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Published on: January 19, 2024
Anemia in disadvantaged children aged under five years; quality of care in primary practice
Casey Mitchinson1, Natalie Strobel2, Daniel McAullay2
1Perth Children's Hospital, Child and Adolescent Health Service, Government of Western Australia, Perth, Western Australia, Australia.
Insights
Disadvantaged children, especially those aged 6-11 months, face concerning anemia care quality and burden. Improvements are crucial, particularly in remote areas, to ensure equitable health outcomes for Indigenous children.
Area of Science:
- Pediatric Health
- Public Health
- Hematology
Background:
- Anemia affects over 60% of disadvantaged children, yet care quality remains under-researched.
- Significant gaps exist in understanding anemia care for vulnerable pediatric populations.
Purpose of the Study:
- To assess the burden and quality of anemia care for disadvantaged Indigenous children.
- To determine variations in anemia care by age and geographic location.
Main Methods:
- Cross-sectional study utilizing clinical audit data from 2287 Indigenous children (6-59 months).
- Data collected from 109 primary health care centers between 2012 and 2014.
- Multivariable regression models were employed for data analysis.
Main Results:
- Children aged 6-11 months were less likely to receive anemia care (aOR 0.48).
- Care provision varied significantly, from 10.2% (food security advice) to 72.8% (nutrition advice).
- Remote families received more anemia care (56.4%) compared to non-remote (38.2%).
- Anemia diagnosis was highest in infants (57% aged 6-11 months).
- Only 49% of diagnosed children received follow-up care.
Conclusions:
- The burden of anemia and quality of care for disadvantaged Indigenous children is concerning across diverse locations.
- Urgent service improvements are needed for infants aged 6-11 months due to their high risk.
- Addressing disparities in anemia care is critical for improving child health outcomes.
Background:
Anemia rates are over 60% in disadvantaged children yet there is little information about the quality of anemia care for disadvantaged children.
Methods:
Our primary objective was to assess the burden and quality of anemia care for disadvantaged children and to determine how this varied by age and geographic location. We implemented a cross-sectional study using clinical audit data from 2287 Indigenous children aged 6-59 months attending 109 primary health care centers between 2012 and 2014. Data were analysed using multivariable regression models.
Results:
Children aged 6-11 months (164, 41.9%) were less likely to receive anemia care than children aged 12-59 months (963, 56.5%) (adjusted odds ratio [aOR] 0.48, CI 0.35, 0.65). Proportion of children receiving anemia care ranged from 10.2% (92) (advice about 'food security') to 72.8% (728) (nutrition advice). 70.2% of children had a hemoglobin measurement in the last 12 months. Non-remote area families (115, 38.2) were less likely to receive anemia care compared to remote families (1012, 56.4%) (aOR 0.34, CI 0.15, 0.74). 57% (111) aged 6-11 months were diagnosed with anemia compared to 42.8% (163) aged 12-23 months and 22.4% (201) aged 24-59 months. 49% (48.5%, 219) of children with anemia received follow up.
Conclusions:
The burden of anemia and quality of care for disadvantaged Indigenous children was concerning across all remote and urban locations assessed in this study. Improved services are needed for children aged 6-11 months, who are particularly at risk.
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