1. The Health of Koori Children
in Victoria
Hung The Nguyen
Hung.nguyen@monash.edu
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2. ➡Overview of Indigenous
Child Health in Victoria
➡Mandatory reporting
requirements
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3. Background
• 14,578 Aboriginal Children (0-17
years)
• >50% of the aboriginal population was
under 19 years
• 1/2 one parent families
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4. What is ‘health’?
Aboriginal and Torres Strait Islander health
means not just the physical wellbeing of
an individual, but also refers to the social,
emotional and cultural wellbeing of the
Text
whole community in which each
individual is able to achieve their full
potential as a human being.
! - NACCHO, 2006
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5. Physical
health
Parental Social
health network
Cultural
SEWB
connection
Home and
Development
environment 5

6. Connection to culture and
community
• half all young Aboriginal people
identify with a clan, tribal or language
group
• over half of young Aboriginal people
recognise an area as their homelands/
country
• half participate in cultural events
• almost all families speak English
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7. Social network
• 2x did not have a family member outside of
the household they could confide in
• 2x did not have a friend outside the family
household they could confide in
• 1/3 did not have any Aboriginal friends
• 1/3 Aboriginal children spent time with an
Elder/leader
• high proportion of parents/guardians and
young can get the support they when needed
• young Aboriginal people have a lower chance
to make decision at home about things that
affect them
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8. Home and Environment
• 1/10 households need an extra
bedroom
• 3x couple family household had both
parents unemployed
• more likely to spend >30% of
household income on housing
• 1/3 household had days without
money to pay for basic living expenses
• 1/5 households ran out of food and
couldn’t afford to buy anymore 8

9. Parental health
• 1/4 parents/guardians had used illicit
drugs
• 1/5 consumed alcohol during pregnancy;
1/2 smoked during pregnancy
• no difference at high risk alcohol intake
(4.3%) but higher at medium risk levels
(14.6%)
• 1/2 parents are smokers, 1/5 never
smoked
• 1/4 smokers smoked inside the house
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10. Children’s health
• 2x likelihood of having low birth
weight
• slightly higher birth defects
• neonatal and perinatal deaths are high
• breast feeding rate are high (80%)
• immunisation rate are very high
• asthma rates are higher
• oral health is poorer
• 2x hearing problems 10

11. Children’s Health
• more likely need special health care
needs
• more likely need assistance with core
activities - disabilities
• exercise regularly
• 1/3 meet guidelines for fruit and
vegetable consumption
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12. Social and emotional
wellbeing
• parents are more likely to be
concerned about their children's
behaviour at school entry
• 1/10 young people experience high to
very high levels of psychological stress
• admissions for psychiatric problems
increased and higher in Aboriginal
youth
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13. Safety
• 1/5 young people (15-24) experienced
physical violence
• 2x more likely to be a victim of assault
• 3x more likely to be processed by the police
• 10x more likely to be in youth justice system
• adult prisoners more likely to be a parent
• 10x more likely to be a victim of substantiated
abuse, neglect or harm
• 11x more likely to be place in out of home care
• 6/10 in OOHC have been placed in accordance
with the Aboriginal Child Placement Principle
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14. Child development
• 60% has taken folate prior to or during
pregnancy
• 90% had regular antenatal checks
• lower Maternal and Child Health Service
participation
• 8/10 children 0-8 years had been read to
by main carer
• 1/3 children 0-8 years and 6/10 9-14
years were assisted with their homework
• 80% of households experienced family
stress 14

15. Development and Learning
• 6/10 use childcare - more likely to be
informal care
• 2x vulnerable on >1 health and wellbeing
domain of the Australian early
Development Index (AEDI)
• fare less well in numeracy and literacy by
20% point at year 9 level
• 94% 4-14 yo attend school
• 40% 12-17 yo aspired to attend university
• rate of being bullied on a daily basis higher
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16. Health of children in OOHC
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17. Health of children in OOHC
➡ Negative effects of health issues on
quality of life – comparable to cystic
fibrosis, asthma, juvenile diabetes
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18. Health of children in OOHC
➡ High levels of chronic and complex
health needs
➡ Negative effects of health issues on
quality of life – comparable to cystic
fibrosis, asthma, juvenile diabetes
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19. KARI (Aboriginal)
SCH
incomplete immunisation 24 34
abnormal vision screen 30 35
abnormal hearing test 28 44
dental problems 30 36
speech delay 33 66
abnormal growth 14
behavioural/emotional 54 45
problems
infections 12
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20. Child protection - reporting
•Doctors and nurses are mandated reporters in
Victoria.
Responsibilities of a mandated reporter:
•You are legally obliged to make a report to Child
Protection if you believe on reasonable grounds that a
child is in need of protection.
•You must make a report without delay.
•You are required to make a report each time you
become aware of any further grounds for your belief.
•You don’t have to prove that the abuse has occurred.
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21. Child protection - reporting
• It is your responsibility to report your belief – it is not
the responsibility of your boss, supervisor, principal
• In instances where the supervisor directs you not to
make a report even where they believe that abuse is
occurring, you are still legally required to make a
report.
• Mandatory reporting requirements take precedence
over professional codes of practice where
confidentiality or client privilege is claimed.
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22. Child protection - reporting
• A report does not constitute unprofessional
conduct or a breach of professional ethics, nor
does it subject the person to any liability if made in
good faith.
• Ringing Child Protection: 1300 655 795
• After hours: 131 278
• Email queries: queries.childprotection@dhs.vic.gov.au
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23. The Aboriginal context
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24. A step-by-step guide to making a report to
Child Protection or Child FIRST
Protective concerns At all times remember to:
You are concerned about a child because you have: • record your observations
• received a disclosure from a child about abuse or neglect • follow appropriate protocols
• observed indicators of abuse or neglect • consult notes and records
• been made aware of possible harm via your involvement • consult with appropriate colleagues if necessary
in the community external to your professional role. • consult with other support agencies if necessary
STEP 1
STEP 2
STEP 3
STEP 4
FORMING A BELIEF ON MAKING A REFERRAL TO MAKE A REPORT TO CHILD
RESPONDING TO CONCERNS
REASONABLE GROUNDS Child FIRST PROTECTION
1. If your concerns relate to a child in 1. Consider the level of immediate Child Wellbeing Referral Mandatory/Protective Report*
need of immediate protection; or danger to the child.
1. Contact your local Child FIRST 1. Contact your local Child Protection
you have formed a belief that a child Ask yourself: provider. Intake provider immediately.
is at significant risk of harm*.
a) Have I formed a belief that the
Go to Step 4 • See over for contact list for • See over for contact list for
child has suffered or is at risk of
local Child FIRST phone local Child Protection phone
2. If you have significant concerns suffering significant harm?
numbers. numbers.
that a child and their family need YES / NO
a referral to Child FIRST for family 2. Have notes ready with your • For After Hours Child
and observations and child and Protection Emergency
services.
b) Am I in doubt about the child’s family details. Services, call
Go to Step 3
safety and the parent’s ability to 131 278.
3. In all other situations protect the child?
Go to Step 2. 2. Have notes ready with your
YES / NO
observations and child and
2. If you answered yes to a) or b) family details.
Go to Step 4 * Non-mandated staff members who
* Refer to Appendix 2: Definitions of
3. If you have significant concerns believe on reasonable grounds that a
child abuse and indicators of harm in
that a child and their family need child is in need of protection are able to
the Protocol – Protecting the safety and
a referral to Child FIRST for family report their concerns to Child Protection
wellbeing of children and young people
services.
Go to Step 3
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For further information refer to Protecting the safety and wellbeing of children and young people – A joint protocol of the Department of Human Services Child Protection,
Department of Education and Early Childhood Development, Licensed Children’s Services and Victorian Schools

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