Abstract
BackgroundRemote dwelling Aboriginal infants from northern Australia have a high burden of disease and frequently use health services. Little is known about the quality of infant care provided by remote health services. This study describes the adherence to infant guidelines for anaemia and growth faltering by remote health staff and barriers to effective service delivery in remote settings.MethodsA mixed method study drew data from 24 semi-structured interviews with clinicians working in two remote communities in northern Australia and a retrospective cohort study of Aboriginal infants from these communities, born 2004–2006 (n = 398). Medical records from remote health centres were audited. The main outcome measures were the period prevalence of infants with anaemia and growth faltering and management of these conditions according to local guidelines. Qualitative data assessed clinicians’ perspectives on barriers to effective remote health service delivery.ResultsData from 398 health centre records were analysed. Sixty eight percent of infants were anaemic between six and twelve months of age and 42% had documented growth faltering by one year. Analysis of the growth data by the authors however found 86% of infants experienced growth faltering over 12 months. Clinical management and treatment completion was poor for both conditions. High staff turnover, fragmented models of care and staff poorly prepared for their role were barriers perceived by clinicians’ to impact upon the quality of service delivery.ConclusionAmong Aboriginal infants in northern Australia, malnutrition and anaemia are common and occur early. Diagnosis of growth faltering and clinicians’ adherence to management guidelines for both conditions was poor. Antiquated service delivery models, organisation of staff and rapid staff turnover contributed to poor quality of care. Service redesign, education and staff stability must be a priority to redress serious deficits in quality of care provided for these infants.
Highlights
Remote dwelling Aboriginal infants from northern Australia have a high burden of disease and frequently use health services
Iron deficiency anaemia is the leading type of anaemia identified in remote dwelling Aboriginal children in the Northern Territory (NT) [8]
Anaemia prevalence among all infants was 68% (n = 228); mean Hb 97.3gm/dl at first diagnosis (SD 9.3, 95% CI 96.1-98.5) when the mean age at diagnosis was 7.6 months (SD 2.8 months, 95% CI 7.3-8.0)
Summary
Remote dwelling Aboriginal infants from northern Australia have a high burden of disease and frequently use health services. This study describes the adherence to infant guidelines for anaemia and growth faltering by remote health staff and barriers to effective service delivery in remote settings. Health outcomes of Australian Aboriginal children are significantly worse than their non-Aboriginal counterparts [1]. These differences are manifest in two to three times higher rates of perinatal mortality, preterm birth and low birth weight [2]. The prevalence of anaemia and nutritional problems is much higher in Aboriginal children during their first years of life as is the overall burden of disease and hospitalisation rate [3,4,5,6]. Numerous studies have shown associations between iron deficiency anemia and delayed psychomotor development and behavioural problems in childhood [12,13,14,15]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
