Health services for aboriginal and Torres Strait Islander children in remote Australia: A scoping review

PLOS Glob Public Health. 2023 Feb 13;3(2):e0001140. doi: 10.1371/journal.pgph.0001140. eCollection 2023.

Abstract

In Australia, there is a significant gap between health outcomes in Indigenous and non-Indigenous children, which may relate to inequity in health service provision, particularly in remote areas. The aim was to conduct a scoping review to identify publications in the academic and grey literature and describe 1) Existing health services for Indigenous children in remote Australia and service use, 2) Workforce challenges in remote settings, 3) Characteristics of an effective health service, and 4) Models of care and solutions. Electronic databases of medical/health literature were searched (Jan 1990 to May 2021). Grey literature was identified through investigation of websites, including of local, state and national health departments. Identified papers (n = 1775) were screened and duplicates removed. Information was extracted and summarised from 116 papers that met review inclusion criteria (70 from electronic medical databases and 45 from the grey literature). This review identified that existing services struggle to meet demand. Barriers to effective child health service delivery in remote Australia include availability of trained staff, limited services, and difficult access. Aboriginal and Community Controlled Health Organisations are effective and should receive increased support including increased training and remuneration for Aboriginal Health Workers. Continuous quality assessment of existing and future programs will improve quality; as will measures that reflect aboriginal ways of knowing and being, that go beyond traditional Key Performance Indicators. Best practice models for service delivery have community leadership and collaboration. Increased resources with a focus on primary prevention and health promotion are essential.

Grants and funding

This work was supported by the Australian National University Medical School and the College of Biology, Medicine and the Environment (to PD); the University of Sydney Poche Institute Scholarship (to PD); the Avant Doctor in Training Research scholarship (to PD). Further support was from the University of Sydney Curtin PhD Scholarship for Clinical Research (to JF); the National Health and Medical Research Council of Australia (NHMRC) TRIP (Translating Research into Practice) Fellowship 2017-2019 (#1112387 to AM) and an NHMRC Investigator Grant 2021-current (#1195086 to AM); NHMRC Practitioner Fellowship 2012-2016 (#1021480 to EE); an NHMRC Centre of Research Excellence Grant 2016-21 (#1110341 to EE) and a Medical Research Futures Fund Next Generation Fellowship 2018-current (#1135959 to EE). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.