The AMA released its 2005 Report Card: Lifting The Weight - Low Birth Weight Babies: An Indigenous Health Burden That Must Be Lifted on May 20th at Winnunga Nimmityjah Aboriginal Health Service in Narrabundah, Canberra.
The 2005 Report Card focusses on the most important intervention to improve the long-term health of the Aboriginal and Torres Strait Islander population: giving every baby a healthy start in life. We know what do. Once again the report card includes a sheet of "Goodnews" stories outlining 5 programs across Australia which have all reduced the number of Aboriginal and Torres Strait Islander babies that are born early or weighing less than 2500g or both.
In the 2005 Report Card the AMA is calling on the Federal Government to:
1. Resource all Aboriginal Medical Services, across urban and remote Australia, for maternal and child health teams to provide antenatal and post natal care as well as care to young children. This should include home visiting as a key component of the service, with a focus on health education and promotion. Services should build on, and adapt as needed, the successful programs already in existence, like the Mums and Babies program in Townsville. Key areas of focus for the teams should be:
- Reduction of smoking by pregnant women and childhood exposure to passive smoking;
- Reduction of alcohol and substance use in pregnancy;
- Reduction of sexually transmitted diseases in all women of reproductive age and prompt diagnosis and treatment during pregnancy;
In addition the service could provide:
- nutrition supplementation;
- mental health interventions for pregnant women and during the post natal period;
- enhanced immunisation coverage of Aboriginal children.
- sudden infant death syndrome prevention advice;
- childhood injury prevention programs; and
- child abuse prevention strategies.
2. Investigate and fund a program targeted to improve the nutritional status of those Aboriginal or Torres Strait Islander women who are assessed to be at risk. All women in the following categories should be assessed: those under the age of 20; pregnant; breastfeeding or postpartum; and those with children under 5 years of age.1
3. Adopt as a National Goal the improvement of Aboriginal and Torres Strait Islander child health. The number of LBW babies and the number of premature deliveries should be set as indicators to monitor the achievement of this goal. It is quite simple; if a program does not reduce these two indicators we know it is not working. National Community Controlled Health Organisation. Submission to the Commonwealth Department of Family and Community Services "What's needed to improve child health in the Aboriginal and Torres Strait Islander populations". June 2003.
4. Ensure that there is sufficient investment in workforce development to support the above program.
5. Fully fund the provision of this culturally appropriate service across the whole country. Based on the costs of the successful Mums and Babies Program in Townsville this would cost approximately $20 million a year in running costs ($2,400/pregnant woman). Initial set-up costs will depend on what is already available and will vary significantly, but would be between $6 and $10 million.
We know the desired outcome: the reduction in the number of low birth weight babies to the level of the rest of the population. We could easily monitor this and only if a program is reducing the number of low birth weight babies should it continue to receive funding. A country wide program doing this would decrease the number of Aboriginal and Torres Strait Islander babies that die in the first year of life by 83 babies. Over the primary school years this would mean there would be 500 more primary school kids than there are at present. These 500 deaths are unacceptable. We need to take this action now. Properly funding a service for pregnant women will save these unnecessary deaths as well as significantly reducing the burden of disease over years to come.