Search

Aim: To identify the barriers associated with inadequate antenatal attendance by disadvantaged women in Australia and to further explore how these barriers are experienced by this population group. Design: A qualitative descriptive study utilizing semi‐structured interviews and thematic analysis. Methods: Interviews were conducted with 11 pregnant women who self‐identified as experiencing disadvantage, purposively sampled from a local government area of Victoria, Australia, characterized by socio‐economic disadvantage. Data were collected from February to July 2019. Results: Study participants reported a range of barriers to receiving timely and adequate antenatal care (ANC). For several women, a combination of personal (e.g., emotions, knowledge), health service provision (e.g., limited access to continuity of care provider and continuity of information, inflexible scheduling, difficulty travelling, staff attitudes), and broader social‐contextual factors (e.g., financial situation, language, cultural norms) were ultimately insurmountable. Whereas some barriers were experienced as hassles or annoyances, others were unacceptable, overwhelming, or humiliating. Conclusion: Women experiencing disadvantage in Australia value ANC but face multiple and complex barriers that undermine timely and regular access. Implications for the Profession and/Patient Care: A wide range of strategies targeting barriers across multiple levels of the social‐ecological environment are required if ANC attendance rates are to improve and ultimately redress existing health disparities. Various continuity of care models are well‐placed to address many of the identified barriers and should be made more accessible to women, and particularly those women experiencing disadvantage. Impact: Antenatal care appointments promote the health of women and their babies during pregnancy, but for many women, particularly those experiencing disadvantage, access is delayed or inadequate. ANC providers play a critical role in facilitating timely and adequate care. Health service practitioners and management, and health services policymakers need to understand the complexity of the barriers women encounter. These stakeholders can utilize the findings reported herein to develop more effective strategies for overcoming multiple and multi‐level barriers. Reporting Method: The study is reported in accordance with the relevant EQUATOR guidelines: the standards for reporting qualitative research (SRQR) and consolidated criteria for reporting qualitative research (COREQ). Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

The first 5 years of a child's life are crucial in laying the foundation for their health and developmental trajectory into adulthood. These early years are especially influenced by the surrounding environments in which children live and grow. A large international body of evidence demonstrates that children who experience disadvantage tend to fall increasingly behind over time. At the societal level, these inequities can cause substantial social burdens and significant costs across health, education, and welfare budgets. A contributing factor is that children experiencing adversity are less likely to have access to the environmental conditions that support them to thrive. Many of these factors are modifiable at the community or place level. We argue for three key—though not exhaustive—ideas that collectively could achieve more equitable outcomes for children facing disadvantage and experiencing adversity: 1. Adopt a social determinants approach to conceptualizing disadvantage; 2. Stack existing, evidence-based government and nongovernment service interventions/programs that operate at the local or community level; and 3. Use data and evidence to focus improvements for more equitable and adaptive systems. We conclude that if adopted, these 3 ideas could contribute to the ability of local communities and networks to identify and respond to factors that address early childhood inequalities. [ABSTRACT FROM AUTHOR]

Compared with most other Organization for Economic Co‐operation and Development (OECD) countries, information about the patterns of health service use for children from immigrant families in Australia is currently limited, and internationally, data on unmet healthcare needs are scarce. This study aims to examine the distribution of health service utilisation and unmet healthcare needs for immigrant children aged 10–11 years in Australia. We drew on data from the Longitudinal Study of Australian Children Birth (B; n = 5,107) and Kindergarten (K; n = 4,983) cohorts. The exposure was family immigration background collected at 0–1 (B‐cohort) and 4–5 (K‐cohort) years. Outcomes were parent‐reported child health service use and unmet healthcare needs (defined as the difference between services needed and services received) at 10–11 years. Logistic regression analyses were used to examine associations between family immigration background and health service use/unmet healthcare needs, adjusting for potential confounders. Results showed that one‐third of Australian children (B‐cohort: 29.0%; K‐cohort: 33.4%) came from immigrant families. There were similar patterns of health service use and unmet healthcare needs between children from English‐speaking immigrant and Australian‐born families. However, children from non‐English‐speaking immigrant families used fewer health services, including paediatric, dental, mental health and emergency ward services. There was a disparity between the services used when considering children's health needs, particularly for paediatric specialist services (B‐cohort: OR = 2.43, 95% CI 1.11–5.31; K‐cohort: OR = 2.72, 95% CI 1.32–5.58). Findings indicate that Australian children from non‐English‐speaking immigrant families experience more unmet healthcare needs and face more barriers in accessing health services. Further effort is needed to ensure that the healthcare system meets the needs of all families. [ABSTRACT FROM AUTHOR]