Journal articles on the topic 'Maternal health services Australia'
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1
Selby Smith, Chris. "Health services management education in South Australia." Australian Health Review 18, no. 4 (1995): 15. http://dx.doi.org/10.1071/ah950015.
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In December 1994 the Australian College of Health Service Executives (SABranch) sought ?a needs analysis for health management training programs withinSouth Australia?. Although the college was interested in a range of matters, thecentral issue was whether the current Graduate Diploma in Health Administration(or a similar course) would continue to be provided in Adelaide. The college providedbackground material and discussions were held with students, the health industry,relevant professional associations and the universities. This commentary sets out someof the background factors and my conclusions, which have been accepted by the SouthAustralian authorities.
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Lima, Fernando, Carrington Shepherd, Janice Wong, Melissa O’Donnell, and Rhonda Marriott. "Trends in mental health related contacts among mothers of Aboriginal children in Western Australia (1990–2013): a linked data population-based cohort study of over 40 000 children." BMJ Open 9, no. 7 (July 2019): e027733. http://dx.doi.org/10.1136/bmjopen-2018-027733.
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ObjectiveThis study examines the scale of maternal mental health related contacts among Australian Aboriginal children over time, and associations with socio-economic characteristics, geographical remoteness and maternal age.DesignA retrospective cohort study of the prevalence of maternal mental health related contacts among Aboriginal children born in Western Australia between 1990 and 2013.SettingPopulation of Western Australia with de-identified linked administrative data from the Western Australian Department of Health.ParticipantsAll Aboriginal children born in Western Australia between 1990 and 2013 and their mothers.Primary outcome measurePrevalence of maternal mental health related contacts among Aboriginal children born between 1990 and 2013. Mental health related contacts were identified using mental health related inpatient hospitalisations and outpatient contacts.ResultsAlmost 30% of cohort children were born to a mother with at least one mental health contact in the 5 years prior to birth, with 15% reported in the year prior to birth and the year post birth. There was a distinct increase in the prevalence of maternal mental health contacts between 1990 and 2013 (4–5% per year, with a peak in 2007). Maternal mental health contacts were associated with living in more disadvantaged areas and major cities, and having a mother aged over 20 years at birth.ConclusionsThe study affirms that mental health issues place a considerable burden on Aboriginal Australia, and suggests that many of the mental health issues that women develop earlier in life are chronic at the time of conception, during pregnancy and at birth. Early intervention and support for women in the earliest stages of family planning are required to alleviate the burden of mental health problems at birth and after birth. There is a clear need for policies on the development of a holistic healthcare model, with a multisector approach, offering culturally appropriate services for Aboriginal people.
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Stewart, Christine, Sharon L. Bourke, Janet A. Green, Elianna Johnson, Ligi Anish, Miriam Muduwa, and Linda K. Jones. "Healthcare challenges of incarcerated women in Australia: An integrative review." International Journal of Healthcare 7, no. 1 (August 25, 2020): 10. http://dx.doi.org/10.5430/ijh.v7n1p10.
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Background: Despite the rise in numbers of incarceration women, disparities between health care services and access exist. The health needs of incarcerated women is complex and influenced by multiple social determinants of health.Purpose: Explore the healthcare issues of incarcerated women within Australian Prisons.Methods: Integrative review of the literature.Results: Incarcerated women represent a small proportion of the prison population within Australia, however, health outcomes are significantly impacted. Socioeconomic status, abuse (physical, emotional, sexual), previous incarceration, generational factors are some of the factors impeding the health of incarcerated women. Mental health, chronic disease conditions, maternal and child factors are significant health concerns of this vulnerable population. There is a disparity in health access and programs to improve their health outcomes. This paper explores the challenges impacting the health of incarcerated women.Conclusions: Significant disparities exist in the access of health services available to incarcerated women. There needs to be more focus upon improving access to health services and health support programs to meet the complex health needs of incarcerated in Australia. Furthermore, there is a need for more primary health nurses to prevent and address the healthcare issues of this population.
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Stewart, Donald E., Vibhavari Das, and Melissa Seibold. "Birth and Empowerment: A Qualitative Study of the Childbirth Experience of Filipino Migrant Women in Brisbane, Australia." Asia Pacific Journal of Public Health 10, no. 2 (April 1998): 64–69. http://dx.doi.org/10.1177/101053959801000202.
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This project aims to understand and explore the notion of empowerment in relation to the childbirth experiences of Filipino women in Brisbane, Australia. Objectives include assessing the responsiveness of the health system to Filipino migrant women; exploring different cultural perspectives on childbirth; and assessing the understanding of the health rights of Filipinas in relation to child and maternal health services. The overwhelming majority of the women in the sample were found to have experienced problems with their childbirth. Most reported that these were due to discrimination, language difficulties, a lack of emotional and social support, marked cultural differences with respect to pregnancy, childbirth and the post-partal care of mother and child. They also reported a lack of knowledge and information about Australian maternal and child health care services. Despite successful clinical outcomes it is suggested that the notion of empowerment could provide insight into ways of improving the birth experience in order to ameliorate many of the problems typical of this group.
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Miller, Margaret, Lydia Hearn, Paige van der Pligt, Jane Wilcox, and Karen J. Campbell. "Preventing maternal and early childhood obesity: the fetal flaw in Australian perinatal care." Australian Journal of Primary Health 20, no. 2 (2014): 123. http://dx.doi.org/10.1071/py13080.
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Almost half of Australian women of child-bearing age are overweight or obese, with a rate of 30–50% reported in early pregnancy. Maternal adiposity is a costly challenge for Australian obstetric care, with associated serious maternal and neonatal complications. Excess gestational weight gain is an important predictor of offspring adiposity into adulthood and higher maternal weight later in life. Current public health and perinatal care approaches in Australia do not adequately address excess perinatal maternal weight or gestational weight gain. This paper argues that the failure of primary health-care providers to offer systematic advice and support regarding women’s weight and related lifestyle behaviours in child-bearing years is an outstanding ‘missed opportunity’ for prevention of inter-generational overweight and obesity. Barriers to action could be addressed through greater attention to: clinical guidelines for maternal weight management for the perinatal period, training and support of maternal health-care providers to develop skills and confidence in raising weight issues with women, a variety of weight management programs provided by state maternal health services, and clear referral pathways to them. Attention is also required to service systems that clearly define roles in maternal weight management and ensure consistency and continuity of support across the perinatal period.
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Sved Williams, Anne E. "Perinatal and infant mental health in Australia: moving forward towards REAL prevention and early intervention – can we do it?" Australasian Psychiatry 25, no. 3 (April 27, 2017): 274–76. http://dx.doi.org/10.1177/1039856217700761.
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Objectives: Australia has been at the forefront of appropriate early intervention. Prevention of mental illness in infants by early identification and intervention in the mental health of their mothers has stalled since the cessation of funding through the National Perinatal Depression Initiative (NPDI, 2009–2015). Whilst screening for maternal mental illness has been widely implemented throughout Australia during the last two decades, services are now diminishing and great opportunities to ride the crest of a wave for appropriate mental illness intervention are receding. Reviews of history and interventions internationally may help guide future directions. Conclusions: Advocacy through across-agency and across-political-party support has been markedly successful for perinatal and infant mental health in the United Kingdom. A solid foundation exists in Australia. Australian psychiatrists have the ability to continue to change the face of prevention and early intervention.
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Bull, Claudia, Peta Howie, and Emily J. Callander. "Inequities in vulnerable children’s access to health services in Australia." BMJ Global Health 7, no. 3 (March 2022): e007961. http://dx.doi.org/10.1136/bmjgh-2021-007961.
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IntroductionChildren born into families at risk of becoming or remaining poor are at significant risk of experiencing childhood poverty, which can impair their start to life, and perpetuate intergenerational cycles of poverty. This study sought to quantify health service utilisation, costs and funding distribution amongst children born into vulnerable compared to non-vulnerable families.MethodsThis study used a large linked administrative dataset for all women giving birth in Queensland, Australia between July 2012 and July 2018. Health service use included inpatient, emergency department (ED), general practice, specialist, pathology and diagnostic imaging services. Costs included those paid by public hospital funders, private health insurers, Medicare and out-of-pocket costs.ResultsVulnerable children comprised 34.1% of the study cohort. Compared with non-vulnerable children, they used significantly higher average numbers of ED services during the first 5 years of life (2.52±3.63 vs 1.97±2.77), and significantly lower average numbers of specialist, pathology and diagnostic imaging services. Vulnerable children incurred significantly greater costs to public hospital funders compared with non-vulnerable children over the first 5 years of life ($16 053 vs $10 247), and significantly lower private health insurer, Medicare and out-of-pocket costs.ConclusionThere are clear inequities in vulnerable children’s health service utilisation in Australia. Greater examination of the uptake and cost-effectiveness of maternal and child services is needed, as these services support children’s development in the critical first 1000 days of life.
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Tran, Mai, Hai Phung, Lisa Young, Ursula Hopper, and Ken Hillman. "Patterns and characteristics of ethnic Australian women utilising ethno-specific maternal and child health services." Australian Health Review 25, no. 4 (2002): 107. http://dx.doi.org/10.1071/ah020107.
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Few studies have explored the socio-economic profile, service utilisation, obstetric history and pregnancy outcomes of ethnic women who utilise ethno-specific obstetric services in Australia. The purpose of this study was to form a profile of women who accessed the Ethnic Obstetric Liaison Services (EOLO) in South Western Sydney Area Health Service (SWSAHS), New South Wales and explore their beliefs about using maternal and infant health services. We found that the prevalence of risks and special needs varied significantly by language groups in this study sample. Our results suggest that equity of access to quality care for this group of mothers and infants can be assured if models similar to the EOLO in SWSAHS are thoroughly planned and developed, and take account of cultural appropriateness for the population served.
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Callander, Emily J., Antonia Shand, and Natasha Nassar. "Inequality in out of pocket fees, government funding and utilisation of maternal health services in Australia." Health Policy 125, no. 6 (June 2021): 701–8. http://dx.doi.org/10.1016/j.healthpol.2021.04.009.
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Nancarrow, Susan A., Alison Roots, Sandra Grace, and Vahid Saberi. "Models of care involving district hospitals: a rapid review to inform the Australian rural and remote context." Australian Health Review 39, no. 5 (2015): 494. http://dx.doi.org/10.1071/ah14137.
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Objectives District hospitals are important symbolic structures in rural and remote communities; however, little has been published on the role, function or models of care of district hospitals in rural and remote Australia. The aim of the present study was to identify models of care that incorporate district hospitals and have relevance to the Australian rural and remote context. Methods A systematic, rapid review was conducted of published peer-reviewed and grey literature using CINAHL, Medline, PsychInfo, APAIS-Health, ATSI health, Health Collection, Health & Society, Meditext, RURAL, PubMed and Google Scholar. Search terms included ‘rural’, ‘small general and district hospitals’, ‘rural health services organisation & administration’, ‘medically underserved area’, ‘specific conditions, interventions, monitoring and evaluation’, ‘regional, rural and remote communities’, ‘NSW’, ‘Australia’ and ‘other OECD countries’ between 2002 and 2013. Models of teaching and education, multipurpose services centres, recruitment and/or retention were excluded. Results The search yielded 1626 articles and reports. Following removal of duplicates, initial screening and full text screening, 24 data sources remained: 21 peer-reviewed publications and three from the grey literature. Identified models of care related specifically to maternal and child health, end-of-life care, cancer care services, Aboriginal health, mental health, surgery and emergency care. Conclusion District hospitals play an important role in the delivery of care, particularly at key times in a person’s life (birth, death, episodes of illness). They enable people to remain in or near their own community with support from a range of services. They also play an important role in the essential fabric of the community and the vertical integration of the health services. What is known about the topic? Little has been published on the function of small-to-medium district hospitals in rural and remote Australia, and almost nothing is known about models of care that are relevant to these settings. What does this paper add? District hospitals form an important part of vertically integrated models of care in Australia. Effective models of care aim to keep health services close to home. There is scope for networked models of care that keep health care within the community supported by hub-and-spoke models of service delivery. What are the implications for practitioners? This review found limited evidence on the skill mix required in district hospitals; however, the skill mix underpins the extent of service and speciality that can be provided locally, particularly with regard to the provision of surgery and emergency services. International evidence suggests that providing surgical services locally can help increase the sustainability of smaller hospitals because they typically provide high return, short episodes of care; however, this depends on the funding model being used. Similarly, the skill mix of staff required to sustain a functioning emergency department brings a skill base that supports a higher level of expertise across the hospital.
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Yelland, Jane, Elisha Riggs, Josef Szwarc, Dannielle Vanpraag, Wendy Dawson, and Stephanie Brown. "Improving the ascertainment of refugee-background people in health datasets and health services." Australian Health Review 42, no. 2 (2018): 130. http://dx.doi.org/10.1071/ah16164.
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Ascertainment of vulnerable populations in health datasets is critical to monitoring disparities in health outcomes, enables service planning and guides the delivery of health care. There is emerging evidence that people of refugee backgrounds in Australia experience poor health outcomes and barriers to accessing services, yet a clear picture of these disparities is limited by what is routinely collected in health datasets. There are challenges to improving the accuracy of ascertainment of refugee background, with sensitivities for both consumers and providers about the way questions are asked. Initial testing of four data items in maternity and early childhood health services (maternal country of birth, year of arrival in Australia, requirement for an interpreter and women’s preferred language) suggests that these are straightforward items to collect and acceptable to service administrators, care providers and to women. In addition to the four data items, a set of questions has been developed as a guide for clinicians to use in consultations. These new approaches to ascertainment of refugee background are essential for addressing the risk of poor health outcomes for those who are forced to leave their countries of origin because of persecution and violence. What is known about the topic? Relatively little attention has been given to identifying refugee-background populations in health datasets and health services. What does the paper add? Four routinely collected data items will provide an indication of refugee background to better understand health disparities and guide service planning and the delivery of health care. What are the implications for practice? The data items, together with a set of questions for practitioners to use in the clinical encounter, are essentials to the provision of culturally competent health care.
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Heilbrunn-Lang, Adina Y., Lauren M. Carpenter, Andrea M. de Silva, Lisa K. Meyenn, Gillian Lang, Allison Ridge, Amanda Perry, Deborah Cole, and Shalika Hegde. "Family-centred oral health promotion through Victorian child-health services: a pilot." Health Promotion International 35, no. 2 (April 21, 2019): 279–89. http://dx.doi.org/10.1093/heapro/daz025.
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Abstract Maternal and Child Health Services (MCHS) provide ideal settings for oral disease prevention. In Victoria (Australia), child mouth-checks (Lift-the-Lip) and oral health promotion (OHP) occur during MCHS child visits. This study trialled Tooth-Packs (OHP resources, toothbrushes, toothpastes) distribution within MCHS to (i) assess the impacts of Tooth-Packs distribution on child and family oral health (OH) behaviours and knowledge, including Maternal and Child Health Nurses (MCHN) child referral practices to dental services, and (ii) determine the feasibility and acceptability of incorporating Tooth-Packs distribution into MCHN OHP practices. A mixed-methods evaluation design was employed. MCHN from four high-needs Victorian Local Government Areas distributed Tooth-Packs to families of children attending 18-month and/or 24-month MCHS visits (baseline). Families completed a questionnaire on OH and dietary practices at baseline and 30-month follow-up. Tooth-Packs distribution, Lift-the-lip mouth-checks and child OH referrals were conducted. Guided discussions with MCHN examined intervention feasibility. Overall, 1585 families received Tooth-Packs. Lift-the-lip was conducted on 1493 children (94.1%). Early childhood caries were identified in 142 children (9.5%) and these children were referred to dental services. Baseline to follow-up behavioural improvements (n = 230) included: increased odds of children having ever seen an OH professional (OR 28.0; 95% CI 7.40–236.88; p < 0.001), parent assisted toothbrushing twice/day (OR 1.76; 95% CI 1.05–3.00; p = 0.030) and toothpaste use >once/day (OR 2.82; 95% CI 1.59–5.24; p < 0.001). MCHN recommendations included distribution of Tooth-Packs to at-risk children <12-months of age. MCHS provide an ideal setting to enable timely family-centred OHP intervention and adoption of good OH behaviours at an early age.
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Bar-Zeev, Sarah, Lesley Barclay, Sue Kruske, Naor Bar-Zeev, Yu Gao, and Sue Kildea. "Use of Maternal Health Services by Remote Dwelling Aboriginal Women in Northern Australia and Their Disease Burden." Birth 40, no. 3 (September 2013): 172–81. http://dx.doi.org/10.1111/birt.12053.
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Kirk, KM, HH Maes, MC Neale, AC Heath, NG Martin, and LJ Eaves. "Frequency of church attendance in Australia and the United States: models of family resemblance." Twin Research 2, no. 2 (April 1, 1999): 99–107. http://dx.doi.org/10.1375/twin.2.2.99.
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AbstractData on frequency of church attendance have been obtained from separate cohorts of twins and their families from the USA and Australia (29 063 and 20 714 individuals from 5670 and 5615 families, respectively). The United States sample displayed considerably higher frequency of attendance at church services. Sources of family resemblance for this trait also differed between the Australian and US data, but both indicated significant additive genetic and shared environment effects on church attendance, with minor contributions from twin environment, assortative mating and parent–offspring environmental transmission. Principal differences between the populations were in greater maternal environmental effects in the US sample, as opposed to paternal effects in the Australian sample, and smaller shared environment effects observed for both women and men in the US cohort.
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Njue, Carolyne, Andrew Hayen, and Angela J. Dawson. "Models of maternal and child healthcare for African refugees: protocol for an exploratory, mixed-methods study." BMJ Open 10, no. 6 (June 2020): e038162. http://dx.doi.org/10.1136/bmjopen-2020-038162.
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IntroductionThere is a paucity of research examining models of maternal and child health (MCH) care for refugees in high-income countries. Attention has focused on tailoring existing healthcare services to meet the needs of this population and ensure accessible high-quality patient-centred care. This protocol reports the methodology of a study designed to identify models of care for African refugees in New South Wales (NSW), Australia, to determine the evidence for these models and the improvements necessary to best meet service needs that can be delivered in line with available resources, organisational readiness and capacity to implement.Methods and analysisThis multiphased, participatory research project will employ an exploratory, mixed-methods design. Preparatory activities involve a situational analysis of current MCH services for African refugees and associated policies and guidelines in NSW. We will consult key health service providers and analyse Australian census and settlement data to identify refugee communities and their relation to healthcare services. Phase 1 will ascertain the MCH care needs of African refugees and appropriate service models using: a Delphi survey with health service managers and providers, a nominal group process with African women refugees and; key informant interviews with senior health service managers. This data will be synthesised to provide insight into appropriate models-of-care that could be implemented. These will be discussed in a stakeholder workshop. Phase 2 will comprise a readiness-to-change survey with a selection of providers to explore the willingness, commitment and efficacy of staff members to adopt such models-of-care.Ethics and disseminationEthical approval was granted by NSW Health. Findings will be disseminated to all stakeholders at a knowledge exchange forum to inform the development of a high-quality MCH service delivery model that can be feasibly implemented specifically for African refugee communities.PROSPERO registration numberCRD42018095564.
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Kildea, Sue, Sophie Hickey, Carmel Nelson, Jody Currie, Adrian Carson, Maree Reynolds, Kay Wilson, et al. "Birthing on Country (in Our Community): a case study of engaging stakeholders and developing a best-practice Indigenous maternity service in an urban setting." Australian Health Review 42, no. 2 (2018): 230. http://dx.doi.org/10.1071/ah16218.
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Developing high-quality and culturally responsive maternal and infant health services is a critical part of ‘closing the gap’ in health disparities between Aboriginal and Torres Strait Islander people and other Australians. The National Maternity Services Plan led work that describes and recommends Birthing on Country best-practice maternity care adaptable from urban to very remote settings, yet few examples exist in Australia. This paper demonstrates Birthing on Country principles can be applied in the urban setting, presenting our experience establishing and developing a Birthing on Country partnership service model in Brisbane, Australia. An initial World Café workshop effectively engaged stakeholders, consumers and community members in service planning, resulting in a multiagency partnership program between a large inner city hospital and two local Aboriginal Community-Controlled Health Services (ACCHS). The Birthing in Our Community program includes: 24/7 midwifery care in pregnancy to six weeks postnatal by a named midwife, supported by Indigenous health workers and a team coordinator; partnership with the ACCHS; oversight from a steering committee, including Indigenous governance; clinical and cultural supervision; monthly cultural education days; and support for Indigenous student midwives through cadetships and placement within the partnership. Three years in, the partnership program is proving successful with clients, as well as showing early signs of improved maternal and infant health outcomes. What is known about the topic? Birthing on Country has been described as a metaphor for the best start in life for Aboriginal and Torres Strait Islander babies, and services that incorporate Birthing on Country principles can improve outcomes for mothers and babies. Currently, few such models exist in Australia. What does this paper add? This paper demonstrates that Birthing on Country principles can be successfully applied to the urban context. We present a real case example of the experience of setting up one such best-practice, community-engaged and informed partnership model of maternity and child healthcare in south-east Queensland. We share our experience using a World Café to facilitate community engagement, service delivery and workforce planning. What are the implications for practitioners? Health professionals providing maternity care for Aboriginal and Torres Strait Islander families are encouraged to incorporate Birthing on Country principles into their model of care to address the specific needs and demands of the local Indigenous community and improve maternal and infant health outcomes.
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Stanton, Pauline. "Managing the healthcare workforce: cost reduction or innovation." Australian Health Review 25, no. 4 (2002): 92. http://dx.doi.org/10.1071/ah020092.
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Few studies have explored the socio-economic profile, service utilisation, obstetric history and pregnancy outcomes of ethnic women who utilise ethno-specific obstetric services in Australia. The purpose of this study was to form a profile of women who accessed the Ethnic Obstetric Liaison Services (EOLO) in South Western Sydney Area Health Service (SWSAHS), New South Wales and explore their beliefs about using maternal and infant health services. We found that the prevalence of risks and special needs varied significantly by language groups in this study sample. Our results suggest that equity of access to quality care for this group of mothers and infants can be assured if models similar to the EOLO in SWSAHS are thoroughly planned and developed, and take account of cultural appropriateness for the population served.
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Vimpani, Graham. "Refashioning child and family health services in response to family, social and political change." Australian Health Review 27, no. 2 (2004): 13. http://dx.doi.org/10.1071/ah042720013.
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Professor Graham Vimpani is head of the Discipline of Paediatrics & Child Health, University of Newcastle.One hundred years ago maternal and child health services emerged as a community response in Australia, and most other industrialised countries, to concerns about the high rates of infant and early childhood mortality from infectious disease and poor nutrition. Major family and social changes over the past 30 years have impacted in new ways on children's health and wellbeing leading to a profound rethink about the kinds of services that are needed. At the same time, second thoughts have emerged about the role of government in service provision, driven by neoliberal and rational economic philosophies as outlined in the paper in this issue by Keleher and Reiger (2004). Together, these issues have challenged the very foundations on which the services were traditionally based.
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Fleming, Joseph, Andrew King, and Tara Hunt. "Just Call Me Dad: Health and Social Benefits to Fathers and their Children." Children Australia 39, no. 1 (February 11, 2014): 34–41. http://dx.doi.org/10.1017/cha.2013.35.
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In the past 20 years, social change and expectations for both maternal and paternal responsibilities have highlighted the need for services for families to better understand the role of a father in family relationships. In Australia, as well as internationally, there have been many contested understandings about what constitutes ‘good fathering’ in research, social media and in the political sphere. More specifically, there has also been an emerging trend to understand the challenging task of recruiting and maintaining men's involvement in child and family services programmes, particularly those fathers who are deemed a risk to children and mothers, violent or have been separated from their children. That many child and family/welfare services have exercised dedicated effort to work with fathers is still a relatively recent phenomenon, and has only emerged following criticism that services have been too geared towards working only with mothers. Despite this increasing interest, there is still ongoing need for more research to be undertaken in Australia. An important area of focus is the views of professionals about their perception and engagement of fathers, particularly the views of fathers who are described as being absent from family-based services. The purpose of this article is to report briefly on a study undertaken to examine how child and family welfare workers engage fathers in their work. First, this paper will describe some of the social and health benefits to fathers and their children, focusing on the key role of attachment through play. Research into effective service delivery involving fathers will then be presented, concluding with key practice factors necessary for fathers to be involved in family life.
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Wyndow, Paula, Elaine Clifton, and Roz Walker. "Improving Aboriginal Maternal Health by Strengthening Connection to Culture, Family and Community." International Journal of Environmental Research and Public Health 17, no. 24 (December 17, 2020): 9461. http://dx.doi.org/10.3390/ijerph17249461.
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(1) Background: To explore the function of smoking in Aboriginal women’s lives from a trauma-informed, women-centred approach in order to inform the design of a culturally meaningful smoking cessation program for women living in the Pilbara, Western Australia; (2) Methods: Qualitative and Community Based Participatory Action Research (CBPAR) was used to discover what Aboriginal women know about smoking, the specific contextual issues that influence their smoking, and what community supports are available to help them quit smoking. Inductive analysis was used to determine key themes; (3) Results: 25 Aboriginal women (smokers, non-smokers, and ex-smokers) participated in focus groups or individual interviews. Women smoked to deal with stress, trauma and for maintaining social connections. Women who stopped smoking did so on their own when the reason was important enough or when they saw alternative ways of living. Creating safe places to bring women together to yarn about women’s business and link with health services was identified as critical to support women to stop smoking. Conclusions: Strategies to address smoking need to bring community, culture and health together in a meaningful way for women and their families; build on existing community strengths; and educate communities about the effects of smoking, and health professionals about how to support women to stop smoking.
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Boland, Cathy. "‘Walking my baby back home’ - Policy and Practice in Health Services and Single Parent Families." Children Australia 15, no. 4 (1990): 21–29. http://dx.doi.org/10.1017/s1035077200003114.
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The position of single parent families in Australia is examined from a historical perspective, and this is a prelude to a discussion of service provision in maternity hospitals and Baby Health Centres in New South Wales, which are now staffed under the auspices of the Community Health Program. The paper is concerned with issues raised by criteria used to predict child abuse. These criteria are examined from two methodological perspectives; the first applies to the welfare critiques of social control to health service delivery, and the second is an epidemiological critique that notes an extremely high error rate in predicting child abuse at one maternity hospital.Some data from the New South Wales Maternal/Perinatal Statistics Collection on low birthweight and hospital status is used to discuss some implications of this critique related to service delivery and social class of both providers and recipients of health services.
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Pfitzner, Naomi, Cathy Humphreys, and Kelsey Hegarty. "Engaging Men as Fathers: How Gender Influences Men’s Involvement in Australian Family Health Services." Journal of Family Issues 39, no. 16 (September 22, 2018): 3956–85. http://dx.doi.org/10.1177/0192513x18802329.
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Despite claims of “new” and “involved” fathers, research shows men’s actual fathering practices remain relatively unchanged. Increasing attention is being paid to the influence of child and family services on father engagement with calls from researchers and practitioners for a game change in parenting interventions. In this article, we draw on case study data to examine how gender impacts on maternal and child health services’ engagement with new fathers in respectful relationships programs. Our analysis shows that gender shapes men’s fathering and consequently their involvement in programs that seek to engage men as fathers. These gendered behaviors intersect with the practices, policies, and orientation of the Maternal and Child Health Service. The findings hold important implications for designing strategies to engage men in family services.
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Ogbo, Felix, Osita Kingsley Ezeh, Mansi Dhami, Sabrina Naz, Sarah Khanlari, Anne McKenzie, Kingsley Agho, et al. "Perinatal Distress and Depression in Culturally and Linguistically Diverse (CALD) Australian Women: The Role of Psychosocial and Obstetric Factors." International Journal of Environmental Research and Public Health 16, no. 16 (August 16, 2019): 2945. http://dx.doi.org/10.3390/ijerph16162945.
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Perinatal distress and depression can have significant impacts on both the mother and baby. The present study investigated psychosocial and obstetric factors associated with perinatal distress and depressive symptoms among culturally and linguistically diverse (CALD) Australian women in Sydney, New South Wales. The study used retrospectively linked maternal and child health data from two Local Health Districts in Australia (N = 25,407). Perinatal distress was measured using the Edinburgh Postnatal Depression Scale (EPDS, scores of 10–12) and depressive symptoms, with EPDS scores of 13 or more. Multivariate multinomial logistic regression models were used to investigate the association between psychosocial and obstetric factors with perinatal distress and depressive symptoms. The prevalence of perinatal distress and depressive symptoms among CALD Australian women was 10.1% for antenatal distress; 7.3% for antenatal depressive symptoms; 6.2% for postnatal distress and 3.7% for postnatal depressive symptoms. Antenatal distress and depressive symptoms were associated with a lack of partner support, intimate partner violence, maternal history of childhood abuse and being known to child protection services. Antenatal distress and depressive symptoms were strongly associated with postnatal distress and depressive symptoms. Higher socioeconomic status had a protective effect on antenatal and postnatal depressive symptoms. Our study suggests that current perinatal mental health screening and referral for clinical assessment is essential, and also supports a re-examination of perinatal mental health policy to ensure access to culturally responsive mental health care that meets patients’ needs.
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Day, Gary. "Book Review: The Australian health care system." Australian Health Review 32, no. 2 (2008): 371. http://dx.doi.org/10.1071/ah080371.
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THIS IS THE THIRD edition of one of the seminal local texts on the Australian health care system. Over the last seven years, this text has proved a basis for helping students, casual readers and health professionals understand Australia?s sometimes difficult to understand health care system. The text is divided into ten chapters that deal with key aspects of Australia?s health care system, namely: � Frameworks for analysis � The Australian population and its health � Financing health care � The health workforce � Departmental and intergovernmental structures � Hospitals � Public health � Primary and community care � Pharmaceuticals � Policy challenges for the Australian health care system. There are several key reasons why this text has been widely used in the past and will continue to be of value well into the future. The author has been able to accurately describe the complexities of the Australian health care system in an easily digestible way. This is a feat in itself and worthy of praise. There is an appropriate use of tables and figures to support the written content. Finally, the author provides excellent conclusions that bring together the salient points and issues in each chapter. The publisher promotes that this edition includes new material on health workforce, patient safety and medical and health insurance. The Australian health care system delivers on this claim, providing useful insights and a deeper understanding of the issues that confront the future direction and delivery of health services in this country. This text is a useful addition to any library as well as a staple for students needing to more clearly understand the complexities and challenges of the Australian health care system. My only suggestion is that the text could have been enhanced by the inclusion of revision or reflective questions at the end of each chapter. In summary, a must-have as part of a good health-related library.
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Bauleni, Esther M., Leesa Hooker, Hassan P. Vally, and Angela Taft. "Intimate-partner violence and reproductive decision-making by women attending Victorian Maternal- and Child-Health services: a cross-sectional study." Australian Journal of Primary Health 24, no. 5 (2018): 422. http://dx.doi.org/10.1071/py17183.
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The reproductive years are a critical period where women experience greater risk of intimate-partner violence (IPV). Most studies investigating the association between IPV and reproductive health have been completed in low- and middle-income countries. This study aimed to examine the relationship between IPV and women’s reproductive decision-making in Victoria, Australia. We analysed secondary data from a cluster-randomised trial of IPV screening that surveyed new mothers attending Maternal- and Child-Health centres in Melbourne. Survey measures included the experience of partner abuse in the past 12 months using the Composite Abuse Scale and four reproductive decision-making indicators. Results showed that IPV affects reproductive decision-making among postpartum women. Women who reported abuse were less likely to plan for a baby (adjusted Odds Ratio 0.48, 95% CI: 0.31–0.75) than were non-abused women, significantly more likely to have partners make decisions for them about contraception (Risk ratio (RR) 4.09, 95% CI: 1.31–12.75), and whether and when to have a baby (RR 12.35, 95% CI: 4.46–34.16), than they were to make decisions jointly. Pregnant and postpartum women need to be screened for partner violence that compromises women’s decision-making power regarding their reproductive rights.
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Cramer, Rhian L., Helen L. McLachlan, Touran Shafiei, Lisa H. Amir, Meabh Cullinane, Rhonda Small, and Della A. Forster. "Maternal and child health nurses’ experiences of implementing two community-based breastfeeding interventions in Victoria, Australia: A mixed methods process evaluation." Australian Journal of Child and Family Health Nursing 16, no. 1 (July 2019): 4–14. http://dx.doi.org/10.33235/ajcfhn.16.1.4-14.
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Despite high rates of breastfeeding initiation in Australia, there is a significant drop in breastfeeding rates in the early postpartum period, and Australian government breastfeeding targets are not being met. The Supporting breastfeeding In Local Communities (SILC) trial was a three-arm cluster randomised trial implemented in 10 Victorian local government areas (LGAs). It aimed to determine whether early home-based breastfeeding support by a maternal and child health nurse (MCH nurse) with or without access to a community-based breastfeeding drop-in centre increased the proportion of infants receiving ‘any’ breast milk at four months. Focus groups, a written questionnaire and semi-structured interviews were undertaken to explore the interventions from the perspective of the SILC-MCH nurses (n=13) and coordinators (n=6), who established and implemented the interventions. Inductive thematic analysis was used to identify themes, then findings further examined using Diffusion of Innovations Theory as a framework. SILC-MCH nurses and coordinators reported high levels of satisfaction, valuing the opportunity to improve breastfeeding in our community; and having focused breastfeeding time with women in their own homes. They felt the SILC interventions offered benefits to women, nurses and the MCH service. Implementing new interventions into existing, complex community health services presented unforeseen challenges, which were different in each LGA and were in part due to the complexity of the individual LGAs and not the interventions themselves. These findings will help inform the planning and development of future programs aimed at improving breastfeeding and other interventions in MCH.
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Cullinane, Meabh, Helen L. McLachlan, Michelle S. Newton, Stefanie A. Zugna, and Della A. Forster. "Using the Kirkpatrick Model to evaluate the Maternity and Neonatal Emergencies (MANE) programme: Background and study protocol." BMJ Open 10, no. 1 (January 2020): e032873. http://dx.doi.org/10.1136/bmjopen-2019-032873.
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IntroductionOver 310 000 women gave birth in Australia in 2016, with approximately 80 000 births in the state of Victoria. While most of these births occur in metropolitan Melbourne and other large regional centres, a significant proportion of Victorian women birth in local rural health services. The Victorian state government recently mandated the provision of a maternal and neonatal emergency training programme, called Maternal and Newborn Emergencies (MANE), to rural and regional maternity service providers across the state. MANE aims to educate maternity and newborn care clinicians about recognising and responding to clinical deterioration in an effort to improve clinical outcomes. This paper describes the protocol for an evaluation of the MANE programme.Methods and analysisThis study will evaluate the effectiveness of MANE in relation to: clinician confidence, skills and knowledge; changes in teamwork and collaboration; and consumer experience and satisfaction, and will explore and describe any governance changes within the organisations after MANE implementation. The Kirkpatrick Evaluation Model will provide a framework for the evaluation. The participants of MANE, 27 rural and regional Victorian health services ranging in size from approximately 20 to 1000 births per year, will be invited to participate. Baseline data will be collected from maternity service staff and consumers at each health service before MANE delivery, and at four time-points post-MANE delivery. There will be four components to data collection: a survey of maternity services staff; follow-up interviews with Maternity Managers at health services 4 months after MANE delivery; consumer feedback from all health services collected through the Victorian Healthcare Experience Survey; case studies with five regional or rural health service providers.Ethics and disseminationThis evaluation has been approved by the La Trobe University Science, Health and Engineering College Human Ethics Sub-Committee. Findings will be presented to project stakeholders in a deidentified report, and disseminated through peer-reviewed publications and conference presentations.
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Klages, Debra, Leah East, Kim Usher, and Debra Jackson. "Health Professionals as Mothers of Adult Children With Schizophrenia." Qualitative Health Research 30, no. 12 (July 10, 2020): 1807–20. http://dx.doi.org/10.1177/1049732320936990.
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In this qualitative narrative study, we critically reflected upon mothering experiences of health professionals with adult children with schizophrenia. Thirteen participants from Australia, Canada, Scotland, and the United States were interviewed. The thematic analysis of the interviews resulted in one overarching theme—mothering in the context of uncertainty: unbalancing and rebalancing as mothers, and three major themes: disrupted mothering, reconfigured mothering, and resolute mothering. The findings suggested participants experienced difficulties in separating their professional role from their maternal responsibilities. The mothers gained expertise by using their dual knowledge to advocate for and support their children’s mental health. The mothers’ dual roles had a positive impact on their relatedness to others within their professional practice. Health care organizations might benefit from the expertise of health professionals with dual roles in the development of support, care, treatment, and delivery of services for people and their family members who live with schizophrenia.
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Goldfeld, Sharon, Hannah Bryson, Fiona Mensah, Anna Price, Lisa Gold, Francesca Orsini, Bridget Kenny, et al. "Nurse home visiting to improve child and maternal outcomes: 5-year follow-up of an Australian randomised controlled trial." PLOS ONE 17, no. 11 (November 28, 2022): e0277773. http://dx.doi.org/10.1371/journal.pone.0277773.
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Objectives Nurse home visiting (NHV) is widely implemented to address inequities in child and maternal health. However, few studies have examined longer-term effectiveness or delivery within universal healthcare systems. We evaluated the benefits of an Australian NHV program (“right@home”) in promoting children’s language and learning, general and mental health, maternal mental health and wellbeing, parenting and family relationships, at child ages 4 and 5 years. Setting and participants Randomised controlled trial of NHV delivered via universal, child and family health services (the comparator). Pregnant women experiencing adversity (≥2 of 10 risk factors) were recruited from 10 antenatal clinics across 2 states (Victoria, Tasmania) in Australia. Intervention Mothers in the intervention arm were offered 25 nurse home visits (mean 23·2 home visits [SD 7·4, range 1–43] received) of 60–90 minutes, commencing antenatally and continuing until children’s second birthdays. Primary and secondary outcomes measured At 4 and 5 years, outcomes were assessed via parent interview and direct assessment of children’s language and learning (receptive and expressive language, phonological awareness, attention, and executive function). Outcomes were compared between intervention and usual care arms (intention to treat) using adjusted regression with robust estimation to account for nurse/site. Missing data were addressed using multiple imputation and inverse probability weighting. Results Of 722 women enrolled in the trial, 225 of 363 (62%) intervention and 201 of 359 (56%) usual care women provided data at 5 years. Estimated group differences showed an overall pattern favouring the intervention. Statistical evidence of benefits was found across child and maternal mental health and wellbeing, parenting and family relationships with effect sizes ranging 0·01–0·27. Conclusion An Australian NHV program promoted longer-term family functioning and wellbeing for women experiencing adversity. NHV can offer an important component of a proportionate universal system that delivers support and intervention relative to need. Trial registration 2013–2016, registration ISRCTN89962120
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Carlin, Emma, David Atkinson, and Julia V. Marley. "‘Having a Quiet Word’: Yarning with Aboriginal Women in the Pilbara Region of Western Australia about Mental Health and Mental Health Screening during the Perinatal Period." International Journal of Environmental Research and Public Health 16, no. 21 (November 1, 2019): 4253. http://dx.doi.org/10.3390/ijerph16214253.
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Despite high rates of perinatal depression and anxiety, little is known about how Aboriginal women in Australia experience these disorders and the acceptability of current clinical screening tools. In a 2014 study, the Kimberley Mum’s Mood Scale (KMMS) was validated as an acceptable perinatal depression and anxiety screening tool for Aboriginal women in the Kimberley region of Western Australia. In the current study, we explored if it was appropriate to trial and validate the KMMS with Aboriginal women in the Pilbara. Yarning as a methodology was used to guide interviews with 15 Aboriginal women in the Pilbara who had received maternal and child health care within the last three years. Data were analysed thematically, the results revealing that this cohort of participants shared similar experiences of stress and hardship during the perinatal period. Participants valued the KMMS for its narrative-based approach to screening that explored the individual’s risk and protective factors. While support for the KMMS was apparent, particular qualities of the administering health care professional were viewed as critical to the tool being well received and culturally safe. Building on these findings, we will work with our partner health services in the Pilbara to validate the KMMS with Pilbara Aboriginal women.
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Taylor, Lee, Delyse Hutchinson, Ron Rapee, Lucy Burns, Christine Stephens, and Paul S. Haber. "Clinical Features and Correlates of Outcomes for High-Risk, Marginalized Mothers and Newborn Infants Engaged with a Specialist Perinatal and Family Drug Health Service." Obstetrics and Gynecology International 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/867265.
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Background. There is a paucity of research in Australia on the characteristics of women in treatment for illicit substance use in pregnancy and the health outcomes of their neonates.Aims. To determine the clinical features and outcomes of high-risk, marginalized women seeking treatment for illicit substance use in pregnancy and their neonates.Methods. 139 women with a history of substance abuse/dependence engaged with a perinatal drug health service in Sydney, Australia. Maternal (demographic, drug use, psychological, physical, obstetric, and antenatal care) and neonatal characteristics (delivery, early health outcomes) were examined.Results. Compared to national figures, pregnant women attending a specialist perinatal and family drug health service were more likely to report being Australian born, Aboriginal or Torres Strait Islander, younger, unemployed, and multiparous. Opiates were the primary drug of concern (81.3%). Pregnancy complications were common (61.9%). Neonates were more likely to be preterm, have low birth weight, and be admitted to special care nursery. NAS was the most prevalent birth complication (69.8%) and almost half required pharmacotherapy.Conclusion. Mother-infant dyads affected by substance use in pregnancy are at significant risk. There is a need to review clinical models of care and examine the longer-term impacts on infant development.
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Ward, Bernadette, Julie Ellis, and Karen Anderson. "Barriers to the provision of home and community care services to culturally and linguistically diverse populations in rural Australia." Australian Journal of Primary Health 11, no. 2 (2005): 147. http://dx.doi.org/10.1071/py05033.
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In 2002, qualitative methods in the form of in-depth interviews and focus groups were used to gather data from culturally and linguistically diverse (CALD) population residents, service providers and key stakeholders across rural Victoria, to identify and describe barriers to the effective delivery of home services to people from CALD populations in rural Australia. Barriers to the provision of Home and Community Care (HACC) services to CALD populations in rural areas were not specific to HACC programs. For CALD residents, barriers included lack of information about the range of available services, cultural factors, and negative past and recent experiences in dealing with both the broader community and service providers. Service providers indicated lack of information about the profile of the local CALD population and lack of experience in working with these groups to be barriers. Communication was also an issue both for CALD residents and service providers, in terms of cultural factors and specific communication strategies such as inadequate printed material and under-utilisation of existing resources such as interpreter services. As one of the world?s most ethno-culturally diverse nations, Australia has a responsibility to provide health services that are culturally responsive and acceptable. Greater attention needs to be given to the needs of rural CALD population groups in accessing home services.
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Tomasi, Ana-Marija, Shameran Slewa-Younan, Renu Narchal, and Pilar Rioseco. "Professional Mental Health Help-Seeking Amongst Afghan and Iraqi Refugees in Australia: Understanding Predictors Five Years Post Resettlement." International Journal of Environmental Research and Public Health 19, no. 3 (February 8, 2022): 1896. http://dx.doi.org/10.3390/ijerph19031896.
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The current longitudinal study sought to identify predictors of professional help seeking for mental health problems amongst Afghan and Iraqi refugees five years post-settlement utilising the Building a New Life in Australia dataset (BNLA). Data were collected via face-to-face or phone interviews across five waves from October 2013 to March 2018. Afghan and Iraqi born refugees numbering 1180 and over 18 years of age with a permanent humanitarian visa were included in this study. The results suggest differences in help-seeking behaviors amongst the two ethnic groups. Amongst the Afghan sample, older adults with high psychological distress were more likely to seek help, while living in regional Australia, not requiring interpreters, and knowing how to find out information about government services were related to lower likelihood of help-seeking. Within the Iraqi sample, poor overall health and knowing how to find out about services were related to a greater likelihood of help-seeking, while fewer financial hardships decreased the likelihood of help-seeking. Amongst those with probable PTSD, disability was associated with an increased likelihood of help-seeking while experiencing fewer financial hardships and living in regional Australia resulted in a lower likelihood of help-seeking in this group. These results have implications for promotional material and mental health interventions, suggesting that more integrated services tailored to specific characteristics of ethnic groups are needed.
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Maclean, Miriam Jennifer, Scott Anthony Sims, and Melissa O'Donnell. "Role of pre-existing adversity and child maltreatment on mental health outcomes for children involved in child protection: population-based data linkage study." BMJ Open 9, no. 7 (July 2019): e029675. http://dx.doi.org/10.1136/bmjopen-2019-029675.
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ObjectivesTo determine mental health outcomes for children with a history of child protection system involvement, accounting for pre-existing adversity, and to examine variation in risk across diagnostic groupings and child protection subgroups.DesignA longitudinal, population-based record-linkage study.ParticipantsAll children in Western Australia (WA) with birth records between 1990 and 2009.Outcome measuresMental health diagnoses, mental health contacts and any mental health event ascertained from International Classification of Diseases codes within WA’s Hospital Morbidity Data Collection and Mental Health Information System from birth until 2013.ResultsCompared with children without child protection contact, children with substantiated maltreatment had higher prevalence of mental health events (37.4% vs 5.9%) and diagnoses (20% vs 3.6%). After adjusting for background risks, all maltreatment types were associated with an almost twofold to almost threefold increased hazard for mental health events. Multivariate analysis also showed mental health events were elevated across all child protection groups, ranging from HR: 3.54 (95% CI 3.28 to 3.82) for children who had entered care to HR: 2.31 (95% CI 2.18 to 2.46) for unsubstantiated allegations. Maternal mental health, aboriginality, young maternal age and living in socially disadvantaged neighbourhoods were all associated with an increased likelihood of mental health events. The increase varied across diagnostic categories, with particularly increased risk for personality disorder, and frequent comorbidity of mental health and substance abuse disorders.ConclusionsYoung people who have been involved in the child protection system are at increased risk for mental health events and diagnoses. These findings emphasise the importance of services and supports to improve mental health outcomes in this vulnerable population. Adversities in childhood along with genetic or environmental vulnerabilities resulting from maternal mental health issues also contribute to young people’s mental health outcomes, suggesting a role for broader social supports and early intervention services in addition to targeted mental health programmes.
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Golenko, Xanthe A., Rania Shibl, Paul A. Scuffham, and Cate M. Cameron. "Relationship between socioeconomic status and general practitioner visits for children in the first 12 months of life: an Australian study." Australian Health Review 39, no. 2 (2015): 136. http://dx.doi.org/10.1071/ah14108.
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Objective The aim of the present study was to examine the relationship between socioeconomic status (SES) and child general practitioner (GP) visits in the first 12 months of life. Methods A longitudinal analysis of 1202 mother and child dyads was conducted as part of the Environments for Healthy Living study from south-east Queensland, Australia, for participants enrolled between 2006 and 2009. Maternally reported survey data (sociodemographic and child health information) were linked with individual Medical Benefits Scheme data from birth to 12 months, identifying GP service use. Results On average, children visited the GP 10.2 times in the first 12 months of life. An inverse relationship was found for SES and child GP visits, with maternal education and child gender the strongest predictors of the total number of GP visits. Almost 70% of participants had all GP consultations bulk billed and only 3.5% paid more than A$100 in total. Conclusions Children from lower SES families may have a greater need for health services due to higher rates of illness and injury. Bulk billing and low-cost access to GP services, regardless of length of consultation, improve equity of access; however, indirect costs may prevent low-income mothers from accessing care for their child when needed. What is known about the topic? The relationship between health and SES, and the influence that health service use can have on this relationship, are well recognised. Previous studies on adult populations in Australia suggest that people of lower SES have more frequent GP consultations due to greater exposure to health risk. However, consultation times are often shorter because short consultations are more likely to be bulk billed, which is resulting in ongoing unmet need. Early childhood visits to the GP can strongly influence long-term health outcomes; however, relatively few studies have examined GP service use among children in Australia. What does this paper add? This paper builds on current knowledge by providing valuable insights into GP service use in the first 12 months of life. It provides evidence to suggest that the relationship between SES and health risk already exists in the first 12 months of life and that bulk billing and low-cost access to GP services improves equity of access. It also highlights the importance of health policy and practice that enables GP service utilisation based on need rather than ability to pay. What are the implications for practitioners? Policies and practice that promote equity of access, such as bulk billing for lower SES families, can assist in improving long-term health outcomes for disadvantaged populations. Greater equity with regard to length of consultation and bulk billing for adults may assist in reducing the disparities in health outcomes between the higher and lower SES populations. Furthermore, indirect costs and the availability of appropriate services for specific groups, such as low income, rural and remote and linguistically and culturally diverse populations, may also be important barriers to access.
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McNamara, Bridgette, Lina Gubhaju, Louisa Jorm, David Preen, Jocelyn Jones, Grace Joshy, Carrington Shepherd, Daniel McAullay, and Sandra Eades. "Exploring factors impacting early childhood health among Aboriginal and Torres Strait Islander families and communities: protocol for a population-based cohort study using data linkage (the ‘Defying the Odds’ study)." BMJ Open 8, no. 3 (March 2018): e021236. http://dx.doi.org/10.1136/bmjopen-2017-021236.
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IntroductionEmpirical evidence on family and community risk and protective factors influencing the comparatively high rates of potentially preventable hospitalisations and deaths among Aboriginal and Torres Strait Islander infants and children is limited. As is evidence on geographical variation in these risks. The ‘Defying the Odds’ study aims to explore the impact of perinatal outcomes, maternal social and health outcomes and level of culturally secure service availability on the health outcomes of Western Australian (WA) Aboriginal infants and children aged 0–5 years.Methods and analysisThe study combines a retrospective cohort study that uses state-wide linked health and administrative data from 12 data sources for multiple generations within Aboriginal families in WA, with specifically collected survey data from health and social services supporting Aboriginal families in regions of WA. Data sources include perinatal/birth registration, hospital, emergency department, mental health services, drug and alcohol service use, mortality, infectious disease notifications, and child protection and family services. Multilevel regression models will be used to examine the intensity of admissions and presentations, mortality, intensity of long stays and morbidity-free survival (no admissions) for Aboriginal children born in WA in 2000–2013. Relationships between maternal (and grand-maternal) health and social factors and child health outcomes will be quantified. Community-level variation in outcomes for Aboriginal children and factors contributing to this variation will be examined, including the availability of culturally secure services. Online surveys were sent to staff members at relevant services to explore the scope, reach and cultural security of services available to support Aboriginal families across selected regions of WA.Ethics and disseminationEthics approvals have been granted for the study. Interpretation and dissemination are guided by the study team’s Aboriginal leadership and reference groups. Dissemination will be through direct feedback and reports to health services in the study and via scientific publications and policy recommendations.
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Kavi, Avinash, Mai-Lei Woo Kinshella, Umesh Y. Ramadurg, Umesh Charantimath, Geetanjali M. Katageri, Chandrashekhar C. Karadiguddi, Narayan V. Honnungar, et al. "Community engagement for birth preparedness and complication readiness in the Community Level Interventions for Pre-eclampsia (CLIP) Trial in India: a mixed-method evaluation." BMJ Open 12, no. 12 (December 2022): e060593. http://dx.doi.org/10.1136/bmjopen-2021-060593.
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ObjectiveTo describe the process of community engagement (CE) in northern Karnataka, India and its impact on pre-eclampsia knowledge, birth preparedness and complication readiness, pregnancy-related care seeking and maternal morbidity.DesignThis study was a secondary analysis of a cluster randomised trial of Community Level Interventions for Pre-eclampsia (CLIP). A total of 12 clusters based on primary health centre catchment areas were randomised to intervention or control. CE was conducted in intervention clusters. CE attendance was summarised according to participant group using both quantitative and qualitative assessment. Pre-eclampsia knowledge, birth preparedness, health services engagement and perinatal outcomes was evaluated within trial surveillance. Outcomes were compared between trial arms using a mixed effects logistic regression model on RStudio (RStudio, Boston, USA). Community feedback notes were thematically analysed on NVivo V.12 (QSR International, Melbourne, Australia).SettingBelagavi and Bagalkote districts in rural Karnataka, India.ParticipantsPregnant women and women of reproductive age, mothers and mothers-in-law, community stakeholders and male household decision-makers and health workers.ResultsA total of 1379 CE meetings were conducted with 39 362 participants between November 2014 and October 2016. CE activities may have had an effect on modifying community attitudes towards hypertension in pregnancy and its complications. However, rates of pre-eclampsia knowledge, birth preparedness, health services engagement and maternal morbidities among individual pregnant women were not significantly impacted by CE activities in their area.ConclusionEvaluation of our CE programme in India demonstrates the feasibility of reaching pregnant women alongside household decision-makers, community stakeholders and health workers. More research is needed to explore the pathways of impact between broad community mobilisation to strengthen support for maternal care seeking and clinical outcomes of individual pregnant women.Trial registration numberNCT01911494.
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Efron, Daryl, Kirsten Furley, Alisha Gulenc, and Emma Sciberras. "Maternal ADHD symptoms, child ADHD symptoms and broader child outcomes." Archives of Disease in Childhood 103, no. 9 (January 9, 2018): 841–46. http://dx.doi.org/10.1136/archdischild-2017-313936.
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ObjectiveThis study investigated the associations between maternal symptoms of attention deficit hyperactivity disorder (ADHD) and child functional outcomes in a community-based sample of children with and without ADHD.Design and settingIn this cohort study, children with ADHD and healthy controls were recruited through schools in Melbourne, Australia, using a combined screening (Conners 3 ADHD Index) and case confirmation (Diagnostic Interview Schedule for Children Version IV) procedure.Patients117 children with ADHD and 149 control children were included in the analyses.Main outcome measuresMaternal ADHD symptoms (Conners Adult ADHD Rating Scale) and child outcomes (ADHD severity, quality of life (QoL), academic competence, social-emotional functioning) were measured at a mean child age of 8.9 years.ResultsMothers of children with ADHD had clinically elevated ADHD symptoms compared with mothers of control children (adjusted analysis: 18.0% vs 2.0%, P<0.001). Elevated maternal ADHD symptoms were associated with greater child ADHD symptom severity and lower QoL by maternal report for children with (severity P=0.01; QoL P=0.003) and without (severity P=0.003; QoL P=0.003) ADHD. Elevated maternal ADHD symptoms were additionally associated with increased parent-rated emotional problems, peer problems and total impairment scores in children without ADHD (all P<0.01).ConclusionsMaternal ADHD symptoms are associated with increased ADHD symptom severity and reduced QoL by maternal report in offspring with or without ADHD, and have broader negative associations with emotional and social functioning in children without ADHD. In the evaluation of the referred children, maternal ADHD symptoms should be considered and referral made to adult services where indicated.
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Bell, Megan F., Donna M. Bayliss, Rebecca Glauert, and Jeneva L. Ohan. "Developmental vulnerabilities in children of chronically ill parents: a population-based linked data study." Journal of Epidemiology and Community Health 73, no. 5 (February 21, 2019): 393–400. http://dx.doi.org/10.1136/jech-2018-210992.
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BackgroundCurrently, there is mixed evidence regarding the effects on children when a parent is chronically ill. Research has also primarily been conducted with adolescent samples. This study investigated developmental vulnerabilities in young children of parents with chronic illness.MethodsThis study used linked administrative data. The study population included children born in Western Australia during 2003–2004 (n=19 071; mean age 5.5 years). The outcome measure was a score in the bottom 25% on any of the five developmental domains (physical, social, emotional, communicative and cognitive) of the Australian Early Development Census (2009 collection). Parental chronic illnesses were identified from hospital and cancer registry records, during the period from 1 year prior to the child’s birth and until the end of 2009.ResultsHigher odds of developmental vulnerabilities in physical, social, emotional and communication domains were observed for daughters of chronically ill mothers. Sons of chronically ill mothers had increased odds of language and cognitive difficulties. Risk level increased with each additional year of exposure to maternal chronic illness. Results also indicated increased odds of developmental vulnerabilities for children of mothers experiencing multiple compared with single chronic conditions; however, results were not statistically significant (all p>0.05). No association between fathers’ chronic illness and children’s developmental outcomes was found.ConclusionsMaternal chronic illness is associated with an increased risk of poor developmental outcomes for children, particularly daughters. Healthcare services have an important role to play in linking families into appropriate family-centred services to best support the needs of chronically ill mothers.
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Kong, Ariana, Michelle Dickson, Lucie Ramjan, Mariana S. Sousa, Joanne Goulding, Jemma Chao, and Ajesh George. "A Qualitative Study Exploring the Experiences and Perspectives of Australian Aboriginal Women on Oral Health during Pregnancy." International Journal of Environmental Research and Public Health 18, no. 15 (July 29, 2021): 8061. http://dx.doi.org/10.3390/ijerph18158061.
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The aim of this study was to explore whether oral health was an important consideration for Aboriginal and Torres Strait Islander women during pregnancy, whether oral health could be promoted by Aboriginal health staff, and strategies that would be appropriate to use in a new model of care. A qualitative descriptive methodology underpinned the study. All participants in this study identified as Aboriginal, with no Torres Strait Islander participants, and were from New South Wales, Australia. The interviews were analysed using inductive thematic analysis. From the data, two themes were constructed. The first theme identified that oral health was not always the first priority for participants as poor accessibility alongside other competing commitments were challenges to accessing oral health services. The second theme highlighted how relationships with personal networks and healthcare providers were essential and could be used to support maternal oral health during pregnancy. Effective strategies to promote oral health during pregnancy for Aboriginal and Torres Strait Islander women should involve key stakeholders and health care providers, like Aboriginal Health Workers, to facilitate culturally safe support and tailored oral health advice.
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Rossen, Larissa, Delyse Hutchinson, Judy Wilson, Lucinda Burns, Steve Allsop, Elizabeth Elliott, Sue Jacobs, Jacqui Macdonald, Craig Olsson, and Richard Mattick. "Maternal Bonding through Pregnancy and Postnatal: Findings from an Australian Longitudinal Study." American Journal of Perinatology 34, no. 08 (February 17, 2017): 808–17. http://dx.doi.org/10.1055/s-0037-1599052.
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Background Mother-infant bonding provides the foundation for secure attachment through the lifespan and organizes many facets of infant social-emotional development, including later parenting. Aims To describe maternal bonding to offspring across the pregnancy and postnatal periods, and to examine a broad range of sociodemographic and psychosocial predictors of the maternal-offspring bond. Methods Data were drawn from a sample of 372 pregnant women participating in an Australian population-based longitudinal study of postnatal health and development. Participants completed maternal bonding questionnaires at each trimester and 8 weeks postnatal. Data were collected on a range of sociodemographic and psychosocial factors. Results Bonding increased significantly through pregnancy, in quality and intensity. Regression analyses indicated that stronger antenatal bonding at all time points (trimesters 1 through 3) predicted stronger postnatal bonding. Older maternal age, birth mother being born in a non-English speaking country, mother not working full time, being a first-time mother, breast-feeding problems, and baby's crying behavior all predicted poorer bonding at 8 weeks postpartum. Conclusion These novel findings have important implications for pregnant women and their infant offspring, and for health care professionals working in perinatal services. Importantly, interventions to strengthen maternal-fetal bonding would be beneficial during pregnancy to enhance postnatal bonding and infant health outcomes.
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Reilly, Lyndon, and Susan Rees. "Fatherhood in Australian Aboriginal and Torres Strait Islander communities: An Examination of Barriers and Opportunities to Strengthen the Male Parenting Role." American Journal of Men's Health 12, no. 2 (October 13, 2017): 420–30. http://dx.doi.org/10.1177/1557988317735928.
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Traditional Australian Aboriginal and Torres Strait Islander societies value men’s role as parents; however, the importance of promoting fatherhood as a key social determinant of men’s well-being has not been fully appreciated in Western medicine. To strengthen the Aboriginal and Torres Strait Islander male parenting role, it is vital to examine current barriers and opportunities. The first author (a male Aboriginal health project officer) conducted yarning sessions in three remote Australian communities, two being Aboriginal, the other having a high Aboriginal population. An expert sample of 25 Aboriginal and 6 non-Aboriginal stakeholders, including maternal and child health workers and men’s group facilitators, considered barriers and opportunities to improve men’s parenting knowledge and role, with an aim to inform services and practices intended to support men’s parenting. A specific aim was to shape an existing men’s group program known as Strong Fathers, Strong Families. A thematic analysis of data from the project identified barriers and opportunities to support men’s role as parents. Challenges included the transition from traditional to contemporary parenting practices and low level of cultural and male gender sensitivity in maternal and child health services. Services need to better understand and focus on men’s psychological empowerment and to address shame and lack of confidence around parenting. Poor literacy and numeracy are viewed as contributing to disempowerment. Communities need to champion Aboriginal and Torres Strait Islander male father role models. Biases and barriers should be addressed to improve service delivery and better enable men to become empowered and confident fathers.
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Immanuel, Jincy, Jeff Flack, Vincent W. Wong, Lili Yuen, Carl Eagleton, Dorothy Graham, Janet Lagstrom, et al. "The ADIPS Pilot National Diabetes in Pregnancy Benchmarking Programme." International Journal of Environmental Research and Public Health 18, no. 9 (May 4, 2021): 4899. http://dx.doi.org/10.3390/ijerph18094899.
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Background: To test the feasibility of benchmarking the care of women with pregnancies complicated by hyperglycaemia. Methods: A retrospective audit of volunteer diabetes services in Australia and New Zealand involving singleton pregnancies resulting in live births between 2014 and 2020. Ranges are shown and compared across services. Results: The audit included 10,144 pregnancies (gestational diabetes mellitus (GDM) = 8696; type 1 diabetes (T1D) = 435; type 2 diabetes (T2D) = 1013) from 11 diabetes services. Among women with GDM, diet alone was used in 39.4% (ranging among centres from 28.8–57.3%), metformin alone in 18.8% (0.4–43.7%), and metformin and insulin in 10.1% (1.5–23.4%); when compared between sites, all p < 0.001. Birth was by elective caesarean in 12.1% (3.6–23.7%) or emergency caesarean in 9.5% (3.5–21.2%) (all p < 0.001). Preterm births (<37 weeks) ranged from 3.7% to 9.4% (p < 0.05), large for gestational age 10.3–26.7% (p < 0.001), admission to special care nursery 16.7–25.0% (p < 0.001), and neonatal hypoglycaemia (<2.6 mmol/L) 6.0–27.0% (p < 0.001). Many women with T1D and T2D had limited pregnancy planning including first trimester hyperglycaemia (HbA1c > 6.5% (48 mmol/mol)), 78.4% and 54.6%, respectively (p < 0.001). Conclusion: Management of maternal hyperglycaemia and pregnancy outcomes varied significantly. The maintenance and extension of this benchmarking service provides opportunities to identify policy and clinical approaches to improve pregnancy outcomes among women with hyperglycaemia in pregnancy.
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Goldfeld, Sharon, Kate L. Francis, Elodie O’Connor, Johnny Ludvigsson, Tomas Faresjö, Beatrice Nikiema, Lise Gauvin, et al. "Comparative inequalities in child dental caries across four countries: Examination of international birth cohorts and implications for oral health policy." PLOS ONE 17, no. 8 (August 31, 2022): e0268899. http://dx.doi.org/10.1371/journal.pone.0268899.
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Child dental caries (i.e., cavities) are a major preventable health problem in most high-income countries. The aim of this study was to compare the extent of inequalities in child dental caries across four high-income countries alongside their child oral health policies. Coordinated analyses of data were conducted across four prospective population-based birth cohorts (Australia, n = 4085, born 2004; Québec, Canada, n = 1253, born 1997; Rotterdam, the Netherlands, n = 6690, born 2002; Southeast Sweden, n = 7445, born 1997), which enabled a high degree of harmonization. Risk ratios (adjusted) and slope indexes of inequality were estimated to quantify social gradients in child dental caries according to maternal education and household income. Children in the least advantaged quintile for income were at greater risk of caries, compared to the most advantaged quintile: Australia: AdjRR = 1.18, 95%CI = 1.04–1.34; Québec: AdjRR = 1.69, 95%CI = 1.36–2.10; Rotterdam: AdjRR = 1.67, 95%CI = 1.36–2.04; Southeast Sweden: AdjRR = 1.37, 95%CI = 1.10–1.71). There was a higher risk of caries for children of mothers with the lowest level of education, compared to the highest: Australia: AdjRR = 1.18, 95%CI = 1.01–1.38; Southeast Sweden: AdjRR = 2.31, 95%CI = 1.81–2.96; Rotterdam: AdjRR = 1.98, 95%CI = 1.71–2.30; Québec: AdjRR = 1.16, 95%CI = 0.98–1.37. The extent of inequalities varied in line with jurisdictional policies for provision of child oral health services and preventive public health measures. Clear gradients of social inequalities in child dental caries are evident in high-income countries. Policy related mechanisms may contribute to the differences in the extent of these inequalities. Lesser gradients in settings with combinations of universal dental coverage and/or fluoridation suggest these provisions may ameliorate inequalities through additional benefits for socio-economically disadvantaged groups of children.
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Makama, Maureen, Mingling Chen, Lisa J. Moran, Helen Skouteris, Cheryce L. Harrison, Tammie Choi, and Siew Lim. "Postpartum Women’s Preferences for Lifestyle Intervention after Childbirth: A Multi-Methods Study Using the TIDieR Checklist." Nutrients 14, no. 20 (October 11, 2022): 4229. http://dx.doi.org/10.3390/nu14204229.
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Postpartum lifestyle interventions are known to be efficacious in reducing postpartum weight retention, but uptake and engagement are poor. This multi-method study explored the preferences of postpartum women for the delivery of lifestyle interventions based on the Template for Intervention Description and Replication (TIDieR) checklist. Semi-structured interviews were conducted with 21 women within 2 years of childbirth, recruited through convenience and snowball sampling throughout Australia (15 May 2020 to 20 July 2020). Transcripts were analysed thematically using an open coding approach. A cross-sectional online survey was conducted in November 2021 among postpartum women within 5 years of childbirth in Australia. Data were summarised using descriptive statistics. The survey was completed by 520 women. Both the survey and interviews revealed that women were interested in receiving lifestyle support postpartum and wanted a program delivered by health professionals. They preferred a flexible low-intensity program embedded within existing maternal and child health services that is delivered through both online and face-to-face sessions. Having a pragmatic approach that taught practical strategies and enlists the support of partners, family and peers was important to mothers. Consumer-informed postpartum lifestyle interventions promote optimal engagement and improve program reach and therefore, impact.
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Hui, Lisa, Melvin B. Marzan, Stephanie Potenza, Daniel L. Rolnik, Joanne M. Said, Kirsten R. Palmer, Clare L. Whitehead, et al. "Collaborative maternity and newborn dashboard (CoMaND) for the COVID-19 pandemic: a protocol for timely, adaptive monitoring of perinatal outcomes in Melbourne, Australia." BMJ Open 11, no. 11 (November 2021): e055902. http://dx.doi.org/10.1136/bmjopen-2021-055902.
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BackgroundThe COVID-19 pandemic has resulted in a range of unprecedented disruptions to maternity care with documented impacts on perinatal outcomes such as stillbirth and preterm birth. Metropolitan Melbourne has endured one of the longest and most stringent lockdowns in globally. This paper presents the protocol for a multicentre study to monitor perinatal outcomes in Melbourne, Australia, during the COVID-19 pandemic.MethodsMulticentre observational study analysing monthly deidentified maternal and newborn outcomes from births >20 weeks at all 12 public maternity services in Melbourne. Data will be merged centrally to analyse outcomes and create run charts according to established methods for detecting non-random ‘signals’ in healthcare. Perinatal outcomes will include weekly rates of total births, stillbirths, preterm births, neonatal intensive care admissions, low Apgar scores and fetal growth restriction. Maternal outcomes will include weekly rates of: induced labour, caesarean section, births before arrival to hospital, postpartum haemorrhage, length of stay, general anaesthesia for caesarean birth, influenza and COVID-19 vaccination status, and gestation at first antenatal visit. A prepandemic median for all outcomes will be calculated for the period of January 2018 to March 2020. A significant shift is defined as ≥6 consecutive weeks, all above or below the prepandemic median. Additional statistical analyses such as regression, time series and survival analyses will be performed for an in-depth examination of maternal and perinatal outcomes of interests.Ethics and disseminationEthics approval for the collaborative maternity and newborn dashboard project has been obtained from the Austin Health (HREC/64722/Austin-2020) and Mercy Health (ref. 2020-031).Trial registration numberACTRN12620000878976; Pre-results.
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Durkin, Shane R. "Eye health programs within remote Aboriginal communities in Australia: a review of the literature." Australian Health Review 32, no. 4 (2008): 664. http://dx.doi.org/10.1071/ah080664.
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Objective: To review the literature regarding the most sustainable and culturally appropriate ways in which to implement eye health care programs within remote Aboriginal communities in Australia from a primary health care perspective. Data sources: The search included letters, editorials and papers (published and unpublished) from January 1955 to April 2006. Study selection: The search revealed 1 106 758 papers, books and other related material. The relevancy of this material was determined by abstract and 378 relevant articles were reviewed in their entirety. After reading the relevant articles and the interview transcripts the themes that emerged from each source were extracted. Conclusions: The ten areas to consider include: clinical practice and access, sustainability, regional-based programs, information technology systems, health worker training, self-determination, cultural and language barriers, funding body responsibilities, embedding specialist programs in primary care services, and other considerations. Further research needs to be undertaken within Aboriginal communities in the area of primary eye health care and barriers to the acceptance of treatment. This may be undertaken using more interactive research methods such as cooperative and narrative inquiry.
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Corr, L., H. Rowe, and J. Fisher. "Mothers’ perceptions of primary health-care providers: thematic analysis of responses to open-ended survey questions." Australian Journal of Primary Health 21, no. 1 (2015): 58. http://dx.doi.org/10.1071/py12134.
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General practitioners and maternal, child and family health nurses have a central role in postpartum primary health care for women and their infants. Positive client-provider relationships are particularly important for women experiencing mental health problems or unsettled infant behaviour. However, little is known about their experiences of postnatal primary health care. The study aimed to describe views of postnatal primary health care among women completing a residential early parenting programme and to identify potential strategies to enhance provider-patient interactions. Participants (n = 138) were women admitted with their infants to a private or a public early parenting service in Melbourne, Australia. Women completed a detailed self-report survey, including open-ended questions about experiences of primary health-care services, and a structured psychiatric interview to diagnose anxiety and depression. Survey responses were analysed thematically. Womens’ experiences of primary health care were influenced by their perceptions of provider competence and the quality of interactions. While similar positive characteristics of doctor and nurse care were valued, medical and nursing practices were judged in different ways. Women described GPs who listened, understood and were thorough as providing good care, and maternal, child and family health nurses were valued for providing support, advice and encouragement. Threats to therapeutic relationships with doctors included feeling rushed during consultations, believing that GPs were not mental health-care providers and the clinician not being ‘good’ with the infant; with nurses, problems included feeling judged or given advice that was inconsistent or lacked an evidence-base. Postpartum primary health care will be improved by unhurried consultations, empathic recognition, encouragement, evidence-informed guidance and absence of criticism.
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O’Keefe, Christine M., Mark Westcott, Maree O’Sullivan, Adrien Ickowicz, and Tim Churches. "Anonymization for outputs of population health and health services research conducted via an online data center." Journal of the American Medical Informatics Association 24, no. 3 (December 19, 2016): 544–49. http://dx.doi.org/10.1093/jamia/ocw152.
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Objective: Online data centers (ODCs) are becoming increasingly popular for making health-related data available for research. Such centers provide good privacy protection during analysis by trusted researchers, but privacy concerns may still remain if the system outputs are not sufficiently anonymized. In this article, we propose a method for anonymizing analysis outputs from ODCs for publication in academic literature. Methods: We use as a model system the Secure Unified Research Environment, an online computing system that allows researchers to access and analyze linked health-related data for approved studies in Australia. This model system suggests realistic assumptions for an ODC that, together with literature and practice reviews, inform our solution design. Results: We propose a two-step approach to anonymizing analysis outputs from an ODC. A data preparation stage requires data custodians to apply some basic treatments to the dataset before making it available. A subsequent output anonymization stage requires researchers to use a checklist at the point of downloading analysis output. The checklist assists researchers with highlighting potential privacy concerns, then applying appropriate anonymization treatments. Conclusion: The checklist can be used more broadly in health care research, not just in ODCs. Ease of online publication as well as encouragement from journals to submit supplementary material are likely to increase both the volume and detail of analysis results publicly available, which in turn will increase the need for approaches such as the one suggested in this paper.
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Bourke-Taylor, Helen, Aislinn Lalor, Louise Farnworth, Julie F. Pallant, Elizabeth Knightbridge, and Gayle McLelland. "Investigation of the self-reported health and health-related behaviours of Victorian mothers of school-aged children." Australian Journal of Primary Health 21, no. 1 (2015): 66. http://dx.doi.org/10.1071/py13056.
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Lifestyle may influence many health-related issues currently facing Australian women. The extent to which women with school-aged children attend to their own health is unknown and the associations between health behaviours and health status requires investigation. This study aimed to investigate the prevalence of health behaviours (alcohol consumption, health-promoting activities) and their impact on self-reported health (weight, sleep quality, mental health) among mothers of school-aged children in Victoria. Mail-out survey design (n = 263) including the Depression Anxiety Stress Scale (DASS) and Health Promoting Activities Scale was used to explore issues. The results indicated that substantial numbers of mothers reported moderate to extreme DASS scores: depression (n = 45, 17%); anxiety (n = 41, 15.6%); stress (n = 57, 21.7%). The majority participated in physical activity less often than daily. High rates of daily alcohol use (20%) and poor sleep quality were reported. Nearly one-half (n = 114, 46%) of the sample were overweight or obese and also reported poorer mental health than other women in the sample (P < 0.001). Significant associations were detected between maternal weight, mental health and participation in health-promoting activities. The findings indicate that there is a need for increased health education and services for women with school-aged children. Direct services and population-based health promotion strategies may be required to address healthy lifestyle issues and educate mothers about the possible health legacy of poor health behaviours.