The quality of health services provided to remote dwelling aboriginal infants in the top end of northern Australia following health system changes: a qualitative analysis

Josif, Cathryn M., Kruske, Sue, Kildea, Sue V. and Barclay, Lesley M. (2017) The quality of health services provided to remote dwelling aboriginal infants in the top end of northern Australia following health system changes: a qualitative analysis. BMC Pediatrics, 17 93: . doi:10.1186/s12887-017-0849-1


Author Josif, Cathryn M.
Kruske, Sue
Kildea, Sue V.
Barclay, Lesley M.
Title The quality of health services provided to remote dwelling aboriginal infants in the top end of northern Australia following health system changes: a qualitative analysis
Journal name BMC Pediatrics   Check publisher's open access policy
ISSN 1471-2431
Publication date 2017-03-01
Year available 2017
Sub-type Article (original research)
DOI 10.1186/s12887-017-0849-1
Open Access Status DOI
Volume 17
Issue 93
Total pages 12
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2018
Language eng
Formatted abstract
Background
In Australia the health outcomes of remote dwelling Aboriginal infants are comparable to infants in developing countries. This research investigates service quality, from the clinicians’ perspective and as observed and recorded by the researcher, in two large Aboriginal communities in the Top End of northern Australia following health system changes.

Methods
Data were collected from semi-structured interviews with 25 clinicians providing or managing child health services in the two study sites. Thirty hours of participant observation was undertaken in the ‘baby-rooms’ at the two remote health centres between June and December 2012. The interview and observational data, as well as field notes were integrated and analysed thematically to explore clinicians’ perspectives of service delivery to infants in the remote health centres.

Results
A range of factors affecting the quality of care, mostly identified before health system changes were instigated, persisted. These factors included ineffective service delivery, inadequate staffing and culturally unsafe practices. The six themes identified in the data: ‘very adhoc’, ‘swallowed by acute’, ‘going under’, ‘a flux’, ‘a huge barrier’ and ‘them and us’ illustrate how these factors continue, and when combined portray a ‘very chaotic system’.

Conclusion
Service providers perceived service provision and quality to be inadequate, despite health system changes. Further work is urgently needed to improve the quality, cultural responsiveness and effectiveness of services to this population.
Keyword Aboriginal
Anaemia
Australia
Child Health
Growth faltering
Indigenous
Infant
Remote
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Nursing, Midwifery and Social Work Publications
 
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