersection with gender (masculinities) and culture (race/ethnicity). We do so to unpack the structural barriers these men face, including those that influence their (mental) health and well-being. The authors identify a gap in research, and argue that there is a need to better understand the intersection of gender and culture on migrant fathers’ decisions to access parental leave and care for children. A better understanding of these decisions is integral to building better policy and programme supports for different groups of fathers and, ultimately, improving their mental health and well-being. It also identifies the need for research and policy to recognise the diversity of “migrant” fathers in both quantitative and qualitative research.
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McCausland, Ruth, and Leanne Dowse. "From ‘at risk’ to ‘a risk’: The criminalisation of young people with cognitive disability in residential care." Incarceration 3, no. 2 (July 2022): 263266632110216. http://dx.doi.org/10.1177/26326663211021687.

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There is a growing body of research in Australia and internationally focused on ‘care-criminalisation’: the criminal justice system involvement of young people in out-of-home care. Residential care – a model of out-of-home care where groups of children and young people live with paid staff – has been identified as a specific site of criminalisation for those who live there, in particular young people with cognitive disability and complex support needs. This raises significant human rights concerns and the need for greater systemic scrutiny. This article aims to make a contribution by focusing specifically on the institutional arrangements and characterisations that criminalise young people with cognitive disability in residential care through interrogating the official administrative records of two young people with cognitive disability who spent time in residential care and had contact with the criminal justice system as teenagers. Analysing case studies compiled from these records illustrates the ways that criminal justice intervention becomes justified and normalised for young people with cognitive disability in residential care. We critique the ways that institutional mechanisms and narratives serve to construct, coerce and constrain young people with cognitive disability in residential care. The specific forms of surveillance and control they are subjected to mean that their designation of ‘at risk’ almost routinely transmutes to ‘a risk’ to others, to themselves and to property and in the process their vulnerability and need for care and protection becomes instead a mechanism of criminalisation. Often disability becomes erased or at least overshadowed in administrative records, with care-specific and disability-related behaviour reinscribed as offending behaviour. Particularly stark in this analysis is the institutional and interpersonal violence that accompanies such criminalisation and the pervasive nature of this violence in the lives of young people with cognitive disability in residential care settings: violence they are subjected to by those responsible for their care and safety and violence as their response to the regulation of their circumstances – against property and staff and towards themselves.
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Dissertations / Theses on the topic "Children Institutional care Australia"

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Parker, Diane. "Institutional experiences of female child migrants in Western Australia between 1947 - 1955." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2013. https://ro.ecu.edu.au/theses/681.

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In this qualitative study I investigated the institutional experiences of former female child migrants who were placed in the care of the Sisters of Mercy in St Joseph’s Catholic Orphanage, Subiaco, Western Australia. My study was guided by the theoretical orientations of Symbolic Interaction and Constructivism. Data were gathered through a series of individual and group interviews with the Female Child Migrants, who are now in their seventies and had spent at least three years in the orphanage between the years 1947 and 1955. Documents were also obtained from the archives of the Catholic Church, the Sisters of Mercy and the National Archives. Documents, photos and artefacts were also accessed from private collections. Significant issues to arise from the study were those of identity, opportunity and social control. These issues were broadly examined in relation to the primary and reference groups in the children’s lives with a particular focus on the role the Sisters of Mercy had in the children’s welfare. A limitation of the research is that some records pertaining to the orphanage during this period have been lost or destroyed and the passing of sixty years since the Female Child Migrants lived at the orphanage has meant that some events and practices may have been forgotten, overlooked or reframed by respondents. One of the most important findings was that the Orphanage’s institutional practices with its underpinning of religious teachings, ensured a lack of suitable social experiences and interactions. This shaped the way the participants viewed the world; which in turn impacted upon their life choices. The findings suggest that access to a wide variety of social situations is a necessary feature in a child’s socialisation and the accumulation of necessary social skills. The impact of socialisation on educational outcomes of the children in institutions such as orphanages was evident in the data. This investigation goes some way to filling the gap in the knowledge of the experiences of female child migrants who were sent here under the British Child Migration Scheme and it shines a light on a very small part of Western Australia’s social history.
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Briskman, Linda 1947. "Aboriginal activism and the stolen generations : the story of SNAICC." Monash University, National Centre for Australian Studies, 2001. http://arrow.monash.edu.au/hdl/1959.1/9293.

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Keenan, Anthony Michael. "The Boys' Reformatory Brooklyn Park : a history, 1898-1941." Title page, contents and abstract only, 1988. http://web4.library.adelaide.edu.au/theses/09ED.M/09ed.mk26.pdf.

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Chan, Kam Tong, and 陳錦棠. "The provision of residential child-care service under six: a policy analysis." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1987. http://hub.hku.hk/bib/B42128286.

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Kwok, Am-ping Louisa. "An exploratory study of the adjustment problems of children entering institutional care /." [Hong Kong : University of Hong Kong], 1985. http://sunzi.lib.hku.hk/hkuto/record.jsp?B12322404.

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Hodges, Jill. "Adolescent development following institutional care in the early years." Thesis, University College London (University of London), 1991. http://discovery.ucl.ac.uk/10018510/.

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This thesis reports the development in mid-adolescence of a group of children raised in institutions until at least 2 years of age, then adopted or restored to a biological parent. These children were previously followed up at four and a half and at eight years of age. They were compared with a group of individually matched adolescents who had never been in institutional care. IQ depended largely on the type of family placement, and did not appear to be adversely affected by institutionalisation, at least so long as this did not extend beyond age four and a half. The experience of multiple changing caregivers during the period of institutionalisation did not necessarily prevent the children from forming strong and lasting attachment relationships to parents once placed in families, but this too depended on family environment, being much more common in adoptive families. However, some long-term effects of early institutionalisation were apparent. Ex-institutional adolescents showed more behaviour and emotional difficulties than matched comparisons, according to teacher questionnaires and interviews with the adolescents and their parents. They also showed greater orientation towards adult attention, and had more difficulties with peers and fewer close or confiding peer relationships than comparison adolescents, again indicating some long term effects of early institutional experience.
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Ng, Yim-wah, and 吳艷華. "Social skill training for children in institutional care: an exploratory study." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1991. http://hub.hku.hk/bib/B31249012.

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Ng, Yim-wah. "Social skill training for children in institutional care : an exploratory study /." [Hong Kong : University of Hong Kong], 1991. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13117051.

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Whiteford, Chrystal Michelle. "Early child care in Australia : quality of care, experiences of care and developmental outcomes for Australian children." Thesis, Queensland University of Technology, 2015. https://eprints.qut.edu.au/81298/1/Chrystal_Whiteford_Thesis.pdf.

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In early childhood research, one of the most debated topics is that of early child care. This thesis draws upon data from Growing Up In Australia: The Longitudinal Study of Australian Children to explore the role of early child care in Australia. It examines the quality of early child care accessed by infants, the patterns of child care use across the early years and the impact of early child care experiences on academic, social-emotional and health outcomes at 6 to 7 years of age. Results indicate child care experiences vary considerably and suggest early child care experiences may have both positive and negative impacts upon later developmental outcomes.
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Kwok, Am-ping Louisa, and 郭鶯萍. "An exploratory study of the adjustment problems of children entering institutional care." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1985. http://hub.hku.hk/bib/B31247507.

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Books on the topic "Children Institutional care Australia"

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Penglase, Joanna. Orphans of the living: Growing up in care in twentieth-century Australia. Fremantle, W. A: Curtin University Book, 2005.

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The last protector: The illegal removal of Aboriginal children from their parents in South Australia. Kent Town, S. Aust: Wakefield Press, 2009.

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Moore, Allan. Growing up with Barnardo's. Sydney, NSW: Hale & Iremonger, 1990.

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Wilson, Jacqueline Z., and Paul Ashton. Silent system: Forgotten Australians and the institutionalisation of women and childern. North Melbourne, Vic: Australian Scholarly, 2014.

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Ann, Delroy, Patuto Michael, and Western Australian Museum, eds. The stolen generations: Separation of aboriginal children from their families in Western Australia. Perth, W.A: Western Australian Museum, 1999.

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Musgrove, Nell. The scars remain: A long history of forgotten Australians and children's institutions. North Melbourne, Vic: Australian Scholarly, 2013.

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Hipkin, Bill. Myths & Memories: Bomaderry Children's Home 1908-2008. Kedron, Qld: Bill Hipkin, 2008.

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Maushart, Susan. Sort of a place like home: Remembering the Moore River Native Settlement. Fremantle, W.A: Fremantle Arts Centre Press, 2003.

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Maushart, Susan. Sort of a place like home: Remembering the Moore River Native Settlement. South Fremantle, W.A: Fremantle Arts Centre Press, 1993.

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Harrison, Jane. Stolen. Sydney: Currency Press in association with Playbox Theatre, 2000.

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Book chapters on the topic "Children Institutional care Australia"

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Quadrio, Carolyn. "Institutional abuse of children – an Australian perspective." In Humanising Mental Health Care in Australia, 112–21. Abingdon, Oxon; New York, NY: Routledge, 2018.: Routledge, 2019. http://dx.doi.org/10.4324/9780429021923-8.

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Lynch, Gordon. "Flawed Progress: Criticisms of Residential Institutions for Child Migrants in Australia and Policy Responses, 1939–1945." In UK Child Migration to Australia, 1945-1970, 55–90. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-69728-0_3.

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AbstractThe positive view of child migration held by UK Government officials in the inter-war period was not based on any regular system of inspections of the institutions in Australia to which children were sent. During the Second World War, UK Government officials became more of reported problems at several of these institutions, relating to standards of accommodation, management, care, training and after-care. This chapter traces the growing awareness of these problems and the UK Government’s response to them. Whilst policy-makers’ positive assumptions about child migration were challenged, and specific issues and institutions were known to require significant improvement, overall confidence in the value of child migration remained. Despite evidence of organisational failings in Australia, Australian welfare professionals were trusted to address these problems, and suggestions about the need for greater control from the United Kingdom were seen as a backward-looking attempt to limit the autonomy of Britain’s Dominions.
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Lynch, Gordon. "‘Australia as the Coming Greatest Foster-Father of Children the World Has Ever Known’: The Post-war Resumption of Child Migration to Australia, 1945–1947." In UK Child Migration to Australia, 1945-1970, 131–89. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-69728-0_5.

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AbstractThis chapter examines the policy context and administrative systems associated with the resumption of assisted child migration from the United Kingdom to Australia in 1947. During the Second World War, the Australian Commonwealth Government came to see child migration as an increasingly important element in its wider plans for post-war population growth. Whilst initially developing a plan to receive up to 50,000 ‘war orphans’ shortly after the war in new government-run cottage homes, the Commonwealth Government subsequently abandoned this, partly for financial reasons. A more cost-effective strategy of working with voluntary societies, and their residential institutions, was adopted instead. Monitoring systems of these initial migration parties by the UK Government were weak. Whilst the Home Office began to formulate policies about appropriate standards of care for child migrants overseas, this work was hampered by tensions between the Home Office and the Commonwealth Relations Office about the extent to control over organisations in Australia was possible.
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Deb, Sibnath, Aleena Maria Sunny, and Bishakha Majumdar. "Children Under Institutional Care: Ensuring Quality Care and Safety." In Disadvantaged Children in India, 175–215. Singapore: Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-15-1318-3_5.

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Tucci, Joe, and Janise Mitchell. "Therapeutic services for traumatised children and young people – healing in the everyday experience of relationships." In Humanising Mental Health Care in Australia, 319–30. Abingdon, Oxon; New York, NY: Routledge, 2018.: Routledge, 2019. http://dx.doi.org/10.4324/9780429021923-24.

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Groza, Victor, and Kelley McCreery Bunkers. "Best Practices for Residential/Institutional/Group Care of Children: A Harm Reduction Framework." In Child Maltreatment in Residential Care, 477–92. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-57990-0_22.

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Kirk, Afton R., Christina J. Groark, and Robert B. McCall. "Institutional Care Environments for Infants and Young Children in Latin America and the Caribbean." In Child Maltreatment in Residential Care, 401–18. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-57990-0_19.

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Biffi, Elisabetta, and Chiara Carla Montà. "Documenting Children in Alternative Care Services: Transitional Spaces Between ‘Being Spoken for’ and ‘Speaking for Oneself’." In Documentation in Institutional Contexts of Early Childhood, 167–83. Wiesbaden: Springer Fachmedien Wiesbaden, 2020. http://dx.doi.org/10.1007/978-3-658-28193-9_9.

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Fernandez, Elizabeth, and Jung-Sook Lee. "Experiences and Outcomes of Adults Who Endured Maltreatment as Children in Care in Australia in the Twentieth Century." In Child Maltreatment in Residential Care, 419–60. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-57990-0_20.

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Li, Minyi, Kay Margetts, and Berenice Nyland. "Education and Care for Children Under Three in Australia and China-Pedagogical Perspectives." In International Perspectives on Early Childhood Education and Development, 61–75. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-53475-2_5.

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Conference papers on the topic "Children Institutional care Australia"

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Stoyanova, Desislava, and Valentina Vassileva. "STRATEGIES FOR INTEGRATION IN THE CONDITIONS OF INSTITUTIONAL CARE FOR CHILDREN AT RISK." In 15th International Technology, Education and Development Conference. IATED, 2021. http://dx.doi.org/10.21125/inted.2021.1045.

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Štenclová, Veronika, and Tomáš Čech. "PREPARATION OF CHILDREN TO LEAVE INSTITUTIONAL CARE AS A MEANS OF SUCCESSFUL SOCIAL INTEGRATION." In 11th annual International Conference of Education, Research and Innovation. IATED, 2018. http://dx.doi.org/10.21125/iceri.2018.0933.

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Petrova, Svetlana M., and Irina V. Kotkova. "Correction of the emotional state of children in institutional care in order to ensure their emotional well-being and psychological safety." In The Herzen University Conference on Psychology in Education. Herzen State Pedagogical University of Russia, 2019. http://dx.doi.org/10.33910/herzenpsyconf-2019-2-62.

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Reports on the topic "Children Institutional care Australia"

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Pessino, Carola, and Teresa Ter-Minassian. Addressing the Fiscal Costs of Population Aging in Latin America and the Caribbean, with Lessons from Advanced Countries. Inter-American Development Bank, April 2021. http://dx.doi.org/10.18235/0003242.

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This paper presents projections for 18 Latin America and Caribbean countries of pensions and health expenditures over the next 50 years, compares them to advanced countries, and calculates estimates of the fiscal gap due to aging. The exercise is crucial since life expectancy is increasing and fertility rates are declining in virtually all advanced countries and many developing countries, but more so in Latin America and the Caribbean. While the populations of many of the regions countries are still relatively young, they are aging more rapidly than those in more developed countries. The fiscal implications of these demographic trends are severe. The paper proposes policy and institutional reforms that could begin to be implemented immediately and that could help moderate these trends in light of relevant international experience to date. It suggests that LAC countries need to include an intertemporal numerical fiscal limit or rule to the continuous increase in aging spending while covering the needs of the more vulnerable. They should consider also complementing public pensions with voluntary contribution mechanisms supported by tax incentives, such as those used in Australia, New Zealand (Kiwi Saver), and the United States (401k). In addition, LAC countries face an urgent challenge in curbing the growth of health care costs, while improving the quality of care. Efforts should focus on improving both the allocative and the technical efficiency of public health spending.
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Hajarizadeh, Behzad, Jennifer MacLachlan, Benjamin Cowie, and Gregory J. Dore. Population-level interventions to improve the health outcomes of people living with hepatitis B: an Evidence Check brokered by the Sax Institute for the NSW Ministry of Health, 2022. The Sax Institute, August 2022. http://dx.doi.org/10.57022/pxwj3682.

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Abstract:
Background An estimated 292 million people are living with chronic hepatitis B virus (HBV) infection globally, including 223,000 people in Australia. HBV diagnosis and linkage of people living with HBV to clinical care is suboptimal in Australia, with 27% of people living with HBV undiagnosed and 77% not receiving regular HBV clinical care. This systematic review aimed to characterize population-level interventions implemented to enhance all components of HBV care cascade and analyse the effectiveness of interventions. Review questions Question 1: What population-level interventions, programs or policy approaches have been shown to be effective in reducing the incidence of hepatitis B; and that may not yet be fully rolled out or evaluated in Australia demonstrate early effectiveness, or promise, in reducing the incidence of hepatitis B? Question 2: What population-level interventions and/or programs are effective at reducing disease burden for people in the community with hepatitis B? Methods Four bibliographic databases and 21 grey literature sources were searched. Studies were eligible for inclusion if the study population included people with or at risk of chronic HBV, and the study conducted a population-level interventions to decrease HBV incidence or disease burden or to enhance any components of HBV care cascade (i.e., diagnosis, linkage to care, treatment initiation, adherence to clinical care), or HBV vaccination coverage. Studies published in the past 10 years (since January 2012), with or without comparison groups were eligible for inclusion. Studies conducting an HBV screening intervention were eligible if they reported proportion of people participating in screening, proportion of newly diagnosed HBV (participant was unaware of their HBV status), proportion of people received HBV vaccination following screening, or proportion of participants diagnosed with chronic HBV infection who were linked to HBV clinical care. Studies were excluded if study population was less than 20 participants, intervention included a pharmaceutical intervention or a hospital-based intervention, or study was implemented in limited clinical services. The records were initially screened by title and abstract. The full texts of potentially eligible records were reviewed, and eligible studies were selected for inclusion. For each study included in analysis, the study outcome and corresponding 95% confidence intervals (95%CIs) were calculated. For studies including a comparison group, odds ratio (OR) and corresponding 95%CIs were calculated. Random effect meta-analysis models were used to calculate the pooled study outcome estimates. Stratified analyses were conducted by study setting, study population, and intervention-specific characteristics. Key findings A total of 61 studies were included in the analysis. A large majority of studies (study n=48, 79%) included single-arm studies with no concurrent control, with seven (12%) randomised controlled trials, and six (10%) non-randomised controlled studies. A total of 109 interventions were evaluated in 61 included studies. On-site or outreach HBV screening and linkage to HBV clinical care coordination were the most frequent interventions, conducted in 27 and 26 studies, respectively. Question 1 We found no studies reporting HBV incidence as the study outcome. One study conducted in remote area demonstrated that an intervention including education of pregnant women and training village health volunteers enhanced coverage of HBV birth dose vaccination (93% post-intervention, vs. 81% pre-intervention), but no data of HBV incidence among infants were reported. Question 2 Study outcomes most relevant to the HBV burden for people in the community with HBV included, HBV diagnosis, linkage to HBV care, and HBV vaccination coverage. Among randomised controlled trials aimed at enhancing HBV screening, a meta-analysis was conducted including three studies which implemented an intervention including community face-to-face education focused on HBV and/or liver cancer among migrants from high HBV prevalence areas. This analysis demonstrated a significantly higher HBV testing uptake in intervention groups with the likelihood of HBV testing 3.6 times higher among those participating in education programs compared to the control groups (OR: 3.62, 95% CI 2.72, 4.88). In another analysis, including 25 studies evaluating an intervention to enhance HBV screening, a pooled estimate of 66% of participants received HBV testing following the study intervention (95%CI: 58-75%), with high heterogeneity across studies (range: 17-98%; I-square: 99.9%). A stratified analysis by HBV screening strategy demonstrated that in the studies providing participants with on-site HBV testing, the proportion receiving HBV testing (80%, 95%CI: 72-87%) was significantly higher compared to the studies referring participants to an external site for HBV testing (54%, 95%CI: 37-71%). In the studies implementing an intervention to enhance linkage of people diagnosed with HBV infection to clinical care, the interventions included different components and varied across studies. The most common component was post-test counselling followed by assistance with scheduling clinical appointments, conducted in 52% and 38% of the studies, respectively. In meta-analysis, a pooled estimate of 73% of people with HBV infection were linked to HBV clinical care (95%CI: 64-81%), with high heterogeneity across studies (range: 28-100%; I-square: 99.2%). A stratified analysis by study population demonstrated that in the studies among general population in high prevalence countries, 94% of people (95%CI: 88-100%) who received the study intervention were linked to care, significantly higher than 72% (95%CI: 61-83%) in studies among migrants from high prevalence area living in a country with low prevalence. In 19 studies, HBV vaccination uptake was assessed after an intervention, among which one study assessed birth dose vaccination among infants, one study assessed vaccination in elementary school children and 17 studies assessed vaccination in adults. Among studies assessing adult vaccination, a pooled estimate of 38% (95%CI: 21-56%) of people initiated vaccination, with high heterogeneity across studies (range: 0.5-93%; I square: 99.9%). A stratified analysis by HBV vaccination strategy demonstrated that in the studies providing on-site vaccination, the uptake was 78% (95%CI: 62-94%), significantly higher compared to 27% (95%CI: 13-42%) in studies referring participants to an external site for vaccination. Conclusion This systematic review identified a wide variety of interventions, mostly multi-component interventions, to enhance HBV screening, linkage to HBV clinical care, and HBV vaccination coverage. High heterogeneity was observed in effectiveness of interventions in all three domains of screening, linkage to care, and vaccination. Strategies identified to boost the effectiveness of interventions included providing on-site HBV testing and vaccination (versus referral for testing and vaccination) and including community education focussed on HBV or liver cancer in an HBV screening program. Further studies are needed to evaluate the effectiveness of more novel interventions (e.g., point of care testing) and interventions specifically including Indigenous populations, people who inject drugs, men who have sex with men, and people incarcerated.
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