Early childhood development and growth
For any generational change to occur in Indigenous communities, government programmes must start with helping parents receive the appropriate level of health care for their children. It is essential to give a young child (birth to three years old) a healthy start in life. Of all births registered in Australia in 2005, 5%-or 12,100-were Indigenous.
Infant mortality rates have decreased over recent years and the survival of infants in their first year of life is generally viewed as an indicator of the general health and wellbeing of the local population. Low birth weight and hearing impediments are important as they can diminish a child's capacity to learn and socialise. This in turn can contribute to future learning disadvantage and poor health outcomes.
The key programmes that contribute towards this strategic area include initiatives that strengthen parenting skills in families and communities to help build their resilience and support networks, especially those at risk of abuse or neglect. Child care facilities and services are also supporting early childhood development and growth and promoting early school engagement and performance.
Outcomes
- Over the period 2001–04, the perinatal death rate of babies born to Indigenous mothers declined significantly (from 16 to 11 per 1,000 births).
- Average birth weights and proportions of low birth weight babies to Indigenous mothers did not change between 1998–2000 and 2002–04.
- In the 12 months from May 2006 to the end of April 2007 there were 5,347 of the new Medicare-funded Aboriginal and Torres Strait Islander child health checks conducted nationally.
Key programmes
Healthy for Life
Healthy for Life, announced in the 2005–06 Budget, provides $102.4 million over four years for over 80 primary health care services to improve the quality of Aboriginal and Torres Strait Islander child and maternal health services and chronic disease care.
These primary health care services are participating in the Healthy for Life programme through 53 sites. Over 80% of services are located in regional or remote areas and 20 sites are in areas with few or no Australian Government provided health services.
Healthy for Life includes Aboriginal Community Controlled Health Organisations and mainstream services. All participating services in Healthy for Life are expected to enhance and implement improved working relationships with other health service providers. Thirteen state and territory health services and three Australian Divisions of General Practice (now called the Australian General Practice Network) are now participating in the programme.
Healthy for Life's expected outcomes in 2005–09 include:
- increases in first attendance for antenatal care in the first trimester and in mean birth weight to within 200 grams of the non-Indigenous population
- 10% increase a year in the number of adult and child health checks
- a decrease in incidence of low birth weight by 10% and a reduction in selected behavioural risk factors in pregnancy by 10%
- 30% improvement in best practice service delivery for people with chronic conditions
- 30% reduction in hospital admissions for chronic disease complications
- 30% improvement in numbers of patients with intermediate health outcomes indicators.
Expenditure 2006–07: $24.3 million.
Outputs 2006–07:
- an outcomes evaluation framework will be in place by July 2006
- 53 Healthy for Life contracted sites selected
- 32 additional Indigenous health scholarships awarded.
Australian Hearing Specialist Programme for Indigenous Australians
The Office of Hearing Services, which was established in 1997, regulates and administers the Commonwealth Hearing Services Programme. The Australian Hearing Specialist Programme for Indigenous Australians (AHSPIA) is a Community Service Obligation category developed in recognition that at times services provided to Indigenous Australians need to be delivered differently from mainstream services.
AHSPIA focuses on providing tertiary level hearing and related services in community settings and in conjunction with Aboriginal communities and local Aboriginal health services. The government provider, Australian Hearing, has developed outreach programmes where services to Indigenous people are delivered away from mainstream hearing centres. These centres provide the basis for delivering services to Indigenous clients, including children and young adults under the age of 21 years and Indigenous Australians over 50 years, or participants in the Community Development Employment Projects (CDEP) programme or former participants in CDEP between 1 December 2005 and 30 June 2008.
The work of AHSPIA acknowledges the key message of the report Overcoming Indigenous Disadvantage: Key Indicators 2003 that while the true inconvenience of hearing loss on the Indigenous population is unclear, the risk of otitis media (middle ear infections) is significantly higher for Indigenous children than for non-Indigenous children and that it is likely that hearing impediments can substantially impact on the developmental future of Indigenous children.
Expenditure 2006–07: $4.6 million.
Outputs 2006–07:
- hearing services were provided at 171 Indigenous outreach sites compared with 129 sites in 2005–06
- 2,671 clients were seen and 3,497 services were provided.
Multifunctional Aboriginal Children's Services
The Australian Government provides funding for a number of Indigenous non-profit child care services including 33 multi-functional Aboriginal children's services (MACS). MACS provide care for preschool and school aged children and may include long day care, playgroups, outside school hours care, vacation care and cultural programmes. Care provided by MACS is culturally inclusive and may provide a range of other integrated early childhood services to support early childhood development and growth and promote early school engagement and performance.
Indigenous playgroups provide children not yet attending school with a wide range of culturally appropriate developmental and socialisation activities that are relevant to the community. The social development aims to prepare children for preschool, school and relationships within the wider community. Playgroups also provide an opportunity for families to share common experiences.
Expenditure 2006–07: $11 million.
Outputs 2006–07:
- 33 services were funded
- approximately 1,155 child care places were provided.
Indigenous Children Programme
The Indigenous Children Programme (ICP) was formed in 2006 by a merger of the previously funded Aboriginal Islander Child Care Agencies and Indigenous Parent and Family Wellbeing programmes. The ICP aims to strengthen parenting skills in families and communities to help build their resilience and support networks, especially those at risk of abuse or neglect. The programme aims to foster social connections and create positive educational outcomes.
Expenditure 2006–07: $4.288 million.
Outputs 2006–07:
Mobile services and toy libraries
Seventeen Indigenous mobile child care services visit regional and remote areas and may provide flexible child care sessions, playgroups sessions, vacation care, parenting and social support for families. Indigenous toy library services provide toy and video lending libraries and parent resource library services. Mobile child care services provide Indigenous children with an opportunity to mix with other children and participate in socialisation and creative activities that would not otherwise be available to them.
Expenditure 2006–07: $2.5 million.
Outputs 2006–07:
- 17 services funded.
Smile-a-mile mobile, Northern Territory
Smile-a-mile mobile playgroup and toy library received funding in 2006-–07 for its mobile service truck, which has been decorated with brightly painted murals by the service. The mobile service receives ongoing Australian Government funding to provide a connection between mainstream services and communities living in remote areas. The Smile-a-mile mobile visits 17 venues on a 5–8 week roster, six of which are the Aboriginal communities of Acacia Larrakia, 15 Mile, Belyuen, Daly River, Kybrook Farm and Jabiru. It also visits Bathurst Island four times a year.