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[Truncated abstract. Please see pdf format for complete text.] Background : The excess burden of mortality born by young Indigenous Australians and the disparity in infant and childhood mortality between Indigenous and non-Indigenous Australians have been well documented. The accuracy and completeness of national data describing the health of Indigenous Australians is inconsistent. The Western Australia (WA) Maternal and Child Health Research Database (MCHRDB), is a linked total population database that includes perinatal maternal and infant data, and infant and childhood morbidity and mortality data. Overall, these data are more than 99% complete, with a similar high level of completeness and validity for Indigenous Western Australians. Aim : The aim of this thesis is to measure Indigenous infant (0 to <1 year) and childhood (>=1 to <19 years) mortality and the disparity between Indigenous and non-Indigenous infants and children in WA for birth cohorts from 1980 to 1997 inclusive. To achieve this aim a number of secondary aims were identified, including the measurement of certain maternal and infant variables, and the age-specific, all-cause and cause-specific mortality for WA infants and children. Method : The study comprises a longitudinal birth cohort study, the primary data source being the MCHRDB. Data included on the MCHRDB are complete for all births in WA from 1980 onwards, with new birth cohorts linked on an annual basis. Maternal and infant variables and the geographical location of the residence and the time of birth and death were included in the descriptive and multivariate analyses. Each infant and childhood death was coded using a three-digit code developed primarily for research purposes. The descriptive analyses of mortality referred to the probability of dying in infancy and in childhood as the cumulative mortality risk (CMR), for various diseases and various population subgroups. Age-specific childhood rates were also calculated. The results of multivariate analyses included the fitting of Cox and Poisson regression models, and estimates of effect were represented as hazard ratios (Cox regression) and relative rates (Poisson regression). Results : Between 1980 and 1997, births to Indigenous mothers accounted for 6% of total WA births. Approximately 46% of Indigenous births were to mothers living in a remote location compared to 9% of non-Indigenous births. Indigenous mothers gave birth at an earlier age (30% of births were to teenage mothers compared to 6% of non-Indigenous births), and were more likely to be single than non-Indigenous mothers (40% Indigenous, 9% non-Indigenous). Indigenous infants had more siblings, were born at an earlier gestation and with a lower birth weight and percentage of expected birth weight. The CMR for Indigenous infants was 22 per 1000 live births compared with 6.7 for non- Indigenous infants, a relative risk (RR) of 3.3 (95%CI 3.0, 3.6). While there was a decrease in the CMR over the birth year groups for both populations, the disparity between the rate of Indigenous and non-Indigenous infant mortality increased. The Indigenous postneonatal (>28 to 365 days) mortality rate (11.7 per 1,000 neonatal survivors) was higher than the neonatal (0 to 28 days) mortality rate (10.3 per 1,000 live births). This profile differed from that for non-Indigenous infants, where the neonatal mortality rate (4.3 per 1,000 live births) was nearly twice that of the postneonatal mortality rate (2.4 per 1,000 neonatal survivors). The main causes of infant mortality among Indigenous infants were potentially preventable. These causes were infection followed by Sudden Infant Death Syndrome (SIDS), which differed from the main causes for non-Indigenous infants, sequelae of prematurity and birth defects. The CMR attributable to SIDS increased over the years amongst Indigenous infants and decreased significantly over the years in the non-Indigenous population. Furthermore, the disparity in mortality between the two populations increased and, in 1995 to 1997, was over seven times higher amongst Indigenous infants. The CMR was highest amongst infants living in remote locations for all causes of death except for Indigenous deaths attributable to SIDS, where the risk of death was highest amongst infants living in metropolitan locations. With the exception of infection, there was no difference in cause-specific mortality amongst Indigenous infants according to geographical location. Indigenous infants living in a remote location were at a significantly increased risk of death due to infection compared with their peers living in a rural or metropolitan location. The risk of death for Indigenous children was more than three times higher than for non-Indigenous children. This risk was significantly increased when most of the perinatal maternal and infant variables were considered.

Thesis (Ph.D.)--University of Wollongong, 2007. / "Including the plays Positive expectations and Waiting for ships." Title from web document (viewed 7/4/08). Includes bibliographical references: leaf 249-267.

Thesis (Ph.D.)--University of Melbourne, Dept. of Linguistics and Applied Linguistics, 2009. / Typescript. Includes bibliographical references (p. 256-264)

In this research, I explore my belief that one the reasons for the continuing poor outcomes for Indigenous people was that State-wide and national programs ignored unique local Indigenous culture and did not actively involve local Indigenous people in the development of programs for their area. I chose to examine this perception through investigation of the tension between Indigenous culture and worldview and the dominant White values of the child welfare system (broadly defined), through description of Martu child rearing practices and beliefs in the remote Western Australian town of Wiluna. The Martu live in a remote environment of material poverty, high levels of unemployment, low levels of educational achievement and poor health outcomes. The research sponsored by the Ngangganawili Aboriginal Health Service and located in its Early Childhood Centre, uses an Indigenous research approach based on Brayboy's (2005) TribalCrit to explore Martu child rearing practices, beliefs and values. It uses the stories told by the Martu in Wiluna about the way they and their families were brought up and observations of Martu families to answer research questions around Martu definitions of children and families, their concerns for their children, ways of ensuring the well being of their children, and whether there is a Martu child welfare approach. The research then considers the implications of these Martu practices for the broadly defined child welfare system. The stories told by the Martu show that they have a unique way of bringing up their children that is different to those in the dominant White culture. This uniqueness is derived from a combination of the recent colonisation of the Martu, their culture and their post colonisation experiences. The implications of Martu child rearing for the child welfare system are based on the assumption that Martu are wholly dependent on poorly designed and targeted government provided or funded services, and the current ways of delivering these services is failing the Martu. The research concludes that the key to improving outcomes for Martu children and their families is for the agencies delivering these services to form close working relationships with the Martu; operate within, understand, appreciate, and respect Martu Law and culture; understand their (personal and agency) and Martu post colonisation histories; and allow for Martu control, definition of priorities and development of strategies to address the problems.

Thesis (Ph.D.)--University of Melbourne, Dept. of Opthalmology, 2007. / Typescript. SAFE Strategy refers to Surgery for trichiasis, Antibiotics for active infection, Facial cleanliness and Environmental improvements. Includes bibliographical references (leaves 233-253). Also available electronically: http://eprints.unimelb.edu.au/archive/00003844.