Infant Mortality in Australian Aboriginals: A Critical Paper on Primary Health Care

This critical paper discusses the issue of infant mortality in Australian Aboriginals due to poor health conditions during the perinatal period, malnutrition, lack of access to health resources, and social determinants of health. It proposes a program called Support from the Beginning to provide a healthy start to life through proper planning, implementation, and evaluation.

Running head: CRITICAL PAPER ON PRIMARY HEALTH CARE
CRITICAL PAPER
INFANT MORTALITY IN AUSTRALIAN ABORIGINALS
Name of the student:
Nam of the University:
Author note:

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Health Issue of the Aboriginals:
Aboriginals or the Torres Strait Islanders are defined as the Indigenous Australians. Due
to their social, cultural and economic condition, they are suffering from many health issues. One
of the most concerned health issues is the infant mortality or premature death in the population
(Stoneham, Goodman & Daube, 2014). The main cause of the premature death in the population
is the poor health condition in the perinatal period. Some of the most specific perinatal health
issues include birth trauma, complication of pregnancy, respiratory disorder, cardiovascular
disorder and foetal growth disorder (Elliott et al., 2014). 48% of the infant death in the
population is due to poor health condition during the perinatal period (Walter & Andersen,
2013). Other medical conditions include, low birth weight, malnutrition and infectious disease.
Malnutrition is one of the serious causes that lead to infant mortality. Due to lack of proper
information regarding nutrition, most of the women fail to fulfil their nutritional requirements. It
leads to poor nutrition condition of the pregnant mother, thus creates enormous problem during
childbirth. Such poor health condition of the mother leads to low birth weight and other
nutritional issue in the newborn. The newborn suffers from the low growth rate, malnutrition and
sometimes the foetus fail to survive in the mother womb (Elliott et al., 2014). The social
condition and the lifestyle of the aboriginals also contribute to the poor health condition, for
example, smoking and drinking alcohol during pregnancy is injurious to the health of the mother
and the foetus, as it leads to sudden infant death syndromes (O’Leary et al., 2013). The economic
condition of the aboriginals is also responsible for such poor health condition. Another reason is
lack of access to the health resources. Due to this, the aboriginals fail to provide proper care to
the newborn babies and they suffer from infectious disease that lead to death of the infants. The

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rate of infant mortality is higher in the indigenous population than the non-indigenous
population. According to the statistics, the rate of infant mortality is approximately twice in the
indigenous population than the non-indigenous population (Walter & Andersen, 2013). Thus, it
is a serious health issue that the aboriginals are facing and it need to be addressed in an effective
manner in order to provide them healthy environment and well-being.
Analysis:
Primary health care service is defined as the essential health care service that is
scientifically, socially and technologically acceptable and which provide universal health care
service that is accessible to all community within a population and to the individual as well. The
main purpose of providing such service is to create health equity and provide equal service to all
in order to inspire healthy living and well-being (Greenhalgh, 2013). However, in some cases,
the service providers fail to reach to every person with need, thus, such person has to suffer from
health related problems. In case of Aboriginals, the lack of proper health care service is one of
the main reasons that influence the poor health condition. The main obstacles include limited
availability of resources (Bar-Zeev et al., 2014). The primary health care service fail to reach the
rustic areas, thus, the people residing in the place lack adequate resources to improve their health
condition. Sometimes they fail to avail the service due to poor transport system. Cultural
appropriateness and institutional racism also contributes to the poor health condition of the
aboriginals. Health literacy provided by the primary health care service providers, but due to lack
of access, the aboriginals lack proper education and information related to health (Mirowsky,
2017). Beside such factors, there are many social determinants that are responsible for creating
health issues in the population.

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Social Determinants of Health:
The conditions, in which people are born, grow and live are he known as the social
determinants. There are many social factors that affect the health condition of a population. The
social determinants of health are mainly responsible for the health inequalities and discrimination
in the health status within a population (Braveman & Gottlieb, 2014). The following factors are
considered as the social determinants of health and they affects the health condition of the
aboriginals –
Economic factors - Employment condition is one of the main economic factors that affect the
health status of a population. The working culture and working environment of a person can
influence poor health condition. Sometimes, according to the employment condition, health
services are provided to a person. Poverty is another economic factor that restricts a person to
avail adequate health service. Housing instability is also responsible for the poor health status of
a population. Most of the health issue is related to the unavailability of food, thus food insecurity
has played an important role in creating health issues (Stoeckl et al., 2013).
Education - Education plays an important role in providing proper health condition. Due to lack
of education, most of the people of aboriginal population fail to understand the signs and
symptoms of diseases. They lack proper information regarding healthy living and well-being.
Due to this, they fail to understand the proper way of treatment, thus, suffer from health issues
that affect the health of the newborn and the children and results in premature death (Mirowsky,
2017).

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Healthcare system – Health care system is another important social determinant of health.
Health care service provides proper information about the signs, prevention, diagnosis and
treatment process of different health issue. Their service is important factor in order to provide
improved health to individual. The Australian aboriginals lack access to proper health service.
Due to this, they are unable to provide adequate health condition to their children; thus, the
population is suffering from high rate of infant mortality (Duckett & Willcox, 2015).
Community context – Discrimination in the community is another factor that results in health
inequality. Indigenous people of Australia are always discriminated by the non-indigenous
population. Such social deprivation restricts the aboriginals to participate in the civic culture.
Thus, they fail to avail the benefits and resources that could help them to improve their health
condition. They fail to be the part of the social programmes that could help them to develop their
living condition (Badland et al., 2014).
Environment – in order to live a healthy life, healthy and hygienic environment and adequate
environmental resources are needed. Poor environmental condition leads to poor health status.
The aboriginals lack healthy environment and the unhygienic living condition affect the health of
individual. They fail to provide proper environment to their children in order to grow up. It is
one of the important reasons of high infant mortality rate in the population (Stoeckl et al., 2013).
The above influencing factors need to be addressed in an effective manner in order to
improve the health condition of the aboriginals and reduce the infant mortality rate in the
population.

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Programme Development:
Australian government has developed many programmes in order to provide proper
health care service to the aboriginals. The government invested huge amount of money in order
to take initiative for the improvement of maternal health and infant health. Some of the important
and commendable programmes include Better Start to Life, Australian Nurse Family Partnership
Program and many others. As an outcome of the programmes, the disparity between the infant
mortality rate of indigenous and non-indigenous population has reduced, but still the infant
mortality rate is higher in the aboriginal population (Ware, 2013). Thus, a proper health
programme is needed to be organised in order to resolve the health issue. The programme would
be named as Support from the Beginning; an initiative to provide healthy start to life. The main
purpose of the programme should be support the indigenous parents to improve the health
condition of their children.
Processing:
In order to process the programme, proper planning is needed to be done to implement it
in an effective manner. Evaluation of the programme is needed to be carried out in order to
understand the effect of the programme on the health condition of the indigenous people. The
overall process related to the programme is as follows -
Planning:
Firstly, a survey would be done in order to collect data about the health issue related to
pregnant mother and infant health. It could help to understand the problems of the indigenous
people in depth. It is important to understand the central needs of the aboriginals in order to
provide them appropriate care service (Cho, Johnson & VanGeest, 2013). Secondly, improved

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transport system would be provided in order to access the resources in the rustic areas. It could
help the indigenous people to avail adequate health resources in time. Next proper nutritional
workshop would be provided in order to give information about the importance of the nutritional
food for the pregnant mothers and the infants. It could help the people to understand the
importance of healthy eating. Due to the economic condition of the population, they fail to avail
proper food and pure drinking water (Taylor, Hunter & Gray, 2013). Thus, the programme would
provide access to clean water and food for the pregnant mother in order to provide healthy birth
of the child. A workshop for checking the health condition of the pregnant mother and the infants
would be a part of the programme in order to monitor the health condition in the population.
Such workshop could provide idea about the improvement of the health condition and it could
help to recognize the health issues (Elliott et al., 2014). The plan would contain immunization to
the pregnant mother and infants in order to protect them from severe disease (Aaby, Kollmann &
Benn, 2014). The most important part of the programme would be providing knowledge to the
aboriginal population in order to create awareness about the high rate of infant mortality. An
education workshop would be provided to give proper information about antenatal care,
preventive health practice during pregnancy, reproductive health, unhealthy practice during
pregnancy, importance of breast feeding and improved technologies related to treatment. It could
help them to understand the importance of the healthy behaviour during pregnancy and they
could avail proper treatment for respective health issues (Mirowsky, 2017).
Implementation:
In order to implement the programme in an effective way, information about the
programme is needed to be provided in individual level, so that the overall population could
access the benefits of the programme and improve their health condition. The survey would be

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done to individual level in order to understand the problems and requirements of individual. It is
important to remember that no one would be forced to participate in the survey, as it could
hamper the dignity and rights (Cho, Johnson & VanGeest, 2013). Education related to health
should be done by considering the cultural, traditional and religious factor of individual
(Mirowsky, 2017). It could help to increase the acceptability of the programme. Proper
information would be provided to all so that they could understand the importance of the
programme and provide their consent regarding the participation in the programme.
Evaluation:
There are many positive aspects of the programme. The idea of survey is beneficial in
order to understand the health related issues of different person. It could help to evaluate the
present health condition of pregnant mother and the infants in the population and introduce
proper interventions in order to counter the issues (Cho, Johnson & VanGeest, 2013). The idea of
develop the transport system could help the indigenous people to avail adequate resources and it
could inspire them to rely on primary health care service. The initiative of providing food and
clean water during pregnancy could resolve the problem of lack of nutrients. Thus, it could help
to reduce the issue of malnutrition in the population, which is one of the most important reasons
of infant mortality. Providing immunization would protect the population from the symptoms of
severe disease (Aaby, Kollmann & Benn, 2014). The best part of the programme would be
providing education related to health and nutrition. It could help the population to understand the
importance of healthy eating and proper health practice during pregnancy. Information regarding
antenatal care could help the population to provide proper care to their children and improve
their health condition (Mirowsky, 2017). However, there are some negative aspects of the
programme. For example, participation in the survey is the individual choice of the population. It

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could affect the primary stage of the programme that is collecting data regarding the health issue.
Problem of social discrimination could not be countered through the programme; it could create
awareness but acceptance of such things depends on individual. Another fact is, huge amount of
funding is needed to implement the programme in an effective manner, so without the help of the
government it could not be carried out properly (Taylor, Hunter & Gray, 2013). Still, the
programme could be beneficial in order to achieve positive outcomes and it is expected that
implementation of such programme would resolve the issue of infant mortality in the indigenous
population.

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