HISTORY AND DEVELOPMENT

There has been a meagre epidemiological base, both within Australia and internationally, from which to draw conclusions about the scope, prevalence and burden of physical and mental health problems, family and community environment problems and educational disadvantage among Aboriginal and Torres Strait Islander peoples. Most population studies of Australia’s Aboriginal people have focussed on those aged 18 years and over — as a result there is relatively few data available that describe the social and emotional circumstances of Aboriginal people.

In 1993, the health of all Western Australian was surveyed by the Telethon Institute for Child Health Research (TICHR). Recognising that this survey did not have a focus on Aboriginal and Torres Strait Islander children, the TICHR met with several key Aboriginal leaders and representatives from across the state to seek support and endorsement to conduct a survey of Aboriginal and Torres Strait Islander children aged 0–17 years.

The survey was subsequently endorsed and has been the first to gather comprehensive health, developmental and educational information on a population-based sample of Aboriginal and Torres Strait Islander children in their families and communities.

Survey objectives

The survey’s primary objective was to identify developmental and environmental factors that enable competency and resiliency in Aboriginal children and young people. There was emphasis on defining priority targets for existing and future health, education and social services. Building an epidemiological knowledge-base from which preventive strategies can be developed to facilitate the social, emotional, academic and vocational competency of young people was a notable feature of this survey.

Survey concept and development

The concept of gathering child health and wellbeing information from families with Aboriginal and Torres Strait Islander children was first proposed in 1991 during the development of the Western Australian Child Health Survey. However, for reasons owing to scale, cost and expertise, families with Aboriginal children were excluded from this earlier survey. The Telethon Institute for Child Health Research undertook to reassess the feasibility of conducting an Aboriginal child health survey following the conclusion of the original Western Australian Child Health Survey. The assessment of the feasibility, design and scope of the Western Australian Aboriginal Child Health Survey (WAACHS) was subsequently undertaken between 1996 and 1999.

Survey methodology and instrumentation were developed in consultation with Aboriginal leaders, key Aboriginal bodies (the Aboriginal and Torres Strait Islander Commission (ATSIC) Regional Councils, the Aboriginal Council of Elders, the Aboriginal Justice Council, and the Western Australian Aboriginal Community Controlled Health Sector), and through extensive community consultations throughout the state. A survey project team, reporting to an Aboriginal Steering Committee, had basic carriage of securing funding, developing the survey instruments, and implementing the fieldwork.

The Australian Bureau of Statistics (ABS) was a principal provider of consultancy services, expertise and support through all phases of survey development, implementation and analyses. Efforts were made to ensure that the data collected were both scientifically relevant and pertinent to current government information needs and policy initiatives. To do this, reference groups were convened during 1997–1998 with representation from the various government departments and community organisations that had an interest in the outcome of the survey findings. This process involved senior policy input from: the Western Australian Government Departments of Health, Education and Training, Community Development and Police; the Alcohol and Drug Authority; the Disability Services Commission; the State Housing Commission; the Catholic Education Office of Western Australia; and the Association of Independent Schools of Western Australia. Australian Government departments were also consulted about policy needs and to comment on the content and design of the survey.

Aboriginal direction

All phases of the survey and its development, design, and implementation were under the direction of the Western Australian Aboriginal Child Health Survey Steering Committee . Established in 1997, the Aboriginal Steering Committee has the responsibility to control and maintain:

Community consultation and approval

The survey was a large undertaking and involved extensive household sampling and voluntary participation in the survey by many Aboriginal and Torres Strait Islander people across Western Australia. Seeking support and approval for the survey required an extensive and ongoing consultation process. Consultations were undertaken during 1998 and 1999 with visits to Aboriginal communities in Albany, Bunbury, Broome, Carnarvon, Collie, Derby, Esperance, Fitzroy Crossing, Geraldton, Halls Creek, Kalgoorlie, Karratha, Katanning, Kwinana, Kununurra, Narrogin, Perth, Pinjarra, Port Hedland, and Roebourne. Every attempt was made to engage community leaders, community councils, administrative staff, service providers, and local residents to obtain their views about the requirements for the survey, and to secure their participation in the implementation of the survey. People were asked about survey methods and processes, their requirements with respect to specific survey content, their expectations about the use of the survey data, and intended outcomes.

The initial community consultations for the survey established that most participating carers and young people expressed a preference for the survey to be written and administered in plain English. The survey materials were assessed in the pilot test and dress rehearsal and found to yield reliable and valid information for all but the most isolated communities where there was a high level of traditional language use. In these communities, the majority of families chose to be interviewed with the assistance of an Aboriginal language translator employed through the local community council or Aboriginal Medical Service.

Approval for the survey was also obtained from the Western Australian Aboriginal Community Controlled Health Sector, the Western Australian Council of Elders, the Aboriginal Justice Advisory Committee and the Aboriginal and Torres Strait Islander Commission (ATSIC) State Council.

Ethical approval for the survey

The project met the requirements of, and was approved by, the Western Australian Department of Health’s Aboriginal Health Information and Ethics Committee as well as the Ethics Committee of King Edward Memorial and Princess Margaret Hospitals. These clearances ensured that the survey process and procedures conformed with requirements and protocols for health research with Aboriginal people and adhered to National Health and Medical Research Council (NHMRC) ethical standards and guidelines for research with human subjects.

Aboriginal identification and the scope of survey

The survey was based on an area sample of dwellings (see Glossary). Families in selected dwellings who reported that there were ‘Aboriginal or Torres Strait Islander children or teenagers living at this address who are aged between 0 and 18 years’ were eligible to be in the survey (see Aboriginal status in Glossary).

Children living within group homes, institutions and non-private dwellings were not in the scope of the survey. However, where a selected household had a child temporarily living away from home (e.g. in a boarding school or hostel), these children were included in the scope of the survey.

Once the authority for the survey and the nature of the survey was explained to a responsible adult (usually the carer(s) or head of the household), and consent to participate was obtained, Aboriginal status was determined for each person who was reported to usually live in the dwelling. This was done by asking ‘Does (the person) consider him/herself to be of Aboriginal or Torres Strait Islander origin?’ Data were collected on all Aboriginal and Torres Strait Islander children under the age of 18 years in each of the participating households.