Healthy Communities: Child and maternal health in 2013–2015 - Technical Note - Child and maternal health in 2013–2015

Healthy Communities: Child and maternal health in 2013–2015

Child and maternal health in 2013–2015

This technical note accompanies Child and maternal health in 2013–2015.

The report provides insights into the following Performance and Accountability Framework indicators:

6.3.3 Equity and effectiveness – Access

  • 6.3.3.11 Number of women with at least one antenatal visit in the first trimester

6.3.5 Population health outcome measures

  • 6.3.5.4 Prevalence of smoking – published as percentage of women who gave birth and smoked during pregnancy
  • 6.3.5.8 Infant mortality rate
  • 6.3.5.8 Infant and child mortality rate
  • 6.3.5.9 Proportion of babies born with low birthweight

Further details are available in the indicator specification tables in the indicator specifications section.

About the data sources

National Mortality Database and Register of Births

Infant and child mortality rates were calculated using the Australian Institute of Health and Welfare (AIHW) National Mortality Database (NMD) and the Australian Bureau of Statistics (ABS) Birth Registrations collection for the period 2013–2015.

Cause of Death Unit Record File data are provided to the AIHW by the Registries of Births, Deaths and Marriages and the National Coronial Information System (managed by the Victorian Department of Justice) and include cause of death coded by the Australian Bureau of Statistics (ABS). The data are maintained by the AIHW in the NMD.

Deaths registered in 2013 and earlier are based on the final version of cause of death data; deaths registered in 2014 and 2015 are based on revised and preliminary versions, respectively, and are subject to further revision by the ABS.

For information on the NMD refer to the AIHW websiteExternal link, opens in a new window.[https://www.aihw.gov.au/about-our-data/how-we-use-our-data/deaths-data]

The ABS Birth Registrations collection includes all live births that occurred and were registered in Australia, including births to mothers whose place of usual residence was overseas. A live birth is the birth of a child who, after delivery, breathes or shows any other evidence of life such as a heartbeat.

For information on ABS Birth Registrations refer to the ABS website (3301.0 - Births, Australia, 2015)External link, opens in a new window.[http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/3301.0Main+Features32015?OpenDocument]

National Perinatal Data Collection

Data for the measures of low birthweight, smoking during pregnancy and antenatal visits in the first trimester are from the National Perinatal Data Collection (NPDC).

The NPDC is a national population-based cross-sectional collection of data on pregnancy and childbirth. The data are based on births reported to the perinatal data collection in each state and territory in Australia. Midwives and other birth attendants, using information obtained from mothers and from hospital or other records, complete notification forms for each birth. A standard de-identified extract is provided to the Australian Institute of Health and Welfare (AIHW) on an annual basis to form the NPDC.

Information is included in the NPDC for both live births and stillbirths, where gestational age is at least 20 weeks or birthweight is at least 400 grams, except in Victoria and Western Australia, where births are included if gestational age is at least 20 weeks or, if gestation is unknown, birthweight is at least 400 grams.

The NPDC consists of the Perinatal National Minimum Data Set and some additional data items.

For information on the NPDC refer to the AIHW websiteExternal link, opens in a new window.[https://www.aihw.gov.au/about-our-data/our-data-collections/national-perinatal-data-collection]

About the measures

The four measures in the release are described below. The metadata specifications for each measure are available in the indicator specification tables.

Infant and young child mortality rate

Infant and young child mortality rates are reported as the number of deaths among liveborn infants aged less than 1 year, and children aged less than 5 years, per 1,000 live births. The denominator for both measures is the number of live births registered during the stated three year period.

The Performance and Accountability Framework (PAF) indicator has the same definition as the National Healthcare Agreement (NHA) indicator, but is reported for local areas including Primary Health Network (PHN) and Statistical Areas Level 3 (SA3) levels of geography.1 Due to small numbers of deaths in local areas, reporting this indicator in local areas requires multiple years of data.

The definition of infant and young child mortality rate is outlined in the Meteor specification: National Healthcare Agreement: PI 07–Infant and young child mortality rate, 2017External link, opens in a new window.[http://meteor.aihw.gov.au/content/index.phtml/itemId/630004]

Percentage of live births that were of low birthweight

Live births that were of low birthweight are reported by percentage for the period 1 January 2013 to 31 December 2015 by two variables: liveborn singleton babies of Aboriginal and Torres Strait Islander women, and all women who gave birth. The denominator for this measure is the total number of liveborn singleton babies from 1 January 2013 to 31 December 2015.

This report uses the World Health Organization (WHO) definition of a low birthweight baby as weighing less than 2,500 grams.2

This PAF indicator is based on the NHA indicator requirements, and is reported for local areas which includes residents of external territories.

For more information on the definitions of live births that were of low birthweight see the Meteor specification: National Healthcare Agreement: PI 01–Proportion of babies born of low birthweight, 2017External link, opens in a new window.[http://meteor.aihw.gov.au/content/index.phtml/itemId/629984]

Percentage of women who gave birth and smoked during pregnancy

Women who gave birth and smoked during pregnancy are reported by percentage for the period 1 January 2013 to 31 December 2015 by two variables: Aboriginal and Torres Strait Islander women who smoked during pregnancy, and all women who smoked during pregnancy. The denominator for this measure is the total number of mothers with a stated smoking status from 1 January 2013 to 31 December 2015. This is based on women who gave birth and self-reported tobacco smoking at any time during the pregnancy.

Percentage of women who gave birth and had at least one antenatal visit in the first trimester

An antenatal visit is a planned visit between a pregnant woman and a midwife or doctor to assess and improve the wellbeing of the mother and baby throughout pregnancy. An antenatal visit does not include a visit where the sole purpose of contact is to confirm the pregnancy, or those contacts that occurred during the pregnancy that related to other non-pregnancy related issues. An antenatal visit in the first trimester is defined as occurring before 14 weeks’ gestational age.3

Women who gave birth and had at least one antenatal visit in the first trimester are reported by percentage for the period 1 January 2013 to 31 December 2015 by two variables: Aboriginal and Torres Strait Islander women who gave birth and had at least one antenatal visit in the first trimester, and all women. The denominator for this measure is the total number of mothers with a recorded week of gestation at the first antenatal visit from 1 January 2013 to 31 December 2015.

About the method

Geography

The report presents information at the geography of:

  • Primary Health Network (PHN) areas – 31 geographic areas covering Australia, with boundaries defined by the Australian Government Department of Health.4
  • Metropolitan and regional PHN areas – PHN area boundaries align well with the ABS remoteness category of major cities.4 A PHN area was categorised as a metropolitan PHN area if at least 85% of the population was in the major cities category. All other PHN areas were categorised as regional PHN areas. See Table 1 for the metropolitan or regional classification of each PHN area.
  • Statistical Areas Level 3 (SA3s) – 333 geographic areas covering Australia, with boundaries defined by the ABS.5
  • Statistical Areas Level 4 (SA4s) – 88 geographic areas covering Australia, with boundaries defined by the ABS.5

Mortality rates for geographical areas were calculated using the Statistical Area Level 2 (SA2) of usual residence in the NMD unit record data, and applying a geographic concordance from SA2 to PHN area, and SA3 area respectively.

Percentages for geographical areas reported from the NPDC were calculated using the SA2 of usual residence. Where the SA2 was not available either the Statistical Local Area (SLA) or postcode of usual residence was used.

Table 1: Metropolitan and regional Primary Health Network areas

PHN Group PHN area name State Proportion of population in major cities category (%)
Metropolitan Primary Health Network areas
Metropolitan Central & Eastern Sydney NSW 100%
Metropolitan Australian Capital Territory ACT 100%
Metropolitan Western Sydney NSW 99%
Metropolitan Northern Sydney NSW 99%
Metropolitan Adelaide SA 99%
Metropolitan South Eastern Melbourne Vic 98%
Metropolitan Gold Coast Qld 98%
Metropolitan Perth South WA 98%
Metropolitan Perth North WA 98%
Metropolitan North Western Melbourne Vic 96%
Metropolitan Eastern Melbourne Vic 96%
Metropolitan Brisbane South Qld 96%
Metropolitan Brisbane North Qld 95%
Metropolitan South Western Sydney NSW 90%
Metropolitan Nepean Blue Mountains NSW 85%
Regional Primary Health Network areas
Regional Hunter New England & Central Coast NSW 64%
Regional South Eastern NSW NSW 53%
Regional Darling Downs & West Moreton Qld 34%
Regional Central Queensland, Wide Bay & Sunshine Coast Qld 31%
Regional Western Victoria Vic 30%
Regional North Coast NSW 14%
Regional Country SA SA 10%
Regional Western NSW NSW 0%
Regional Murrumbidgee NSW 0%
Regional Gippsland Vic 0%
Regional Murray Vic/NSW 0%
Regional Western Queensland Qld 0%
Regional Northern Queensland Qld 0%
Regional Country WA WA 0%
Regional Tasmania Tas 0%
Regional Northern Territory NT 0%
*
ABS Estimated Resident Population at 30 June 2013
Major cities – as defined by the ABS Australian Statistical Geography Standard Remoteness Areas
  1. SCRGSP (Steering Committee for the Review of Government Service Provision) 2013. National Agreement performance information 2012–13: National Healthcare Agreement. Productivity Commission: Canberra. Viewed 7 December 2017, http://www.pc.gov.au/research/supporting/national-agreements/healthcareExternal link, opens in a new window..
  2. WHO (World Health Organization) 1992. International Statistical Classification of Diseases and Related Health Problems, 10th Revision. Geneva: WHO.
  3. AIHW 2017. Australia’s mothers and babies 2015—in brief. Perinatal statistics series no. 33. Cat no. PER 91. Canberra: AIHW. Viewed 14 November 2017, https://www.aihw.gov.au/reports-statistics/population-groups/mothers-babies/overviewExternal link, opens in a new window..
  4. Department of Health 2016. Primary Health Networks (PHNs). Canberra: Department of Health. Viewed 19 June 2017, http://www.health.gov.au/internet/main/publishing.nsf/Content/PHN-HomeExternal link, opens in a new window..
  5. ABS (Australian Bureau of Statistics) 2011. Australian Statistical Geography Standard (ASGS): Volume 1—Main structure and greater capital city statistical areas, ABS cat. no. 1270.0.55.001. Canberra: ABS.