NACCHO news: Aboriginal Families Study: a population-based study keeping community and policy goals in mind

“This paper describes the development of a statewide study in South Australia that aims to invite approximately 300 women giving birth to an Aboriginal baby to talk about their experiences of using services during pregnancy, labour and birth, and the first 4–12 months after having a baby

We are delighted to confirm that the final versions of your manuscript have been published on the International Journal for Equity in Health website,

Mary Buckskin, CEO , Aboriginal Health Council of SA (pictured above)

Title: Aboriginal Families Study: a population-based study keeping community and policy goals in mind right from the start

DOWNLOAD the STUDY HERE

Authors: Buckskin  Mary, Ah Kit  Jackie, Glover  Karen, Mitchell  Amanda, Miller  Roxanne, Weetra  Donna, Wiebe  Jan, Yelland S Jane, Newbury  Jonathan, Robinson  Jeffrey, Brown J Stephanie,

Journal: International Journal for Equity in Health

The study has been developed by researchers based at the Murdoch Children’s Research Institute and the University of Adelaide, in partnership with the Aboriginal Health Council of South Australia Inc.

Abstract

Background: Australian Aboriginal and Torres Strait Islander women are between two to five times more likely to die in childbirth than non-Aboriginal women, and two to three times more likely to have a low birthweight infant.

Babies with a low birthweight are more likely to have chronic health problems in adult life.

Currently, there is limited research evidence regarding effective interventions to inform new initiatives to strengthen antenatal care for Aboriginal families.

Method/Design:

The Aboriginal Families Study is a cross sectional population-based study investigating the views and experiences of Aboriginal and non-Aboriginal women having an Aboriginal baby in the state of South Australia over a 2-year period.

The primary aims are to compare the experiences and views of women attending standard models of antenatal care with those accessing care via Aboriginal Family Birthing Program services which include Aboriginal Maternal Infant Care (AMIC) Workers as members of the clinical team; to assess factors associated with early and continuing engagement with antenatal care; and to use the information to inform strengthening of services for Aboriginal families.

Women living in urban, regional and remote areas of South Australia have been invited to take part in the study by completing a structured interview or, if preferred, a self-administered questionnaire, when their baby is between 4–12 months old.

Discussion: Having a baby is an important life event in all families and in all cultures. How supported women feel during pregnancy, how women and families are welcomed by services, how safe they feel coming in to hospitals to give birth, and what happens to families during a hospital stay and in the early months after the birth of a new baby are important social determinants of maternal, newborn and child health outcomes.

The Aboriginal Families Study builds on consultation with Aboriginal communities across South Australia. The project has been implemented with guidance from an Aboriginal Advisory Group keeping community and policy goals in mind right from the start. The results of the study will provide a unique resource to inform quality improvement and strengthening of services for Aboriginal families.

Keywords: Antenatal care, Health inequalities, Indigenous health, Maternal health, Participatory research, Perinatal health outcomes.

Introduction

Australian Aboriginal and Torres Strait Islander women are between two to five times more likely to die in childbirth than non-Indigenous women, and two to three times more likely to have a low birthweight infant [1].

Babies with a low birth weight are more likely to die in infancy [2], more likely to be admitted to neonatal intensive care [3], and may be more likely to have serious health problems (e.g. cardiovascular disease, diabetes) in adult life [4]. Recent data suggest that in some Australian states, including South Australia, the proportion of low birth weight babies born to Aboriginal mothers may be increasing [5,6].

The Australian Government has set agreed targets for closing the gap in Indigenous disadvantage outlined by the Council of Australian Governments (COAG) in the National Indigenous Reform Agenda [7].

Under the terms of this agreement, federal, state and territory governments have committed to closing the gap in life expectancy between Aboriginal and non-Aboriginal Australians within a generation, and halving the gap in mortality rates for Aboriginal children under five within a decade.

Key performance indicators for the National Indigenous Reform Agenda include: an increase in the proportion of Aboriginal and Torres Strait Islander mothers receiving antenatal care in the first trimester of pregnancy (≤13 weeks’ gestation) and in the proportion of Aboriginal and Torres Strait Islander mothers attending five or more antenatal visits; and a reduction in the proportion of Aboriginal and Torres Strait Islander infants with a low birthweight (<2,500 grams).

New funding made available under the COAG National Partnership Agreement on Indigenous Early Childhood Development has facilitated a range of new programs and initiatives to strengthen antenatal care and child and maternal health services for Aboriginal families in all Australian states and territories [8].

Currently there is a dearth of research evidence regarding effective intervention strategies to inform these initiatives [9-12].

Most of the available evidence comes from small-scale local evaluation studies, predominantly undertaken in regional and remote locations [13-20]. The roll out of COAG funding under the National Partnership Agreement has in effect created an Australia wide ‘natural experiment’ in seeking to improve maternal and perinatal outcomes for Aboriginal and Torres Strait Islander women and children. It is vital that lessons learned fromthe range of programs being developed and implemented with COAG funding are captured by concurrent evaluation at a state and territory level.

However, there is still no complete national perinatal data for Aboriginal mothers and babies. State and territory based perinatal data collections vary in their capacity to ascertain Aboriginal and Torres Strait Islander status of mothers and infants, and steps have only recently been taken to include information regarding status of the infant in the minimum data set for most state jurisdictions [21].

This paper describes the development of a statewide study in South Australia that aims to invite approximately 300 women giving birth to an Aboriginal baby to talk about their experiences of using services during pregnancy, labour and birth, and the first 4–12 months after having a baby.

The study has been developed by researchers based at the Murdoch Childrens Research Institute and the University of Adelaide, in partnership with the Aboriginal Health Council of South Australia Inc. (AHCSA). The project arose in the context of planning for a population-based postal survey of recent mothers in South Australia and Victoria.

In 2006, the researchers planning this survey approached the AHCSA about working in partnership on a project to provide avenues for Aboriginal women’s voices to be included in the research. At our initial meeting we discussed the idea of seeking funding to facilitate consultations with Aboriginal community organisations and communities in South Australia as a way to seek input into development of the research. The Aboriginal Families Study is the name given to the project that grew out of these discussions. South Australia where the project is based is one of six Australian states, and covers a geographic area four times the size of the UK.

Often when researchers approach Aboriginal community organisations and/or communities, they already havea fairly well developed research question and study protocol in mind. We did not. This paper charts the social history of the project, and outlines the steps we took to get from our initial discussions in 2006 to the stage of developing the study protocol, governance arrangements, and procedures for carrying out the study.

These include: obtaining ‘in principle’ support from the Board of Management of the AHCSA for the conduct of consultations with Aboriginal communities about the project; development of a project agreement between MCRI and the AHCSA; establishment of an Aboriginal Advisory Group to guide the consultations, and subsequently, the development of the study protocol, and conduct of the research; statewide consultations with  Aboriginal communities, policy makers and service providers preceding development of the study design and methods; a lengthy pilot study phase that tested different versions of the study questionnaire and recruitment procedures; obtaining ethics approval from a variety of institutional ethics committees; development of a Research Agreement covering governance arrangements for the research phase of the study signed by all partner organisations and study investigators; appointment and training of the fieldwork team; through to recruitment and interviewing of women in urban, regional and remote areas of South Australia.

NACCHO health news:More action needed on alcohol misuse among Aboriginal people in Ceduna SA

The CEO of the Aboriginal Health Council of South Australia (AHCSA), Mrs Mary Buckskin (pictured above)  has called for more action to address the problem of alcohol misuse among Aboriginal people in the Ceduna area in the far west of South Australia.

“AHCSA supported the findings and recommendation of the 2011 report of the State Coroner following the inquest into a number of alcohol-related deaths in the area,” she said.

“We are pleased that some of the recommendations have been implemented. In particular, the expansion of the sobering-up shelter managed by Ceduna-Koonibba Aboriginal Health Service is clearly better meeting the need.”

However, Mrs Buckskin stressed that much more must be done, as clearly problems persist. “There is a need for a more strategic approach involving Aboriginal communities and their organisations in Ceduna and surrounding areas, as well as Yalata and Oak Valley.

“Currently, some actions taken by some agencies are ad hoc rather than being part of an overall strategy, and are not necessarily helping the problem.

“There is no single magic bullet to address it. What is required is a range of strategies developed with appropriate consultation, and introduced in a coordinated way.

“We need strategies to reduce the availability of alcohol; we need strategies to ensure that people with alcohol problems have access to health services where they can be properly assessed and offered treatment; we need appropriate rehabilitation services for individuals and families,” Mrs Buckskin said.

She added that people who have alcohol-related brain damage need to be properly assessed and provided with appropriate services.

“Above all, it must be recognised that the people at most risk of alcohol-related harm or death come from the communities further west. A comprehensive strategy to deal with alcohol problems in the Ceduna area must include supporting people to return to their country and ensuring that the communities concerned are adequately resourced to support this happening.

“While this will require significant resources, in the long run a coordinated comprehensive strategy will save lives and money. And this is really an issue of human dignity,” Mrs Buckskin said.

The Aboriginal Health Council of SA Inc. (AHCSA) is the peak body representing Aboriginal community controlled health and substance misuse services, and Aboriginal health advisory committees across South Australia. AHCSA is an affiliate of the National Aboriginal Community Controlled Health Organisation.

ENDS. For further information contact: Mrs Mary Buckskin, Chief Executive Officer, Aboriginal Health Council of South Australia Inc., 08 8273 7200.

NACCHO tribute :Aboriginal Health Council of SA in ANZAC DAY tributes

 CEO Mary Buckskin thanks Board Member Les Kropinyeri

CEO Mary Buckskin thanks Les Kropinyeri

$1 million has been fundraised to erect a Memorial for all Aboriginal and Torres Strait Islander people in Australia at the Torrens Parade Ground in South Australia.

“When Australia went to war, Aboriginal and Torres Strait Islander people went to war voluntarily to fight for our own country,” said Corporal Les Kropinyeri, returned serviceman and Board Member of the Aboriginal Health Council of SA Inc.

“Aboriginal and Torres Strait Islander people used Afghan names or any other name to enlist as service men and women.

“We didn’t have to go to war – we wanted to go to war to fight for our country and to protect what we have for all Australians,” Les Kropinyeri said.

This is the story that is often unheard – the story of our Indigenous Australians who numbered in their thousands to fight for freedom.

According to Reconciliation Australia, over 3,000 Aboriginal and Torres Strait Islander men and women enlisted in World War II and over 800 are known to have served in World War I. The true number is likely to be much higher. There are up to 7,000 Aboriginal and Torres Strait Islander veterans and war widows in the Australian community today, and more than 800 Aboriginal and Torres Strait Islander Australians currently serve with distinction in the Australian Defence Forces.

Les Kropinyeri who went into the Defence Force in April 1967, served in Vietnam from 1968-69 in the 9th Batallion of the Royal Australian Regiment, five months before the end of his voluntary 2-year national service.

He recalls the infantry, ‘Charlie Company’, where he was in charge of a section of men within the 7th Platoon, comprising ten in all, including a rifle section, a gun section and forward scouts.  Les Kropinyeri was a Section Commander and proud of it.

Les Kropinyeri has since served his community and all Australians well including as a Board Member of the Aboriginal Health Council of SA Inc.

Chairperson of the Council Mr John Singer pays particular respect on behalf of the Board to Les Kropinyeri and his fellow Aboriginal and Torres Strait Islander service men and women on this ANZAC Day, 25 April 2013.

Led by Sir Eric Neale, $1 million has been fundraised to erect a Memorial for all Aboriginal and Torres Strait Islander people in Australia at the Torrens Parade Ground in South Australia. Les Kropinyeri says this is a first because most other states have only erected memorials for Aboriginal and Torres Strait Islander people of their own states.

A Committee was formed comprising retired, non-active service men and service women including Les Kropinyeri, Gill Green, Frank Clarke, Francis Lampard (Deputy Chairperson), Marj Tripp (Chairperson), Bill Hignett, Bill Denny, Mike Mummery, Garth Dodd (representing Janine Haynes), Elaine Lomas, Lowitja O’Donoghue, Rossalyn Cox, Mark Waters, Eunmi Parke, Ian Smith, and Barry Forrest. This Committee decided to record all the names of Aboriginal and Torres Strait Islander people in Australia who served on any war, and the list is growing.

Names have been gathered from everywhere with Elders Groups being the main contributors. “There will be a roll somewhere in time when we have completed the list,” said Les Kropinyeri.

Considering the funds raised through Sir Eric Neale, it was decided to erect a Memorial and now the Committee is concentrating on completing the bronze statues of male and female Aboriginal and Torres Strait Islander people who served in the wars. It is expected that the Memorial will be unveiled in November 2013.

The Aboriginal Health Council of SA Inc. would like to honour Les Kropinyeri and all Aboriginal and Torres Strait Islander veterans on this ANZAC Day 2013. Mr John Singer, Chairperson said, “We are suitably proud of Les Kropinyeri and his fellow returned service men and women, and the fact that they voluntarily fought for our country and freedom.”

The Aboriginal Health Council of SA Inc. (AHCSA) is the peak body representing Aboriginal community controlled health and substance misuse services, and Aboriginal health advisory committees across South Australia. AHCSA is an affiliate of the National Aboriginal Community Controlled Health Organisation.

ENDS. For further information contact: Mrs Mary Buckskin, Chief Executive Officer, Aboriginal Health Council of South Australia Inc., 08 8273 7200.