Adherence to management guidelines for growth faltering and anaemia in remote dwelling Australian Aboriginal infants and barriers to health service delivery

Journal article

Bar-Zeev, Sarah, Kruske, Sue, Barclay, Lesley, Bar-Zeev, Naor and Kildea, Sue. (2013). Adherence to management guidelines for growth faltering and anaemia in remote dwelling Australian Aboriginal infants and barriers to health service delivery. BMC Health Services Research. 13(250), pp. 1 - 12. https://doi.org/10.1186/1472-6963-13-250
AuthorsBar-Zeev, Sarah, Kruske, Sue, Barclay, Lesley, Bar-Zeev, Naor and Kildea, Sue
Abstract

Background

Remote dwelling Aboriginal infants from northern Australia have a high burden of disease and frequently use health services. Little is known about the quality of infant care provided by remote health services. This study describes the adherence to infant guidelines for anaemia and growth faltering by remote health staff and barriers to effective service delivery in remote settings. Methods

A mixed method study drew data from 24 semi-structured interviews with clinicians working in two remote communities in northern Australia and a retrospective cohort study of Aboriginal infants from these communities, born 2004–2006 (n = 398). Medical records from remote health centres were audited. The main outcome measures were the period prevalence of infants with anaemia and growth faltering and management of these conditions according to local guidelines. Qualitative data assessed clinicians’ perspectives on barriers to effective remote health service delivery. Results

Data from 398 health centre records were analysed. Sixty eight percent of infants were anaemic between six and twelve months of age and 42% had documented growth faltering by one year. Analysis of the growth data by the authors however found 86% of infants experienced growth faltering over 12 months. Clinical management and treatment completion was poor for both conditions. High staff turnover, fragmented models of care and staff poorly prepared for their role were barriers perceived by clinicians’ to impact upon the quality of service delivery. Conclusion

Among Aboriginal infants in northern Australia, malnutrition and anaemia are common and occur early. Diagnosis of growth faltering and clinicians’ adherence to management guidelines for both conditions was poor. Antiquated service delivery models, organisation of staff and rapid staff turnover contributed to poor quality of care. Service redesign, education and staff stability must be a priority to redress serious deficits in quality of care provided for these infants.

KeywordsAboriginal; Adherence; Anaemia; Australia; Barriers; Growth faltering; Infant; Management guidelines; Primary health care; Remote; Quality of care
Year2013
JournalBMC Health Services Research
Journal citation13 (250), pp. 1 - 12
ISSN1472-6963
Digital Object Identifier (DOI)https://doi.org/10.1186/1472-6963-13-250
Scopus EID2-s2.0-84879832432
Open accessOpen access
Page range1 - 12
Research GroupSchool of Nursing, Midwifery and Paramedicine
Publisher's version
Permalink -

https://acuresearchbank.acu.edu.au/item/870zq/adherence-to-management-guidelines-for-growth-faltering-and-anaemia-in-remote-dwelling-australian-aboriginal-infants-and-barriers-to-health-service-delivery

Log in to edit

Download files

Publisher's version
Bar_Zeev_2013_Adherence_to_managment.pdf

  • 124
    total views
  • 99
    total downloads
  • 3
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Exploring the impact of a dual occupancy neonatal intensive care unit on staff workflow, activity, and their perceptions
Broom, Margaret, Kecskes, Zsuzsoka, Kildea, Sue and Gardner, Anne. (2019). Exploring the impact of a dual occupancy neonatal intensive care unit on staff workflow, activity, and their perceptions. Health Environments Research and Design Journal. 12(2), pp. 44-54. https://doi.org/10.1177/1937586718779360
Does introducing a dedicated early labour area improve birth outcomes? A pre-post intervention study
Williams, Lauren, Jenkinson, Bec, Lee, Nigel, Gao, Yu, Allen, Jyai, Morrow, Jane and Kildea, Sue. (2019). Does introducing a dedicated early labour area improve birth outcomes? A pre-post intervention study. Women and Birth. 33(3), pp. 259 - 264. https://doi.org/10.1016/j.wombi.2019.05.001
The Indigenous Birthing in an Urban Setting study: the IBUS study
Sophie Hickey, Yvette Roe, Yu Gao, Carmel Nelson, Adrian Carson, Jody Currie, Maree Reynolds, Kay Wilson, Sue Kruske, Renee Blackman, Megan Passey, Anton Clifford, Sally Tracy, Roianne West, Daniel Williamson, Machellee Kosiak, Shannon Watego, Joan Webster and Sue Kildea. (2018). The Indigenous Birthing in an Urban Setting study: the IBUS study. BMC Pregnancy and Childbirth. 18(431), pp. 1-12. https://doi.org/10.1186/s12884-018-2067-8
Predictors of breastfeeding exclusivity and duration in a hospital without Baby Friendly Hospital Initiative accreditation : A prospective cohort study
O'Connor, Michelle, Allen, Jyai, Kelly, Jennifer, Gao, Yu and Kildea, Sue. (2018). Predictors of breastfeeding exclusivity and duration in a hospital without Baby Friendly Hospital Initiative accreditation : A prospective cohort study. Australian Midwifery. 31(4), pp. 319-324. https://doi.org/10.1016/j.wombi.2017.10.013
Is the Birthing Unit Design Spatial Evaluation Tool valid for diverse groups?
Sara Menke, Bec Jenkinson, Maralyn Foureur and Sue Kildea. (2018). Is the Birthing Unit Design Spatial Evaluation Tool valid for diverse groups? Australian Midwifery. 32(4), pp. 372-379. https://doi.org/10.1016/j.wombi.2018.09.009
Birthing on Country (in Our Community): A case study of engaging stakeholders and developing a best-practice Indigenous maternity service in an urban setting
Sue Kildea, Sophie Hickey, Carmel Nelson, Jody Currie, Adrian Carson, Maree Reynolds, Kay Wilson, Sue Kruske, Megan Passey, Yvette Roe, Roianne West, Anton Clifford, Machellee Kosiak, Shannon Watego and Sally Tracy. (2018). Birthing on Country (in Our Community): A case study of engaging stakeholders and developing a best-practice Indigenous maternity service in an urban setting. Australian Health Review. 42(2), pp. 230-238. https://doi.org/10.1071/AH16218
Transition from an open-plan to a two-cot neonatal intensive care unit : A participatory action research approach
Broom, Margaret, Gardner, Anne, Kecskes, Zsuzsoka and Kildea, Sue. (2017). Transition from an open-plan to a two-cot neonatal intensive care unit : A participatory action research approach. Journal of Clinical Nursing. 26(13-14), pp. 1939-1948. https://doi.org/10.1111/jocn.13509
So you want to conduct a randomised trial? Learnings from a ‘failed’ feasibility study of a Crisis Resource Management prompt during simulated paediatric resuscitation
Teis, Rachel, Allen, Jyai, Lee, Nigel and Kildea, Sue. (2017). So you want to conduct a randomised trial? Learnings from a ‘failed’ feasibility study of a Crisis Resource Management prompt during simulated paediatric resuscitation. Australasian Emergency Nursing Journal. 20(1), pp. 37 - 44. https://doi.org/10.1016/j.aenj.2016.12.001
How optimal caseload midwifery can modify predictors for preterm birth in young women : Integrated findings from a mixed methods study
Allen, Jyai, Kildea, Sue and Stapleton, Helen. (2016). How optimal caseload midwifery can modify predictors for preterm birth in young women : Integrated findings from a mixed methods study. Midwifery. 41, pp. 30-38. https://doi.org/10.1016/j.midw.2016.07.012
Reconceptualising risk: Perceptions of risk in rural and remote maternity service planning
Barclay, Lesley, Kornelsen, Jude, Longman, Jo, Robin, Sarah, Kruske, Sue, Kildea, Sue Verlie, Pilcher, Jennifer, Martin, Tanya, Grzybowski, Stefan, Donoshue, Deborah Anne, Rolfe, Margaret and Morgan, Geoff. (2016). Reconceptualising risk: Perceptions of risk in rural and remote maternity service planning. Midwifery. 38, pp. 63 - 70. https://doi.org/10.1016/j.midw.2016.04.007
Does model of maternity care make a difference to birth outcomes for young women? A retrospective cohort study
Allen, Jyai, Gibbons, Kristen, Beckmann, Michael, Tracy, Mark, Stapleton, Helen and Kildea, Sue. (2015). Does model of maternity care make a difference to birth outcomes for young women? A retrospective cohort study. International Journal of Nursing Studies. https://doi.org/10.1016/j.ijnurstu.2015.04.011
Identifying maternity services in public hospitals in rural and remote Australia
Longman, Jo, Pilcher, Jennifer, Donoshue, Deborah Anne, Rolfe, Margaret, Kildea, Susan, Kruske, Sue, Oats, Jeremy, Morgan, Geoffrey and Barclay, Lesley. (2014). Identifying maternity services in public hospitals in rural and remote Australia. Australian Health Review. 38(3), pp. 337 - 344. https://doi.org/10.1071/AH13188
Improving Aboriginal maternal and infant health services in the 'Top End' of Australia: synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change
Barclay, Lesley, Kruske, Sue, Bar-Zeev, Sarah, Steenkamp, Malinda, Josif, Cath, Narjic, Concepta Wulili Ulili, Wardaguga, Molly, Belton, Suzanne, Gao, Yu and Dunbar, Terry. (2014). Improving Aboriginal maternal and infant health services in the 'Top End' of Australia: synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change. BMC Health Services Research. 14(241), pp. 1 - 9. https://doi.org/10.1186/1472-6963-14-241
A cost-consequences analysis of a Midwifery Group Practice for Aboriginal mothers and infants in the Top End of the Northern Territory, Australia
Gao, Yu, Gold, Lisa, Josif, Cath, Bar-Zeev, Sarah, Steenkamp, Malinda, Barclay, Lesley, Zhao, Yuejen, Tracy, Sally and Kildea, Sue. (2014). A cost-consequences analysis of a Midwifery Group Practice for Aboriginal mothers and infants in the Top End of the Northern Territory, Australia. Midwifery. 30(4), pp. 447 - 455. https://doi.org/10.1016/j.midw.2013.04.004
Factors affecting the quality of antenatal care provided to remote dwelling Aboriginal women in northern Australia
Barclay, Lesley, Bar-Zeev, Sarah, Kruske, Sue and Kildea, Sue. (2014). Factors affecting the quality of antenatal care provided to remote dwelling Aboriginal women in northern Australia. Midwifery. 30(3), pp. 289 - 296. https://doi.org/10.1016/j.midw.2013.04.009
'No more strangers': Investigating the experiences of women, midwives and others during the establishment of a new model of maternity care for remote dwelling aboriginal women in northern Australia
Josif, Cath, Barclay, Lesley, Kruske, Sue and Kildea, Sue. (2014). 'No more strangers': Investigating the experiences of women, midwives and others during the establishment of a new model of maternity care for remote dwelling aboriginal women in northern Australia. Midwifery. 30(3), pp. 317 - 323. https://doi.org/10.1016/j.midw.2013.03.012
Use of maternal health services by remote dwelling aboriginal women in Northern Australia and their disease burdern
Bar-Zeev, Sarah, Barclay, Lesley, Kruske, Sue, Bar-Zeev, Naor, Gao, Yu and Kildea, Susan. (2013). Use of maternal health services by remote dwelling aboriginal women in Northern Australia and their disease burdern. Birth : Issues in perinatal care. https://doi.org/10.1111/birt.12053
'Give us the full story': Overcoming the challenges to achieving informed choice about fetal anomaly screening in Australian Aboriginal communities
Wild, Kayli, Maypilama, Elaine, Kildea, Sue, Boyle, Jacqueline, Barclay, Lesley and Rumbold, Alice. (2013). 'Give us the full story': Overcoming the challenges to achieving informed choice about fetal anomaly screening in Australian Aboriginal communities. Social Science & Medicine. https://doi.org/10.1016/j.socscimed.2012.10.031
Can the fetal fibronectin test be used by remote dwelling pregnant women to predict the onset of labour at term and delay transfer for birth in regional settings?
Rumbold, Alice, Kruske, Sue, Boyle, Jacqueline, Weckert, Rosemary, Putland, Sally, Giles, Lynne, Barclay, Lesley and Kildea, Susan V.. (2013). Can the fetal fibronectin test be used by remote dwelling pregnant women to predict the onset of labour at term and delay transfer for birth in regional settings? Rural and Remote Health.
Can the fetal fibronectin test be used by remote dwelling pregnant women to predict the onset of labour at term and delay transfer for birth in regional settings?
Rumbold, Alice, Kruske, Sue, Boyle, Jacqueline, Weckert, Rosemary, Putland, Sally, Giles, Lynne, Barclay, Lesley and Kildea, Susan V.. (2013). Can the fetal fibronectin test be used by remote dwelling pregnant women to predict the onset of labour at term and delay transfer for birth in regional settings? Rural and Remote Health.
Impact on Caesarean section rates following injections of sterile water (ICARIS): a multicentre randomised controlled trial
Lee, Nigel, Mårtensson, Lena B., Homer, Caroline, Webster, Joan, Gibbons, Kristen, Stapleton, Helen, Dos Santos, Natalie, Beckmann, Michael, Gao, Yu and Kildea, Sue. (2013). Impact on Caesarean section rates following injections of sterile water (ICARIS): a multicentre randomised controlled trial. BMC Pregnancy and Childbirth. 13(105), pp. 1 - 10. https://doi.org/10.1186/1471-2393-13-105
Caseload midwifery care versus standard maternity care for women of any risk : M@NGO, a randomised controlled trial
Tracy, Sally, Hartz, Donna, Tracy, Mark, Allen, Jyai, Forti, Amanda, Hall, Bev, White, Jan, Lainchbury, Anne, Stapleton, Helen, Beckmann, Michael, Bisits, Andrew, Homer, Caroline, Foureur, Maralyn and Kildea, Sue. (2013). Caseload midwifery care versus standard maternity care for women of any risk : M@NGO, a randomised controlled trial. The Lancet. https://doi.org/10.1016/S0140-6736(13)61406-3
Measuring what matters in delivering services to remote-dwelling Indigenous mothers and infants in the Northern Territory, Australia
Steenkamp, Malinda, Rumbold, Alice R., Kildea, Susan V., Bar-Zeev, Sarah J., Kruske, Sue, Dunbar, Terry and Barclay, Lesley. (2012). Measuring what matters in delivering services to remote-dwelling Indigenous mothers and infants in the Northern Territory, Australia. Australian Journal of Rural Health. 20(4), pp. 228 - 237. https://doi.org/10.1111/j.1440-1584.2012.01279.x
Niyith Nniyith Watmam (the quiet story): Exploring the experiences of Aboriginal women who give birth in their remote community
Ireland, S., Wulili Narjic, C., Belton, S. and Kildea, Sue. (2011). Niyith Nniyith Watmam (the quiet story): Exploring the experiences of Aboriginal women who give birth in their remote community. Midwifery (print version). 27(5), pp. 634 - 641. https://doi.org/10.1016/j.midw.2010.05.009
A randomised controlled trial of caseload midwifery care: M@NGO (Midwives @ New Group practice Options)
Tracy, S., Hartz, D., Hall, B., Allen, Jyai D., Forti, A., Lainchbury, A., White, J., Walsh, A., Tracy, M. and Kildea, Sue. (2011). A randomised controlled trial of caseload midwifery care: M@NGO (Midwives @ New Group practice Options). BMC Pregnancy and Childbirth. 11(82), pp. 1 - 8. https://doi.org/10.1186/1471-2393-11-82
Study protocol: A randomised non-inferiority controlled trial of a single versus a four intradermal sterile water injection technique for relief of continuous lower back pain during labour
Lee, Nigel J., Coxeter, P., Beckmann, M., Webster, J., Wright, V., Smith, T. and Kildea, Sue. (2011). Study protocol: A randomised non-inferiority controlled trial of a single versus a four intradermal sterile water injection technique for relief of continuous lower back pain during labour. BMC Pregnancy and Childbirth. 11(21), pp. 1 - 9. https://doi.org/10.1186/1471-2393-11-21
An account of significant events influencing Australian breastfeeding practice over the last 40 years
Thompson, Robyn, Kildea, Sue, Barclay, L. and Kruske, S.. (2011). An account of significant events influencing Australian breastfeeding practice over the last 40 years. Women and Birth (print version). 24(3), pp. 97 - 104. https://doi.org/10.1016/j.wombi.2010.08.005
Pragmatic indicators for remote Aboriginal maternal and infant health care: Why it matters and where to start
Kildea, Sue, Barclay, Lesley, Steenkamp, Malinda and Rumbold, Alice. (2010). Pragmatic indicators for remote Aboriginal maternal and infant health care: Why it matters and where to start. Australian and New Zealand Journal of Public Health. 34(1), pp. 55 - 58. https://doi.org/10.1111/j.1753-6405.2010.00545.x
Rural birth index for Australia?
Kildea, Sue and Stratagos, Susan. (2010). Rural birth index for Australia? Australian Journal of Rural Health. 18(2), pp. 85 - 86. https://doi.org/10.1111/j.1440-1584.2010.01130.x
Barriers to increasing hospital birth rates in rural Shanxi province, China
Gao, Yu, Barclay, Lesley, Kildea, Sue, Hao, Min and Belton, Suzanne. (2010). Barriers to increasing hospital birth rates in rural Shanxi province, China. Reproductive Health Matters. 18(36), pp. 35 - 45. https://doi.org/10.1016/S0968-8080(10)36523-2
'Closing the gap': How maternity services can contribute to reducing poor maternal infant health outcomes for Aboriginal and Torres Strait Islander women
Kildea, Sue, Kruske, Sue, Barclay, Lesley and Tracy, Sally. (2010). 'Closing the gap': How maternity services can contribute to reducing poor maternal infant health outcomes for Aboriginal and Torres Strait Islander women. Rural and Remote Health. 10(3), pp. 1383 - 1402.
The role of the midwife in Australia: views of women and midwives
Homer, Caroline, Passant, Lyn, Brodie, Pat, Kildea, Sue, Leap, Nicky, Pincombe, Jan and Thorogood, Carol. (2009). The role of the midwife in Australia: views of women and midwives. Midwifery. 25(6), pp. 673 - 681. https://doi.org/10.1016/j.midw.2007.11.003
Making pregnancy safer in Australia: The importance of maternal death review
Kildea, Sue, Pollock, Wendy E. and Barclay, Lesley. (2008). Making pregnancy safer in Australia: The importance of maternal death review. Australian and New Zealand Journal of Obstetrics and Gynaecology. 48(2), pp. 130 - 136. https://doi.org/10.1111/j.1479-828X.2008.00846.x
Maternal deaths high for indigenous women
Kildea, Sue. (2008). Maternal deaths high for indigenous women. Women and Birth. 21(4), pp. 175 - 176. https://doi.org/10.1016/j.wombi.2008.06.002
Maternal mortality and psychiatric morbidity in the perinatal period: Challenges and opportunities for prevention in the Australian setting
Austin, Marie-Paule, Kildea, Sue and Sullivan, Elizabeth. (2007). Maternal mortality and psychiatric morbidity in the perinatal period: Challenges and opportunities for prevention in the Australian setting. Medical Journal of Australia. 186(7), pp. 364 - 367.
The development of national competency standards for the midwife in Australia
Homer, Caroline, Passant, Lyn, Kildea, Sue, Pincombe, Jan, Thorogood, Carol, Leap, Nicky and Brodie, Pat. (2007). The development of national competency standards for the midwife in Australia. Midwifery. 23(4), pp. 350 - 360. https://doi.org/10.1016/j.midw.2006.03.008
Maternity emergency care: Short course in maternity emergencies for remote area health staff with no midwifery qualifications
Kildea, Sue, Kruske, Sue and Bowell, Libby. (2006). Maternity emergency care: Short course in maternity emergencies for remote area health staff with no midwifery qualifications. Australian Journal of Rural Health. 14(3), pp. 111 - 115. https://doi.org/10.1111/j.1440-1584.2006.00785.x
Cultural safety and maternity care for Aboriginal and Torres Strait Islander Australians
Kruske, Sue, Kildea, Sue and Barclay, Lesley. (2006). Cultural safety and maternity care for Aboriginal and Torres Strait Islander Australians. Women and Birth. 19(3), pp. 73 - 77. https://doi.org/10.1016/j.wombi.2006.07.001
Maternity care in the bush: Using the internet to provide educational resources to isolated practitioners
Kildea, Sue, Barclay, Lesley and Brodie, Pat. (2006). Maternity care in the bush: Using the internet to provide educational resources to isolated practitioners. Rural and Remote Health. 6(3), pp. 1 - 12.
AARN and CRANA: Peak rural and remote nursing bodies welcome Medicare item for maternity care
Kildea, Sue and Armstrong, Wendy. (2006). AARN and CRANA: Peak rural and remote nursing bodies welcome Medicare item for maternity care. Australian Journal of Rural Health. 14(2), pp. 91 - 92.
Risky business: Contested knowledge over safe birthing services for Aboriginal women
Kildea, Sue. (2006). Risky business: Contested knowledge over safe birthing services for Aboriginal women. Health Sociology Review. 15(4), pp. 387 - 396.
A broader understanding of indigenous health
Kildea, Sue. (2004). A broader understanding of indigenous health. Women and Birth. 14(4), pp. 24 - 24.