Do Australian policies enable a primary health care system to identify family adversity and subsequently support these families-A scoping study

Suzy Honisett; Hayley Loftus; HueiMing Liu; Alicia Montgomery; Denise De Souza; Teresa Hall; John Eastwood; Harriet Hiscock; Sharon Goldfeld

doi:10.1002/hpja.684

Do Australian policies enable a primary health care system to identify family adversity and subsequently support these families-A scoping study

Health Promot J Austr. 2023 Feb;34(1):211-221. doi: 10.1002/hpja.684. Epub 2022 Dec 12.

Authors

Suzy Honisett¹, Hayley Loftus¹, HueiMing Liu², Alicia Montgomery³, Denise De Souza⁴, Teresa Hall¹, John Eastwood^{3

5}, Harriet Hiscock⁶, Sharon Goldfeld⁶

Affiliations

¹ Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
² Health Systems Science, The George Institute for Global Health, Newtown, New South Wales, Australia.
³ Sydney Institute for Women, Children, and their Families, Sydney Local Health District, Camperdown, New South Wales, Australia.
⁴ Torrens University, Melbourne, Victoria, Australia.
⁵ Centre for Research Excellence for Integrated Health and Social Care, University of Sydney Menzies Centre for Health Policy and Economics, Sydney, New South Wales, Australia.
⁶ Centre for Community Child Health, Murdoch Children's Research Institute, The Royal Children's Hospital, The University of Melbourne, Parkville, Victoria, Australia.

Abstract

Issue addressed: To determine if Australian policies support a primary health care system to identify family adversity and subsequently support these families.

Methods: Two methodological approaches were used: (i) a scoping review of Australian federal and two states (Victoria and New South Wales) policies related to family adversity (e.g., childhood maltreatment or household dysfunction, such as parental mental illness); (ii) thirteen semi-structured interviews with Victorian Community Health Service (CHS) staff and government policy makers, recruited via snowball sampling to understand the context of policy making and service implementation. Data collected were subsequently discussed in relation to the Stages Model of policy analysis.

Results: One hundred and eighty-eight policies referenced family adversity. Of these, 37 policies met all eligibility criteria including a focus on early intervention within primary care and were included in the review. Most policies were developed within health departments (78%) and included a wide range of adversities, with the majority based within maternal and child health and CHS platforms. Most policy development included consultation with stakeholders. Although most policies received some level of funding, few included funding details and only a third included evaluation.

Conclusions: There are many policies related to family adversity in Australia, with most focused within existing primary care platforms. Given these policies, Australia should be well positioned to identify and respond to family adversity.

So what: More work needs to be done to ensure policies are adequately implemented, evaluated and transparently and appropriately funded. The co-occurrence of adversity should focus policy action; and potentially lead to more effective and efficient outcomes.

Keywords: family adversity; health policy; policy implementation; scalability; scale-up.

Publication types

Review

MeSH terms

Child
Community Health Services*
Delivery of Health Care*
Humans
New South Wales
Policy
Victoria

Abstract

Publication types

MeSH terms

Grants and funding