Developing Headline Indicators to monitor the health, development and wellbeing of for Australia’s children

Dr Sharon Goldfeld, Child Health Advisor, Office for Children, Victoria

Dr Judy StratonDirector, Statewide Policy and Planning, Western Australia

Ronelle HutchinsonSenior Program Analyst - National Headline Indicators

ISCI Conference June 2007

Recognition of the problem Identification of the

solution through policy

Political imperative

Kingdon J. Agendas, Alternatives and Public Policies. 2nd ed.

New York: Harper Collins College Publishers, 1995

Creating sustainable policy

DATA

Data should be at the centre of child health, not in the periphery of monitoring

Child Health Indicators of Life Development

Report to the European Union 2002

Priority-policy cycle

Priority Setting

Evidence Based strategies

Data Driven/Evidence Based Policy

Improved Outcomes

Data

Research

Data

Data

National Child Health, Development and Well-Being

Headline Indicators

A project undertaken on behalf of the Child Health and Well-being Reform Initiative

Steering Committee

Under the auspices of the Australian Health Ministers’ Conference (AHMC) and the Community and Disability Services Ministers’ Conference (CDSMC)

National Child Health, Development and Well-Being

Headline Indicators

A project undertaken on behalf of the Child Health and Well-being Reform Initiative

Steering Committee

Under the auspices of the Australian Health Ministers’ Conference (AHMC) and the Community and Disability Services Ministers’ Conference (CDSMC)

Headline Indicators Project OverviewThe aim of the Headline Indicators project was to:

Establish a national, jurisdictionally agreed set of Headline Indicators for children’s health, development and well-being Scope an ongoing program to collate, coordinate and report on Headline Indicators

Headline Indicators Project OverviewThe aim of the Headline Indicators project was to:

Establish a national, jurisdictionally agreed set of Headline Indicators for children’s health, development and well-being Scope an ongoing program to collate, coordinate and report on Headline Indicators

What are Headline Indicators?

Headline Indicators form a key set of high level summary statistics for reporting on the progress made in the health, development and well-being of Australia’s children

Headline Indicators focus the policy attention of all Governments on a subset of priority issues for children and assist in guiding and evaluating policy development

Inter-relationships between the Headline Indicators, current national reporting on children’s indicators and jurisdictional data

collections

National Headline Indicators – the benefits

A national, jurisdictionally agreed set of Headline Indicators has the capacity to:

Promote commitment to improving key child outcomes across Governments Direct policy attention to a set of priority issues that are potentially amenable to change

over time Monitor key outcomes through comparison of State and Territory and National data Monitor key outcomes for sub-populations of children

Children with disability Children from culturally and linguistically diverse backgrounds Children living in disadvantage Aboriginal and Torres Strait Islander children

Facilitate jurisdictional and organisational coordination and collaboration around data collection

Enhance the quality, consistency and availability of data relating to the Headline Indicators

Reduce duplication of effort across sectors

The Development of Child Health, Development and Well-Being

Headline Indicators Managed by cross-jurisdictional steering group A review of the national and international work Two rounds of consultation with jurisdictions using

semi structured interviews and with national data committees across health, community services and education

Feedback on ‘draft’ of proposed Headline Indicators Received formal support of final recommendations

from NHIG, NCSIMG and AESOC Reported to AHMC and CDSMC in July 06

Consultations• ABS• ACT Government • AESOC Early Learning Working Group• AESOC PMRT• AESOC Senor Officials Working Party on

Indigenous Education• AIHW• Antenatal Guidelines Project Steering

Group• Australian Government DoHA• Australian Government FaCSIA• Housing Ministers Policy Research

Working Group• National Advisory Group on Aboriginal

and Torres Strait Islander Health Information and Data (NAGATSIHID)

• National Child Protection and Support Services (NCPASS)

• National Community Services Data Working Group (NCSDWG)

• NDA• NCSIMG• NPHIWG• NSW Commission for Children• NSW Department of Community Services• NSW Department of Health• NT Government • QLD Government • SA Government • SIMC• Tasmania (TAS) Department of Health

and Human Services• Telethon Institute for Child Health

Research• Victorian DHS• WA Department of Community

Development• WA Department of Health• Women’s Hospitals Australasia

Consultations

Priority areas

Indicators

Consultations

Final report

Start with want you want to know… NOT what you have

Priority area criteria

• broadly cover the domains of child health, development and learning, safety and well-being;

• recognise issues at the individual, family and community level, and hence be based on an ecological approach;

• include both risk and protective factors for health, development and well-being;

• be based on a prevention approach to health, development and well-being;

• amenable to change through policy• include a mix of outcomes, determinants and system performance

indicators;• be able to reflect any differences for sub-groups of children; • be relevant to all Australian children; and• be relevant to State/Territory and Australian Governments policy and

agendas.

Indicator criteria

• indicator is sensitive to evidence based intervention strategies;

• indicator is unambiguous in meaning and interpretation and is based on sound empirical evidence;

• data collection is methodologically rigorous;• data are potentially capable of reflecting differences

and diversity in sub-groups including:• Aboriginal and Torres Strait Islander children• children with a disability• children from CALD backgrounds• children from socio-economically disadvantaged backgrounds• geographically defined groups (i.e. rural and remote areas).

Priority Area Headline Indicator Data Source

Smoking in Pregnancy

Proportion of women who smoked during the first 20 weeks of pregnancy*

AIHW National Perinatal Statistics Unit

(not implemented at present)

Infant Mortality Mortality rate for infants less than one year of age ABS Births and Deaths

Birth Weight Proportion of live born infants of low birth weight AIHW National Perinatal Statistics Unit

Breastfeeding Proportion of infants exclusively breast fed at 4 months of age

Not available in all states

Immunisation Proportion of children on the Australian Childhood Immunisation Register who are fully immunised at 2

years of age

Australian Childhood Immunisation Register

Overweight and Obesity

Proportion of children whose body mass index (BMI) score is above the international cut off points for ‘overweight’ and ‘obese’ for their age and sex*

National Children's Nutrition and Physical

Activity Survey proposed for 2006/07

Dental Health Mean number of decayed, missing or filled teeth (dmft/DMFT) among primary school children*

Child Dental Health Survey

Social and Emotional Well-

Being

No indicator identified Not available at present

Priority Area Headline Indicator Data SourceInjuries Age specific death rates from all injuries for children

aged 0-4, 5-9 and 10-14 years ABS Cause of Death

Attending Early Childhood Education

Programs

Proportion of children attending an early educational program in the two years prior to beginning primary

school *

Children Services National Minimum Data Set (not implement as

yet)

Transition to Primary School

Proportion of children entering school with basic skills for life and learning*

Not available

Attendance at Primary School

Attendance rate of children at primary school* Not available

Literacy Proportion of primary school children who achieve the literacy benchmark

MCEETYA National Report on Schooling

Numeracy Proportion of primary school children who achieve the numeracy benchmark

MCEETYA National Report on Schooling

Teenage Births Age specific fertility rate for 15-19 year old women ABS Births Australia

Family Economic Situation

Average real equivalised disposable household income for households with children in the 2nd and

3rd income deciles*

ABS Survey of Income and Housing

Shelter No indicator identified Not available

Child Abuse and Neglect

Rate of children aged 0-12, who were the subject of child protection substantiation in a given year

AIHW Child Protection Statistics

Family Social Network

No indicator identified Not available

Priority Area: Smoking in Pregnancy

Headline Indicator: Proportion of women who smoked during the first

20 weeks of pregnancy

Data Sources:

In future, Australian Institute of Health and Welfare (AIHW) National Perinatal Statistics Unit (NPSU)

Data not currently available

Notes: Indicator sourced from the Women’s Hospitals Australiasia (WHA) core

maternity indicators project Core maternity indicators require piloting and feasibility testing prior to

implementation in the Perinatal Forms in all States and Territories

Priority Area: Infant Mortality

Headline Indicator: Mortality rate for infants less than one year of age

Data Sources: ABS Birth and ABS deaths

Frequency of Data: Annual administrative data

Disaggregation possible: Indigenous status for QLD, NT, SA and WA Socio-Economic Indexes for Area (SEIFA) Australian Standard Geographical Classification (ASGC) remoteness

Priority Area: Birth Weight

Headline Indicator: Proportion of live born infants of low birth weight

(<2500 grams at birth)

Data Sources: Australian Institute of Health and Welfare (AIHW) National Perinatal

Statistics Unit (NPSU)

Frequency of Data: Annual administrative data

Disaggregation possible: State and territory Indigenous status of mother maternal country of birth Socio-Economic Indexes for Area (SEIFA) for some jurisdictions Australian Standard Geographical Classification (ASCG) remoteness

classification

Priority Area: Breastfeeding

Headline Indicator: Proportion of infants exclusively breast-fed at 4

months of age

Data Sources: No consistent national data collection source Data not currently available for all states

Priority Area: Immunisation

Headline Indicator: Proportion of children on the Australian Childhood

Immunisation Register who are fully immunised at 2 years of age

Data Sources: Australian Childhood Immunisation Registry (ACIR) National data source

Frequency of Data: Quarterly from 1996

Disaggregation possible: State and Territory Indigenous status (although improvements are needed) Socio-Economic Indexes for Area (SEIFA)

Priority Area: Overweight and Obesity

Headline Indicator: Proportion of children whose BMI score is above the

international cut off points for ‘overweight’ and ‘obese’ for their age and sex

Data Sources: The National Children’s Nutrition and Physical Activity Survey 2007

could be a source of gathering information in relating to weight and BMI in children

Current data not available (since 1995)

Disaggregation possible: Disaggregation of proposed data not known

Priority Area: Dental Health

Headline Indicator: Mean number of decayed, missing or filled teeth

(dmft/DMFT) among primary school children

‘DMFT’ is the decayed, missing or filled teeth for children aged 12 years

‘dmft’ is the decayed, missing or filled teeth for children aged 6 years

Data Sources: The Child Dental Health Survey

Frequency of Data: Annual

Disaggregation possible: Sex of child birth place of child indigenous status of child state and territory

Priority Area: Social and Emotional Well-being

Headline Indicator: ???

No indicator identified at present

Further work required to identify relevant existing indicators of children’s social and emotional wellbeing

Further work required in relation to a data collection source for this Headline Indicator

Priority Area: Injuries

Headline Indicator: Age specific death rates from all injuries for children

aged 0-4, 5-9 and 10-14 yearsData Sources: Australian Bureau of Statistics (ABS) Cause of Death collection

Frequency of Data: Annual from 1964

Disaggregation possible: State and territories Indigenous status Sex Age remoteness index

Priority Area: Attending Early Childhood Education Programs

Headline Indicator: Proportion of children attending an educational program

in the two years prior to beginning primary schoolData Sources: Children’s Service National Minimum Data Set (CSNMDS) CSNMDS not yet implemented – data not currently available

Disaggregation proposed: Indigenous status Sex Age main language other than English spoken at home disability status State and Territory

Notes: Further work required in regards to the definition of ‘attending’ and ‘educational

program’ in line with implementation of the CSNMDS and data collection.

Priority Area: Transition to Primary School

Headline Indicator: Proportion of children entering school with basic

skills for life and learningNotes:

There is no current national source of information about children’s transition to Primary School

Identified as a priority area by Council of Australian Governments (COAG)

Precise definition of this indicator, numerator and denominator and methodology for data collection yet to be determined.

The Australian Early Development Index (AEDI) may provide information on children’s successful transition to schooling

The Longitudinal Study of Australian Children (LSAC) may provide information on the factors which relate to children’s success in transition to schooling and the factors behind this success

Priority Area: Attendance Rate at Primary School

Headline Indicator: Attendance rate of children at Primary School

Notes:

Data not currently available Work is being progressed by the MCEETYA Performance

Measurement and Reporting Taskforce Precise definition of this indicator, numerator and denominator and

methodology for data collection yet to be determined.

Priority Area: Literacy Skills

Headline Indicator: The proportion of primary school children who achieve the

literacy benchmark  

MCEETYA has established national benchmarks for reading and writing that represents the minimum standards of performance of children

Reporting of % of children meeting the literacy benchmark for grades 3 and 5.

Data Sources: Ministerial Council on Education, Employment, Training and Youth Affairs (MCEETYA) annual

National Report on Schooling

Disaggregation possible: State and Territory Language spoken at home Indigenous status Socio-economic situation Sex

Notes: Recent changes to the design and administration of literacy testing aims to increase comparability of

results across States/Territories, consistency of data collection and effectiveness in recording of demographic details of children.

Priority Area: Numeracy Skills

Headline Indicator:The proportion of primary school children who achieve the

numeracy benchmark MCEETYA has established national benchmarks for numeracy that represents the minimum

standards of performance of children Reporting of % of children meeting the numeracy benchmark for grades 3 and 5.

Data Sources: Ministerial Council on Education, Employment, Training and Youth Affairs (MCEETYA) annual

National Report on Schooling

Disaggregation possible: State and Territory Language spoken at home Indigenous status Socio-economic situation Sex

Notes: Recent changes to the design and administration of literacy testing aims to increase comparability of

results across States/Territories, consistency of data collection and effectiveness in recording of demographic details of children.

Priority Area: Teenage Births

Headline Indicator: Age specific fertility rate for 15-19 year old women

 Data Sources: Australian Bureau of Statistics (ABS) Births Australia

Frequency of Data: Annual administrative data

Disaggregation possible: State and Territory Indigenous status of mother country of birth of mother Socio-Economic Indexes for Area (SEIFA)

Priority Area: Family Economic Situation

Headline Indicator:  Average real equivalised disposable

household income for households with children in the 2nd and 3rd income decilesData Sources:

Births Australia Australian Bureau of Statistics (ABS) Survey of Income and Housing

Frequency of Data: Most years from 1994-1995 to 2003-2004

Disaggregation possible: State and Territory

Notes: Recognised that indicator has some limitations in addressing cause and

type of financial hardship facing families – in the future, the indicator may be altered to measure more accurately family economic situation.

Priority Area: Shelter

Headline Indicator:  ???

No indicator identified at present

Further work required to identify most relevant indicators of shelter – including affordability, availability and quality

Further work required in relation to a data collection source for this Headline Indicator

Priority Area: Child Abuse and Neglect

Headline Indicator:  Rate of children aged 0-12, who were the subject of

child protection substantiation in a given year Data Sources: Australian Institute of Health and Welfare (AIHW) Child Protection Statistics

Disaggregation possible: State and Territory Indigenous status of child Sex age

Notes: National aggregation from this data source is problematic – data are a measure of

the activity/services of the Government departments responsible for statutory child protection services in each State and Territory. Data and the definitions of ‘substation are influenced by differences in legislation, policy, practices and data systems.

Priority Area: Family Social Network

Headline Indicator:  ???

No indicator identified at present

Further work required to identify most relevant indicators of family social network

Further work required in relation to a data collection source for this Headline Indicator

Headline Indicator Program: Next steps

• Providing national leadership and coordination with existing data initiatives

• Facilitating data development activities

• Data management

• Reporting of data for Headline Indictors (publicly and to government)

Acknowledgments Project was managed by steering group

Dr Sharon Goldfeld (Chair) - Statewide Outcomes for Children, Office for Children, DHS VIC

Dr Michael Ackland - Health Surveillance and Evaluation, DHS VIC Dr Judy Straton – Child and Community Health, WA Health Ms Shalini Bellis - National Children and Youth Statistics Unit, ABS Ms Lesley Martin - National Children and Youth Statistics Unit, ABS Dr Penny Allbon, Director, AIHW Ms Cynthia Kim - Children, Youth and Families Unit, AIHW Dr Indrani Pieris Caldwell – Children, Youth and Families Unit, AIHW Dr Caroline Pappas, Child Health and PHOFA, DoHA Ms Padmaja Jha - Child Health and PHOFA, DoHA Ms Lauren Heller - Child Health and PHOFA, DoHA

The project was supported by Dr Ronelle Hutchinson - Senior Program Analyst and Project Manager, Statewide Outcomes for Children, Office for Children, DHS VIC

Not everything that is faced Can be changed

But nothing can be changed Until it is faced

James Baldwin 1924-87