| 1. |
- Arat, Arzu, et al.
(author)
-
Childhood vaccination coverage in Australia : an equity perspective
- 2021
-
In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 21:1
-
Journal article (peer-reviewed)abstract
- Background: This study describes trends in social inequities in first dose measles-mumps-rubella (MMR1) vaccination coverage in Western Australia (WA) and New South Wales (NSW). Using probabilistically-linked administrative data for 1.2 million children born between 2002 and 2011, we compared levels and trends in MMR1 vaccination coverage measured at age 24 months by maternal country of birth, Aboriginal status, maternal age at delivery, socio-economic status, and remoteness in two states.Results: Vaccination coverage was 3-4% points lower among children of mothers who gave birth before the age of 20 years, mothers born overseas, mothers with an Aboriginal background, and parents with a low socio-economic status compared to children that did not belong to these social groups. In both states, between 2007 and 2011 there was a decline of 2.1% points in MMR1 vaccination coverage for children whose mothers were born overseas. In 2011, WA had lower coverage among the Aboriginal population (89.5%) and children of young mothers (89.3%) compared to NSW (92.2 and 92.1% respectively). Conclusion: Despite overall high coverage of MMR1 vaccination, coverage inequalities increased especially for children of mothers born overseas. Strategic immunisation plans and policy interventions are important for equitable vaccination levels. Future policy should target children of mothers born overseas and Aboriginal children.
|
|
| 2. |
- Coscini, Nadia, et al.
(author)
-
Multicountry review : developmental surveillance, assessment and care by outpatient paediatricians
- 2023
-
In: Archives of Disease in Childhood. - : BMJ Publishing Group Ltd. - 0003-9888 .- 1468-2044. ; 108:3, s. 153-159
-
Research review (peer-reviewed)abstract
- BACKGROUND: Care of young children with neurodevelopmental disorders (NDD) is a major component of paediatric outpatient practice. However, cross-country practice reviews to date have been limited, and available data demonstrate missed opportunities for early identification, particularly in vulnerable population subgroups.METHODS: Multicountry review of national paediatric body guidance related to developmental surveillance, early identification and early childhood intervention together with review of outpatient paediatrician practices for developmental assessment of children aged 0-5 years with/at risk of NDDs. Review included five countries with comparable nationalised universal child healthcare systems (ie, Australia, Canada, New Zealand, Sweden and the UK). Data were collected using a combination of published and grey literature review, supplemented by additional local sources with descriptive review of relevant data points.RESULTS: Countries had broadly similar systems for early identification of young children with NDDs alongside universal child health surveillance. However, variation existed in national paediatric guidance, paediatric developmental training and practice, including variable roles of paediatricians in developmental surveillance at primary care level. Data on coverage of developmental surveillance, content and quality of paediatric development assessment practices were notably lacking.CONCLUSION: Paediatricians play an important role in ensuring equitable access to early identification and intervention for young children with/at risk of NDDs. However, strengthening paediatric outpatient care of children with NDD requires clearer guidance across contexts; training that is responsive to shifting roles within interdisciplinary models of developmental assessment and improved data to enhance equity and quality of developmental assessment for children with/at risk of NDDs.
|
|
| 3. |
- Goldfeld, Sharon, et al.
(author)
-
Comparative inequalities in child dental caries across four countries : Examination of international birth cohorts and implications for oral health policy
- 2022
-
In: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 17:8
-
Journal article (peer-reviewed)abstract
- Child dental caries (i.e., cavities) are a major preventable health problem in most high-income countries. The aim of this study was to compare the extent of inequalities in child dental caries across four high-income countries alongside their child oral health policies. Coordinated analyses of data were conducted across four prospective population-based birth cohorts (Australia, n = 4085, born 2004; Quebec, Canada, n = 1253, born 1997; Rotterdam, the Netherlands, n = 6690, born 2002; Southeast Sweden, n = 7445, born 1997), which enabled a high degree of harmonization. Risk ratios (adjusted) and slope indexes of inequality were estimated to quantify social gradients in child dental caries according to maternal education and household income. Children in the least advantaged quintile for income were at greater risk of caries, compared to the most advantaged quintile: Australia: AdjRR = 1.18, 95%CI = 1.04-1.34; Quebec: AdjRR = 1.69, 95%CI = 1.36-2.10; Rotterdam: AdjRR = 1.67, 95%CI = 1.36-2.04; Southeast Sweden: AdjRR = 1.37, 95%CI = 1.10-1.71). There was a higher risk of caries for children of mothers with the lowest level of education, compared to the highest: Australia: AdjRR = 1.18, 95%CI= 1.01-1.38; Southeast Sweden: AdjRR = 2.31, 95%CI = 1.81-2.96; Rotterdam: AdjRR = 1.98, 95%CI = 1.71-2.30; Quebec: AdjRR = 1.16, 95%CI = 0.98-1.37. The extent of inequalities varied in line with jurisdictional policies for provision of child oral health services and preventive public health measures. Clear gradients of social inequalities in child dental caries are evident in high-income countries. Policy related mechanisms may contribute to the differences in the extent of these inequalities. Lesser gradients in settings with combinations of universal dental coverage and/or fluoridation suggest these provisions may ameliorate inequalities through additional benefits for socio-economically disadvantaged groups of children.
|
|
| 4. |
|
|
| 5. |
- Johansson, Nina, et al.
(author)
-
Ameliorating Child poverty through Connecting Economic Services with child health Services (ACCESS) : study protocol for a randomised controlled trial of the healthier wealthier families model in Sweden
- 2022
-
In: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 22:1
-
Journal article (peer-reviewed)abstract
- BackgroundSweden is often held up as an example of a country with low child deprivation; yet, rates of relative deprivation are rising. Every municipality in Sweden is required to provide free, timely and accessible budget and debt counselling under the Social Services Act. The services have been encouraged to perform preventative practice with families; however, this has not been realised. The Healthier Wealthier Families (HWF) model embeds universal screening for economic hardship into child health services and creates a referral pathway to economic support services. Given the universal child health system in Sweden, which is freely available and has excellent coverage of the child population, implementation of the HWF model has potential to support families to access the freely available municipal budget and debt counselling and ultimately improve rates of child deprivation in Sweden.Methods/designWe will conduct a two-arm randomised waitlist-control superiority trial to examine the effectiveness and cost-effectiveness of the HWF model in the Sweden. A longitudinal follow-up with the cohort will explore whether any effects are maintained in the longer-term.DiscussionHWF is a collaborative and sustainable model that could maximise the effectiveness of current services to address child deprivation in Sweden. The study outlined in this protocol is the first effectiveness evaluation of the HWF model in Sweden and is a crucial step before HWF can be recommended for national implementation within the child health services.
|
|
| 6. |
- Quach, Jon, et al.
(author)
-
Do Fathers' Home Reading Practices at Age 2 Predict Child Language and Literacy at Age 4?
- 2018
-
In: Academic pediatrics. - : Elsevier BV. - 1876-2859 .- 1876-2867. ; 18:2, s. 179-187
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Maternal shared reading practices predict emergent literacy, but fathers' contributions are less certain. We examined whether fathers' shared home reading activities at 2 years (1) predict language and emergent literacy at age 4 years, when controlling for maternal contributions; and (2) differentially benefit these outcomes in disadvantaged children.METHODS: Design: Two-parent families recruited from 5 relatively disadvantaged communities for the universal Let's Read literacy promotion population-based trial (ISRCTN 04602902) in Melbourne, Australia. Exposure, 2 years: Home reading practices via self-reported maternal and paternal StimQ-Toddler questionnaires, dichotomised at study median (high vs. low). Outcomes, 4 years: Receptive and expressive language (Clinical Evaluation of Language Fundamentals-4), emergent literacy (Sunderland Phonological Awareness Test-Revised).ANALYSES: Aim 1: Linear regression, adjusted for mothers' home reading, 2-year-old vocabulary and communication skills and family disadvantage. Aim 2: Interaction of disadvantage [yes vs. no] with high home reading by (a) fathers and (b) at least one parent.RESULTS: Data were available for 405 (62.3%) families. High father reading at 2 years (reference: low) predicted better expressive (mean difference 8.0, 95%CI 4.5 to 11.5) and receptive (mean difference 7.3, 95%CI 4.1 to 10.5) language at 4 years (both p<0.001) but not emergent literacy skills. Similar patterns were observed in families with at least one parent with high home reading. Father reading did not differentially benefit outcomes in disadvantaged children.CONCLUSION: Fathers' involvement in reading at 2 years predicted better language but not emergent literacy at 4 years, and did not protect against adverse effects of socioeconomic disadvantage.
|
|
| 7. |
|
|
| 8. |
- Stubbe Østergaard, Liv, et al.
(author)
-
Restricted health care entitlements for child migrants in Europe and Australia
- 2017
-
In: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 27:5, s. 869-873
-
Journal article (peer-reviewed)abstract
- BackgroundMore than 300 000 asylum seeking children were registered in Europe alone during 2015. In this study, we examined entitlements for health care for these and other migrant children in Europe and Australia in a framework based on United Nations Convention of the Rights of the Child (UNCRC).MethodsSurvey to child health professionals, NGO's and European Ombudspersons for Children in 30 EU/EEA countries and Australia, supplemented by desktop research of official documents. Migrant children were categorised as asylum seekers and irregular/undocumented migrants.ResultsFive countries (France, Italy, Norway, Portugal and Spain) explicitly entitle all migrant children, irrespective of legal status, to receive equal health care to that of its nationals. Sweden and Belgium entitle equal care to asylum seekers and irregular non-EU migrants, while entitlements for EU migrants are unclear. Twelve European countries have limited entitlements to health care for asylum seeking children, including Germany that stands out as the country with the most restrictive health care policy for migrant children. In Australia entitlements for health care are restricted for asylum seeking children in detention and for irregular migrants. The needs of irregular migrants from other EU countries are often overlooked in European health care policy.ConclusionPutting pressure on governments to honour the obligations of the UNCRC and explicitly entitle all children equal rights to health care can be an important way of advocating for better access to primary and preventive care for asylum seeking and undocumented children in Australia and the EU.
|
|
