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Maari Ma Health has initiated a number of activities that is bringing together all the people providing services to Aboriginal children and their families to

1. Improve understanding of the current evidence about 'best buys' to positively influence child development and well-being, and
2. Start working together to improve outcomes.  Maari Ma's Healthy Start program has seen significant improvement in Aboriginal children and their families accessing health services but we recognised that health practitioners alone could not 'close the gap' on Aboriginal disadvantage.  By meeting with all service providers and working on what can be achieved by working together better, we can hasten the improvement in the life circumstances for Aboriginal children in our communities.

Maari Ma's Healthy Start program has been in place for a few years – part of a whole of life course chronic disease strategy in our region. Healthy Start target's pregnant mums and then children up to the age of 14 with home and clinic visits, education, and school-based health promotion.

While this program has seen Aboriginal people significantly improving their access to health services antenatally and for their children, we recognised that an improved start to life from the perspective of health was not the only thing impacting on whether or not Aboriginal children developed and thrived in their home and community.

National figures regarding Aboriginal disadvantage are reflected in the far west of NSW: high unemployment, low retention at school, poor literacy and numeracy, high interactions with justice and detention systems. Improving breastfeeding and immunisation rates would not necessarily improve these other indicators of development and well-being.

Maari Ma recognised that we needed to make sure that improving outcomes for Aboriginal children was on everyone's agenda; that everyone needed to understand what the indicators to improving outcomes were; that we could all understand what positive steps we could make together.

Maari Ma engaged a well-respected community paediatrician to guide us in looking at the available evidence.  We held a Child Development and Well-Being Forum in Broken Hill and invited all organisations who provide services to children and their families in the region to come along and hear Dr Garth Alperstein present the latest in research findings.

The response was fantastic with more than 50 government and non-government agencies attending (70+ people).  Commitment to working better together to improve outcomes for Aboriginal children was the clear product of that day.

Out of this positive response, a management group was established, co-chaired by Maari Ma and NSW Education and Training, and including GWAHS, DOCS, Police, and Mission Australia.  All commited to meet monthly to develop a strategy to improve Aboriginal child development in far west NSW.

The management group agreed from the original forum that the following steps were required:

1. broad, easily accessible knowledge of services available to individual communities, age groups or groups with special needs
2. dissemination of the evidence presented at the Broken Hill forum
3. development of a strategic framework document to guide specific activities
4. an understanding of the current circumstances for Aboriginal children in far west NSW.

To date the following has occurred:

• A Far West Regional Child and Family Services Directory has been developed with 82 services across the region listed alphabetically, by community and by specific categories.  This will be printed as well as be available on various websites.
• Public forums similar to that held in Broken Hill have been held in Menindee and Wilcannia, and one is planned for Ivanhoe.
• A workshop was held in Broken Hill in April for service providers to hear about the mental health and emotional development of a child from birth from a perinatal psychiatrist, and about early childhood education services from an early childhood education lecturer.
• A strategic framework document has been developed by the management group and this was launched in April.
• A regional child profile has been developed using local, regional, state and national data.  This looks at various aspects that impact on a child’s development and well-being to enable us to measure the impact of the strategies implemented in the coming months and years.  In particular a "closing the gap" table has been developed with nationally agreed indicators used to chart our progress.

The principle objectives of the strategy (to improve understanding of the 'best buys' in child development and well-being, and work better together to improve outcomes for Aboriginal children) have been met in that, to date, more than 150 children and family service providers have attended presentations to learn more about the factors that influence positive outcomes for child development and well-being and have committed to working better together.  All of the main activities which came out of the original forum have been completed: local forums, service directory, strategic framework document and regional child profile.

The next step will be to identify at a local/community level the next step/project/activity which is do-able given existing resources, a new awareness of the 'best buys' for child development and well-being and a new commitment to working better together for improved outcomes for Aboriginal children and their families.

The most important aspect of the activities to date has been the willingness of the various child and family service providers to use the evidence regarding child development presented to them and to commit to work better together for improved outcomes in Aboriginal child development and well-being.

The flow-on effect – in pre-schools, child care, playgroups, parenting groups, schools, after school activities, family services, clinicians, policing and community supports – will hopefully be tracked through another regional child profile, to take place in after a reasonable period, to determine the impact our collaborative activities have had.

This collaborative approach will not see results for Aboriginal children and communities instantly but over years.  However, some of the products of this collaborative approach are already available (the service directory, the strategic framework document) and these will guide further activities in the short and medium term future.

Manager Primary Health Programs, Maari Ma Primary Health
Phone: 08 8082 9832