Review of Aboriginal child health services in remote Western Australia identifies challenges and informs solutions

Philippa J. Dossetor, Kathryn Thorburn, June Oscar, Maureen Carter, James Fitzpatrick, Carol Bower, John Boulton, Emily Fitzpatrick, Jane Latimer, Elizabeth J. Elliott, Alexandra L.C. Martiniuk

Research output: Contribution to journalReview article

Abstract

Background: Despite a national focus on closing the gap between Aboriginal and non-Aboriginal child health outcomes in Australia, there remain significant challenges, including provision of health services in very remote communities. We aimed to identify and map child health services in the very remote Fitzroy Valley, West Kimberley, and document barriers to effective service delivery. Methods: Identification and review of all regional child health services and staffing in 2013. Verification of data by interview with senior managers and staff of key providers in the Western Australian Country Health Service, Kimberley Population Health Unit, Nindilingarri Cultural Health Services and non-government providers. Results: We identified no document providing a comprehensive overview of child health services in the Fitzroy Valley. There were inadequate numbers of health professionals, facilities and accommodation; high staff turnover; and limited capacity and experience of local health professionals. Funding and administrative arrangements were complex and services poorly coordinated and sometimes duplicated. The large geographic area, distances, extreme climate and lack of public and private transport challenge service delivery. The need to attend to acute illness acts to deprioritise crucial primary and preventative health care and capacity for dealing with chronic, complex disorders. Some services lack cultural safety and there is a critical shortage of Aboriginal Health Workers (AHW). Conclusions: Services are fragmented and variable and would benefit from a coordinated approach between government, community-controlled agencies, health and education sectors. A unifying model of care with emphasis on capacity-building in Aboriginal community members and training and support for AHW and other health professionals is required but must be developed in consultation with communities. Innovative diagnostic and care models are needed to address these challenges, which are applicable to many remote Australian settings outside the Fitzroy Valley, as well as other countries globally. Our results will inform future health service planning and strategies to attract and retain health professionals to work in these demanding settings. A prospective audit of child health services is now needed to inform improved planning of child health services with a focus on identifying service gaps and training needs and better coordinating existing services to improve efficiency and potentially also efficacy.

Original languageEnglish
Article number758
JournalBMC Health Services Research
Volume19
Issue number1
DOIs
Publication statusPublished - 26 Oct 2019

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Child Health Services
Western Australia
Health Services
Health
Capacity Building
Training Support
Health Planning
Preventive Medicine
Health Facilities
Climate
Health Education
Primary Health Care
Referral and Consultation
Interviews
Safety
Population

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Dossetor, Philippa J. ; Thorburn, Kathryn ; Oscar, June ; Carter, Maureen ; Fitzpatrick, James ; Bower, Carol ; Boulton, John ; Fitzpatrick, Emily ; Latimer, Jane ; Elliott, Elizabeth J. ; Martiniuk, Alexandra L.C. / Review of Aboriginal child health services in remote Western Australia identifies challenges and informs solutions. In: BMC Health Services Research. 2019 ; Vol. 19, No. 1.
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title = "Review of Aboriginal child health services in remote Western Australia identifies challenges and informs solutions",
abstract = "Background: Despite a national focus on closing the gap between Aboriginal and non-Aboriginal child health outcomes in Australia, there remain significant challenges, including provision of health services in very remote communities. We aimed to identify and map child health services in the very remote Fitzroy Valley, West Kimberley, and document barriers to effective service delivery. Methods: Identification and review of all regional child health services and staffing in 2013. Verification of data by interview with senior managers and staff of key providers in the Western Australian Country Health Service, Kimberley Population Health Unit, Nindilingarri Cultural Health Services and non-government providers. Results: We identified no document providing a comprehensive overview of child health services in the Fitzroy Valley. There were inadequate numbers of health professionals, facilities and accommodation; high staff turnover; and limited capacity and experience of local health professionals. Funding and administrative arrangements were complex and services poorly coordinated and sometimes duplicated. The large geographic area, distances, extreme climate and lack of public and private transport challenge service delivery. The need to attend to acute illness acts to deprioritise crucial primary and preventative health care and capacity for dealing with chronic, complex disorders. Some services lack cultural safety and there is a critical shortage of Aboriginal Health Workers (AHW). Conclusions: Services are fragmented and variable and would benefit from a coordinated approach between government, community-controlled agencies, health and education sectors. A unifying model of care with emphasis on capacity-building in Aboriginal community members and training and support for AHW and other health professionals is required but must be developed in consultation with communities. Innovative diagnostic and care models are needed to address these challenges, which are applicable to many remote Australian settings outside the Fitzroy Valley, as well as other countries globally. Our results will inform future health service planning and strategies to attract and retain health professionals to work in these demanding settings. A prospective audit of child health services is now needed to inform improved planning of child health services with a focus on identifying service gaps and training needs and better coordinating existing services to improve efficiency and potentially also efficacy.",
keywords = "Child health, Coordination, Fetal alcohol Spectrum disorders, Health services, Indigenous, Integration, Remote Australia",
author = "Dossetor, {Philippa J.} and Kathryn Thorburn and June Oscar and Maureen Carter and James Fitzpatrick and Carol Bower and John Boulton and Emily Fitzpatrick and Jane Latimer and Elliott, {Elizabeth J.} and Martiniuk, {Alexandra L.C.}",
year = "2019",
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Dossetor, PJ, Thorburn, K, Oscar, J, Carter, M, Fitzpatrick, J, Bower, C, Boulton, J, Fitzpatrick, E, Latimer, J, Elliott, EJ & Martiniuk, ALC 2019, 'Review of Aboriginal child health services in remote Western Australia identifies challenges and informs solutions' BMC Health Services Research, vol. 19, no. 1, 758. https://doi.org/10.1186/s12913-019-4605-0

Review of Aboriginal child health services in remote Western Australia identifies challenges and informs solutions. / Dossetor, Philippa J.; Thorburn, Kathryn; Oscar, June; Carter, Maureen; Fitzpatrick, James; Bower, Carol; Boulton, John; Fitzpatrick, Emily; Latimer, Jane; Elliott, Elizabeth J.; Martiniuk, Alexandra L.C.

In: BMC Health Services Research, Vol. 19, No. 1, 758, 26.10.2019.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Review of Aboriginal child health services in remote Western Australia identifies challenges and informs solutions

AU - Dossetor, Philippa J.

AU - Thorburn, Kathryn

AU - Oscar, June

AU - Carter, Maureen

AU - Fitzpatrick, James

AU - Bower, Carol

AU - Boulton, John

AU - Fitzpatrick, Emily

AU - Latimer, Jane

AU - Elliott, Elizabeth J.

AU - Martiniuk, Alexandra L.C.

PY - 2019/10/26

Y1 - 2019/10/26

N2 - Background: Despite a national focus on closing the gap between Aboriginal and non-Aboriginal child health outcomes in Australia, there remain significant challenges, including provision of health services in very remote communities. We aimed to identify and map child health services in the very remote Fitzroy Valley, West Kimberley, and document barriers to effective service delivery. Methods: Identification and review of all regional child health services and staffing in 2013. Verification of data by interview with senior managers and staff of key providers in the Western Australian Country Health Service, Kimberley Population Health Unit, Nindilingarri Cultural Health Services and non-government providers. Results: We identified no document providing a comprehensive overview of child health services in the Fitzroy Valley. There were inadequate numbers of health professionals, facilities and accommodation; high staff turnover; and limited capacity and experience of local health professionals. Funding and administrative arrangements were complex and services poorly coordinated and sometimes duplicated. The large geographic area, distances, extreme climate and lack of public and private transport challenge service delivery. The need to attend to acute illness acts to deprioritise crucial primary and preventative health care and capacity for dealing with chronic, complex disorders. Some services lack cultural safety and there is a critical shortage of Aboriginal Health Workers (AHW). Conclusions: Services are fragmented and variable and would benefit from a coordinated approach between government, community-controlled agencies, health and education sectors. A unifying model of care with emphasis on capacity-building in Aboriginal community members and training and support for AHW and other health professionals is required but must be developed in consultation with communities. Innovative diagnostic and care models are needed to address these challenges, which are applicable to many remote Australian settings outside the Fitzroy Valley, as well as other countries globally. Our results will inform future health service planning and strategies to attract and retain health professionals to work in these demanding settings. A prospective audit of child health services is now needed to inform improved planning of child health services with a focus on identifying service gaps and training needs and better coordinating existing services to improve efficiency and potentially also efficacy.

AB - Background: Despite a national focus on closing the gap between Aboriginal and non-Aboriginal child health outcomes in Australia, there remain significant challenges, including provision of health services in very remote communities. We aimed to identify and map child health services in the very remote Fitzroy Valley, West Kimberley, and document barriers to effective service delivery. Methods: Identification and review of all regional child health services and staffing in 2013. Verification of data by interview with senior managers and staff of key providers in the Western Australian Country Health Service, Kimberley Population Health Unit, Nindilingarri Cultural Health Services and non-government providers. Results: We identified no document providing a comprehensive overview of child health services in the Fitzroy Valley. There were inadequate numbers of health professionals, facilities and accommodation; high staff turnover; and limited capacity and experience of local health professionals. Funding and administrative arrangements were complex and services poorly coordinated and sometimes duplicated. The large geographic area, distances, extreme climate and lack of public and private transport challenge service delivery. The need to attend to acute illness acts to deprioritise crucial primary and preventative health care and capacity for dealing with chronic, complex disorders. Some services lack cultural safety and there is a critical shortage of Aboriginal Health Workers (AHW). Conclusions: Services are fragmented and variable and would benefit from a coordinated approach between government, community-controlled agencies, health and education sectors. A unifying model of care with emphasis on capacity-building in Aboriginal community members and training and support for AHW and other health professionals is required but must be developed in consultation with communities. Innovative diagnostic and care models are needed to address these challenges, which are applicable to many remote Australian settings outside the Fitzroy Valley, as well as other countries globally. Our results will inform future health service planning and strategies to attract and retain health professionals to work in these demanding settings. A prospective audit of child health services is now needed to inform improved planning of child health services with a focus on identifying service gaps and training needs and better coordinating existing services to improve efficiency and potentially also efficacy.

KW - Child health

KW - Coordination

KW - Fetal alcohol Spectrum disorders

KW - Health services

KW - Indigenous

KW - Integration

KW - Remote Australia

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U2 - 10.1186/s12913-019-4605-0

DO - 10.1186/s12913-019-4605-0

M3 - Review article

VL - 19

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

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ER -