Abstract
Research and evaluation studies can be applied to promote equitable health services delivery,
through identifying disparities in health services delivery between different population groups, and
recommending strategies to address these disparities. This thesis reports on four applied research
studies which explore these issues, undertaken through the NSW Public Health Officer Training
Program.
The first study is an evaluation of the NSW Early Childhood Oral Health Program, a program
designed to improve the oral health of infants and young children in NSW. The evaluation shows
that models of shared responsibility for oral health have been established which facilitate
prevention and early intervention for early childhood caries, however additional strategies
targeting vulnerable populations are required for more equitable access and outcomes.
In the second study eye health services for Aboriginal people in western NSW are reviewed through
observational visits, key stakeholder consultation and service provision data analysis. The findings
indicate that eye health services are not equitably available and accessible for Aboriginal people in
this region. Strategies recommended to address this disparity include improved collaborative
practice, improved cultural competence, and routine monitoring of service uptake by Aboriginal
people.
The third study involves a component of “The health of Aboriginal people of NSW: Report of the
Chief Health Officer 2012”, which reports on the performance of mainstream health services at the
local level in providing effective, equitable, and culturally competent services to Aboriginal people.
Health services achieve differential outcomes in key performance indicators for Aboriginal and non-
Aboriginal people, and it is anticipated that enhanced reporting of performance in Aboriginal
health may increase awareness and precipitate action at a local level to address this disparity.
The fourth study investigates issues related to influenza vaccination during pregnancy in central
and south western Sydney. Influenza during pregnancy poses significant risks to pregnant women,
and although the influenza vaccine is safe, effective, and recommended in guidelines, uptake is low
and providers do not routinely recommend it. Understanding the perspectives of pregnant women
and antenatal care providers towards the vaccine will enable targeted strategies to address their
concerns in order to improve uptake of the vaccine and mitigate the risks of influenza during
pregnancy.