Child Health Assessments
Child health assessments provide an opportunity for parents to gain information, support and advice, to assist in caring for their child. Assessments are intended to support parents to keep their baby well and provide the opportunity for any potential problems to be dealt with promptly. The assessment evaluates the child’s development at particular ages, including growth, physical movements, behaviour, play, physical examinations, hearing and eye screenings and behavioural interactions with family members and peers.
- Promote public health issues such as immunisation
- Provides a single repository of health and developmental information about a child from birth to school entry
- Enables doctors, nurses and other professionals to obtain details of previous consultations
- Provides parents with accurate health and development information about their child
- Facilitates communication between professionals and between parents and professionals
Data are compiled on a financial year basis from information submitted by individual Maternal and Child Health (M&CH) Centres. Data should be checked and, if necessary, corrected at this stage. The information is then aggregated to form data at the Local Government Area (LGA) level. Once compiled at LGA level and submitted, data are not further corrected.
The data have been sourced directly from the Participation Rates for Key Ages & Stages Visits table in the Maternal & Child Health Services Annual Report.
In most cases, M&CH services are provided by local councils. Each provider maintains a client management system that records basic client information and information relating to clients’ (children and parents) usage of the service. The client management system provides the principal record through which M&CH Nurses record activities undertaken with clients and client-based notes. The client management system is also the principal system through which information is sourced for compilation into the Maternal & Child Health Services Annual Report. Across Victoria, a range of different client management systems are used – manual paper-based systems; in house (i.e. self developed) software systems; and commercial software systems. As at March 2006, one system (the Maternal and Child Health System (MaCHS) program) was used by 55 of the 79 Victorian municipalities, however smaller non-metropolitan councils were less likely than larger metropolitan councils to be using this system. Whichever system is used, it is highly reliant on M&CH Nurses completing the relevant data entry, and there may be limited processes in place for updating, reviewing and enhancing the quality and reliability of the data. (KPMG (2006)).
Key Ages and Stages Maternal and Child Health Visits at Age 3.5 Years: expressed as a rate per 100 M&CH enrolled children of the appropriate age for this visit (i.e. born 3.5 years before visiting).
The numerator and denominator of this measure are compiled separately, so the measure is a rate rather than a proportion. It is possible for the rate to be greater than 100. One explanation of this is that visits (particularly those due in June or July) may not be made in the financial year they are due, leading to undercounting or overcounting in a particular financial year.
Children born in January 2002 were aged 3.5 years in July 2005, while children born in December 2002 were aged 3.5 years in June 2006. Therefore, children born in calendar year 2003 should be attending the 3.5 Years Key Ages and Stages visit in financial year 2005-06, and this cohort should be the denominator of the measure. As M&CH data are only compiled on a financial year basis, it is not possible to obtain the number of children in this cohort. As an approximation, the denominator used is the annual average number of children born in the whole of the two financial years in which the calendar year is part - so, for calendar year 2002, the denominator is the average of births for 2001-02 and 2002-03. Note also that births in a financial year relate to the date of receipt by the M&CH Centre of the birth notification, rather than the actual date of birth.
The total count of enrolments in a particular financial year for each age cohort is based on an aggregation of the number of record cards for that age cohort. For the first age cohort, this will be enrolments from birth notifications received in the current financial year and any other new enrolments (e.g. transfers in) over the course of the financial year. Transfers out over the financial year will be subtracted. For subsequent age cohorts, the number of enrolments will be that from the previous financial year, but adjusted to account for new enrolments or transfers out over the current year.
When compared with ABS Estimated Resident Population (ERP), M&CH enrolments may be overstated. At 30 June 2006, the number of M&CH enrolments of children aged 0-4 years (i.e. yet to turn 5-years-old) across Victoria was 2.4% higher than the corresponding ERP figure. This may have the effect of the reported data slightly understating the true participation rate in M&CH. Family mobility may be a source of potential overstatement if enrolment details are not updated when a family moves. Children may remain enrolled with a particular M&CH service even though the family have moved out of the area. This could be the case if a family moves interstate or overseas, or moves within Victoria but the family is no longer actively attending the M&CH service. With more than one client management system in place, family moves also create the potential for duplicate records to be created as a result. If a M&CH provider is using the MaCHS system, a state-wide unique child identifier is created when the birth is notified, and this unique identifier follows the child if the parents move (KPMG (2006)). However, if a child moves out of or into the MaCHS system 'area' this will not be the case.