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

Research Article

Sue V. Kildea¹  Sue Kruske¹  Lesley M. Barclay²  Cathryn M. Josif² 

[1] School of Nursing Midwifery and Social Work, The University of Queensland (UQ), 4010, Brisbane, Australia;University Centre for Rural Health Sydney School of Public Health, University of Sydney, 2480, Sydney, NSW, Australia;

关键词: Aboriginal;    Anaemia;    Australia;    Child Health;    Growth faltering;    Indigenous;    Infant;    Remote;   

DOI  :  10.1186/s12887-017-0849-1

 received in 2016-09-28, accepted in 2017-03-24,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIn 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.MethodsData 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.ResultsA 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’.ConclusionService 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.

【 授权许可】

CC BY   
© The Author(s). 2017