This first Annual Report 2010 provides readers with a snap shot of the Northern Territory profile of chronic conditions and the progress against each of the eight key action areas outlined in the CCPMS Implementation Plan.

Under-identification of Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) people can result in inaccurate estimation of health outcomes. Data linkage has improved identification of Aboriginal people in administrative datasets.To compare three methods of ascertainment of Aboriginal status using only pregnancy data from the Western Australian Midwives Notification System (MNS), to the linked Indigenous Status Flag (ISF) derived by the Department of Health.This retrospective population-based cohort study utilised logistic regression to determine which demographic characteristics were associated with under-identification, and the effect of ascertainment method on perinatal adverse outcomes.All methods identified a core group of 19 017 (83.0%) Aboriginal women and the ISF identified 2298 (10.0%) women who were not identified using any other method. Under-ascertainment was lowest when a woman's Aboriginal status was determined by ever being recorded as Aboriginal in the MNS data, and highest when taken as it had been recorded for the birth in question. Maternal age <20 years, smoking during pregnancy, pre-existing diabetes, a history of singleton preterm birth and being in the lowest 20% of Socio-Economic Indexes for Areas score were all associated with a higher chance of being identified by the methods using only the MNS. These methods were less likely to identify nulliparous women, and those with maternal age ≥35 years. The method of ascertainment of Aboriginality did not make a significant difference to the adjusted predicted marginal probabilities of adverse perinatal outcomes.Unlinked pregnancy data can be used for epidemiological research in Aboriginal obstetric populations.

The Northern Territory has the highest burden of disease in Australia, and our response to improve this situation presents a significant challenge for all Territorians. The Northern Territory Chronic Conditions Prevention and Management Strategy 2010-2020, provides the framework for improving population health and well being across the Territory through reducing the incidence and impact of chronic conditions on our communities.

The Northern Territory Aboriginal Health Forum (NT AHF), that comprises representatives from the Commonwealth Department of Health (DoH), Aboriginal Medical Services Alliance of the Northern Territory (AMSANT) and the Northern Territory Department of Health (NT DoH), have developed this set of Key Performance Indicators (KPI’s). The NT wide health jurisdiction Aboriginal Health Key Performance Indicators system (NT AHKPI) is capturing and measuring primary health care data consistently across the variety of NT remote Primary Health Care service providers. The objective of the NT AHKPI system is to contribute to improving primary health care services for Aboriginal Australians in the Northern Territory by building capacity at the service level and the system level to collect, analyse and interpret data that will:

The Northern Territory (NT) and Far North Queensland (FNQ) have a high proportion of Aboriginal and Torres Strait Islander women birthing who experience hyperglycaemia in pregnancy. A multi-component health systems intervention to improve antenatal and postpartum care in these regions for women with hyperglycaemia in pregnancy was implemented between 2016 and 2019. We explored health professional perspectives on the impact of the intervention on healthcare. The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) underpinned this mixed-methods evaluation. Clinicians were surveyed before ( = 183) and following ( = 137) implementation. The constructs explored included usual practice and satisfaction with care pathways and communication between services. Clinicians, policymakers and the implementation team were interviewed ( = 36), exploring the impact of the health systems intervention on practice and systems of care. Survey and interview participants reported improvements in clinical practice and systems of care. Self-reported glucose screening practices improved, including the use of recommended tests (72.0% using recommended first-trimester screening test at baseline, 94.8% post-intervention, < 0.001) and the timing of postpartum diabetes screening (28.3% screening at appropriate interval after gestational diabetes at baseline, 66.7% post-intervention, < 0.001). Health professionals reported multiple improvements to care for women with hyperglycaemia in pregnancy following the health systems intervention.

The health inequalities experienced by Aboriginal and Torres Strait Islander Australians are well documented but there are few empirical data outlining the burden, consequences, experience and expression of depressive illness. This paper seeks to address the lack of accessible, culturally specific measures of psychosocial stress, depression or quality of life developed for, and validated within, this population. Building on an extensive qualitative phase of research, a psychosocial questionnaire comprising novel and adapted scales was developed and piloted with 189 Aboriginal men across urban and remote settings in central Australia. With a view to refining this tool for future use, its underlying structure was assessed using exploratory factor analysis, and the predictive ability of the emergent psychosocial constructs assessed with respect to depressive symptomatology. The latent structure of the psychosocial questionnaire was conceptually aligned with the components of the a priori model on which the questionnaire was based. Regression modelling indicated that depressive symptoms were driven by a sense of injury and chronic stress and had a non-linear association with socioeconomic position. This represents the first community-based survey of psychosocial stress and depression in Aboriginal men. It provides both knowledge of, and an appropriate process for, the further development of psychometric tools, including quality of life, in this population. Further research with larger and more diverse samples of Aboriginal people is required to refine the measurement of key constructs such as chronic stress, socioeconomic position, social support and connectedness. The further refinement, validation against criterion-based methods and incorporation within primary care services is essential.

The Northern Territory Aboriginal Health Forum (NT AHF) - comprises senior representatives from the Australian Government Department of Health (DoH), the Aboriginal Medical Services Alliance of the NT (AMSANT) and the NT Department of Health (NT DoH). The Forum’s role is to provide advice and direction on Aboriginal health issues. The NT AHF provided leadership in the development and implementation of the Key Performance Indicators and the NT AHKPI system.

The Northern Territory has the highest burden of disease in Australia, and our response to improve this situation presents a significant challenge for all Territorians. The Northern Territory Chronic Conditions Prevention and Management Strategy 2010-2020, provides the framework for improving population health and wellbeing across the Territory through reducing the incidence and impact of chronic conditions on our communities.

The Framework will remain current for the life of the NT Chronic Conditions Prevention and Management Strategy ie until 2020; as such it will be evaluated together with the Strategy.

Northern Territory Aboriginal Cultural Security Framework 2016-2026 is a policy framework that aims to guide and strengthen implementation of culturally secure services for Aboriginal and Torres Strait Islander (Aboriginal) people in the Northern Territory.

The Aboriginal Cultural Security Policy aims to strengthen Aboriginal Territorians’ access to and benefits of health services by ensuring that the health system recognises the centrality of culture in delivering successful health outcomes.

This document provides an overview of the NT Preventable Chronic Diseases Strategy. It should be read in conjunction with two other documents produced in August 1999: the Ministerial Statement delivered by Hon. Stephen Dunham MLA, Minister for Health, Family and Children’s Services; and the PCDS Evidence Base (containing a description of the best buys and key result areas in chronic disease control). The above two documents can be found in ePublications at http://hdl.handle.net/10137/538.

Preconception care may decrease adverse pregnancy outcomes associated with pre-existing diabetes mellitus. Aboriginal Australians are at high risk of type 2 diabetes mellitus (T2DM), with earlier onset. We explored practitioner views on preconception care delivery for women with T2DM in the Northern Territory, where 31% of births are to Aboriginal women. Mixed-methods study including cross-sectional survey of 156 health practitioners and 11 semi-structured interviews. Practitioners reported low attendance for preconception care however, 51% provided counselling on an opportunistic basis. Rural/remote practitioners were most likely to find counselling feasible. The majority (69%) utilised appropriate guidelines and addressed lifestyle modifications including smoking (81%), weight management (79%), and change medications appropriately such as ceasing ACE inhibitors (69%). Fewer (40%) prescribed the recommended dose of folate (5mg) or felt comfortable recommending delaying pregnancy to achieve optimal preconception glucose control (42%). Themes identified as barriers to care included the complexity of care setting and infrequent preconception consultations. There was a focus on motivation of women to make informed choices about conception, including birth spacing, timing and contraception. Preconception care enablers included cross-cultural communication, a multi-disciplinary care team and strong client-based relationships. Health practitioners are keen to provide preconception counselling and reported knowledge of evidence-based guidelines. Improvements are needed in recommending high dose folate and optimising glucose control. Cross-cultural communication and team-based care were reported as fundamental to successful preconception care in women with T2DM. Continued education and policy changes are required to support practitioners in opportunities to enhance pregnancy planning.

This volume outlines the theory and a range of strategies and resources for practice in the field. It includes step by step guides to processes and strategies and a range of checklists. It will assist teams in planning and evaluating their work. It also includes a list of contacts for further information and assistance. This is the first edition of volume 1 of the Bush Book superseded by the 2nd edition in 2002 and the 3rd edition in 2007