The National Partnership Agreement on Indigenous Early Childhood Development (NPA IECD) was signed by the Council of Australian Governments (COAG) in October 2008 as a first step to close the gap in life expectancy for Aboriginal and Torres Strait Islander children. Under the National Partnership, clause 49 requires that the Commonwealth provide an annual report to the Parties for the preceding financial year by 31 August of each year, with regard to annual expenditure under Element 3.
This 2012/13 Annual Report describes progress on achievements against outputs for Element Three of the National Partnership from 1 July 2012 to 30 June 2013. The Report should be considered in conjunction with the ministerially agreed Implementation Plan and includes reporting against the milestones, financials and timelines detailed in the Implementation Plans.
Achievements against Outputs:
- Increase access to, and use of, maternal and child health services by Indigenous families
- From 1 July 2009, New Directions: Mothers and Babies Services represented the Commonwealth’s Own Purpose Expenditure contribution to Element 3 of NPA IECD and is now an ongoing program with an allocation of $32.69 million in 2012-13. Of this $31.80 million was expended and the remaining funds were redirected to primary health care projects for Aboriginal and Torres Strait Islander families with young children.
- New Directions: Mothers and Babies Services is managed by the Department of Health through the Indigenous and Rural Health Division. The programme provides Aboriginal and Torres Strait Islander children and their mothers with increased access to:
- antenatal and postnatal care;
- standard information about baby care;
- practical advice and assistance with breastfeeding, nutrition and parenting;
- monitoring of developmental milestones, immunisation status and infections; and
- health checks and referrals to treatment for Indigenous children before starting school.
- Between 2008 and 2012, the Department of Health undertook five targeted, merit based selection rounds to select and fund primary health care organisations to deliver services that meet the aims of the programme. As part of these the Department considered regional demographics, levels of funding and health care provision with particular emphasis on the `29 priority communities identified in COAG’s National Partnership Agreement on Remote Service Delivery (RSD NP). Consultations were held with the Aboriginal Health Forums (or their equivalent) in each state/territory to assist in the identification of priority locations in order to target areas in high need of child and maternal health services. Organisations, both large and small, within the identified priority regions were invited to apply for New Directions: Mothers and Babies Services funding. Applications were assessed against agreed assessment criteria.
- The service delivery model in each location is determined by the primary health care provider to ensure that services are provided in the most appropriate way for their clients and communities.
- The Commonwealth’s Implementation Plan is published on the Federal Financial Relations website (www.federalfinancialrelations.gov.au).
- The strategies and measures detailed in the Implementation Plan to meet the aim of increasing access to, and use of, child and maternal health services in priority regions across Australia through the New Directions: Mothers and Babies programme have been successfully achieved.
Progress Against Benchmarks and Deliverables
Activities undertaken, services developed and/or Implemented in the reporting period to achieve the objectives under Element 3
Ongoing implementation Plan and scope Departmental program review.
- 85 services have been approved for funding following five funding rounds. The final funding round was in the 2011-12 financial year. A list of sites and services are provided at Attachment A.
- The Australian National Audit Office (ANAO) conducted an audit of the New Directions: Mothers and Babies Services programme between July 2011 and March 2012. The final report was tabled in Parliament in May 2012 and made a single recommendation that the Department review its performance framework and strengthen measures to monitor service delivery and determine whether use of services is in line with the programme’s objectives.
- In response to the ANAO’s recommendation, the Department engaged a contractor in mid-2012 to undertake a descriptive analysis of services delivered through the New Directions: Mothers and Babies programme to inform programme performance monitoring. A final report was provided to the Department in March 2013. A summary of the findings in this report is at Attachment B.
- The report identified that the flexibility of the New Directions: Mothers and Babies programme funding allowed organisations to develop a wide range of service models and to adapt their activities to meet the needs of their local communities. Home visiting has been described by many services as a crucial element of their service delivery models as it enables the provision of care to clients who would otherwise be unlikely to access clinic-based services, for example, due to transport difficulties.
- Many families accessing the programme have significant health needs and face higher than normal risks during pregnancy. Furthermore, some families have complex social issues that affect their capacity to engage in ongoing antenatal and postnatal care. The New Directions: Mothers and Babies programme supports a range of strategies to facilitate access to appropriate care and support services for these families.
- The Descriptive Analysis survey also documented increased capacity of organisations that are delivering maternal and child health services through New Directions funding, including antenatal consultations, postnatal check-ups and child health and development checks. Organisations are also providing a range of education and health promotion activities, including:
- antenatal care services that include: advice about healthy eating and physical activities; referrals to other health services; referrals to support services; referrals to specialists; parenting advice; social and emotional wellbeing services; and antenatal consultations;
- postnatal services that provide breastfeeding support/information; parenting support/advice; nutrition/healthy eating support or education; and midwife consultations; and
- child health services that provide child health and development checks; breastfeeding support; hearing screening; parenting advice to mothers and families when the child is six weeks to five years old.
- To improve performance monitoring and reporting, New Directions: Mothers and Babies Services are required to report on national Key Performance Indicators (nKPI), from July 2013. The nKPIs will include outcome information related to birth weight, child immunisations and maternal health. From July 2014, smoking status during pregnancy will also be collected.
- As part of the NPA IECD, the Commonwealth, states and territories agreed to a set of performance indicators designed to measure progress towards the achievement of each of the three elements of the agreement and committed to collecting data allowing evaluation of each of the indicators of the NPA IECD. The performance indicators are listed at Attachment C.
- The Department of Health commissioned the Australian Institute of Health and Welfare (AIHW) to collate national data for the health related indicators 5-10, relevant to the health components of the NPA IECD, published in August 2013.
- The Department of Education commissioned Urbis to conduct a national evaluation of the NPA IECD. The Evaluation Final Report is due in 2014.
Linkages and coordination with other services provided and community Involvement
- The Department maintains links with the Department of Education, the Department of Social Services, and State and Territory Governments through formal and informal communication channels and forums, such as the Standing Committee on Child and Youth Health.
Key issues and constraints in implementing proposed activities and services
- All activities and milestones outlined in the Implementation Plan have been achieved.
- The most common barriers faced by funded organisations are: recruitment and retention of qualified staff; lack of transport for clients; capacity issues; difficulties associated with remote service delivery; and with engaging and maintaining contact with clients.
Service Location: Urban; Regional; or Remote
- 15 organisations funded are in urban locations;
- 38 organisations funded are in regional locations;
- 32 organisations funded are in remote locations; and
- 12 organisations funded are identified as Remote Service Delivery Priority Sites.
Further information is provided at:
Attachment A: New Directions: Mothers and Babies Services sites
Attachment B: Summary of Key Findings from Descriptive Analysis of New Directions: Mothers and Babies Services Programme
Attachment C: NPA IECD Performance Indicators