Improving Health Services Delivery for Better Outcomes for Aboriginal and Torres Strait Islander Children

Abstract

Objectives: To identify and describe the outcomes of health services for Aboriginal and Torres Strait Islander children valued by stakeholders, and to elicit the preferences of stakeholders for characteristics of health services delivery for Aboriginal and Torres Strait Islander children. Methods: Mixed methods were used to achieve the aims. Systematic reviews were conducted examining outcomes from health services for and by Indigenous. Qualitative studies involved staff and caregivers and decision-makers in semi-structured interviews to identify the outcomes and aspects of health services delivery that are important for health services for Aboriginal and Torres Strait Islander children. Decision-makers’ were also asked about factors informing funding. Qualitative data were analysed thematically. The final study was a best-worst scaling survey (BWS) to elicit preferences for health services delivery characteristics from carers of Aboriginal and Torres Strait Islander children and health services staff. Data were analysed using a multinomial logit regression model. Results: The systematic reviews identified a focus on biomedical outcomes in health services for Indigenous peoples and described outcomes valued by service users. In the qualitative studies, carers of Aboriginal and Torres Strait Islander children, staff working at those health services, and decision-makers involved in funding those health services identified outcomes and aspects of health services that are important for delivering child health services. The BWS identified the most important aspect of health services delivery for carers and staff as ‘Treatment options are explained, and the carer is involved in decisions about the child’s care.’ Conclusion: Collectively, the experiences of service users and their preferences data can guide the design, delivery, development, and evaluation of health services for Aboriginal and Torres Strait Islander children and support resource allocation.