Population Child Health

The key health challenge of our time is to address the changing health needs of children and young people in our population. Our current model of hospital‐centred paediatric care was developed to deliver acute inpatient and high intensity specialist services rather than high quality care for children and young people with long-term conditions.

Our health systems needs radical transformation if it is to meet the health needs of the future. Our research aims to understand the determinants of poor health in children and young people; co-develop integrated scalable intervention packages that can be delivered by existing practitioners; evaluate these packages at scale and integrate them into everyday practice.

As part of the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE) our focus is on translational research that will have a direct impact on the everyday lives of children, especially children and young people whose voices often go unheard, such as those from Aboriginal, refugee and culturally and linguistically diverse backgrounds and those living in socioeconomic disadvantage or out of home care.

As well as working with communities and partners across New South Wales and Australia, we also have ongoing projects to help kids in the UK, Fiji, Bangladesh, India, Pakistan, Sri Lanka and Uganda.

Current projects

Our work is based along three strands with child health equity a key theme throughout: transforming health systems, optimising the life chances for children young people and families that are doing it tough, and ensuring children and young people get the best start in life.

Transforming Health Systems

  • Developing a Child Health Translational Research Unit based within South West Sydney Local Health District – BestSTART-SW (System Transformation and Research Translation - South West Sydney).
  • Using innovative, evidence-based approaches to reshape everyday health services through integrated care both in Australia and the UK through the NSW integrated care programme and the Children and Young People’s Health Partnership (CYPHP) respectively: https://www.cyphp.org/.
  • Targeting the needs of refugee and Aboriginal children through service development
  • Investigating inequity in childhood diseases and health services use across the Sydney Children’s Hospital Network.
  • Exploring mental health services for young people and young mothers who are pregnant or just given birth.
  • CYP GPS Integrated care program- projects in SCHN, Murrumbidgee LHD, SESLHD and WSLHD for children with chronic and complex conditions to improve care coordination and reduce variation in care
     

Working with CYP and priority populations

  • Improving the health of urban Aboriginal children and adolescents in the SEARCH study: Study of Environment on Aboriginal Resilience and Child Health
  • La Perouse Aboriginal Community Child Health Service and community forums
  • Refugee Paediatric Clinics
  • Healthy Housing Project with George Institute
  • Investigating the impact of inequitable health service provision on child health outcomes in the early years of childhood in Australia and globally
  • Investigating the impact of detention on the social–emotional wellbeing of children seeking asylum
  • Developing innovative models of care to support mothers from Aboriginal backgrounds through the Ngala Nanga Mai pARenT Group Program (NNM).
  • Changing children’s chance’s project in collaboration with MCRI
  • Reducing problem drug and alcohol use and enhance mental health of children in care
  • Developing interventions such as SILVER: Smart Interventions for Local Vulnerable Families, which will use data from health, criminal justice and social care to inform the day to day practice of key workers dealing with families currently involved with the UK “Troubled Families Programme”
     

The Best Start

  • Good Beginnings - Developing new models of child health care in developmental surveillance for children from culturally and linguistically diverse backgrounds in Botany and Rockdale
  • Developmental surveillance, screening and assessment services
  • Behavioural clinic for children from priority populations
  • Establishing determinants of wellbeing in childhood to guide early childhood intervention programs through programs (e.g. through SPHERE Early Life Determinants of Health program)
  • Evaluating technological interventions such as “Best Beginnings: Baby Buddy App” to enhance maternal wellbeing and child development in the United Kingdom
  • Early identification and  universal surveillance of developmental disorders through involvement in the “Watch Me Grow” study
  • Developing and evaluating a sustainable health visiting intervention in India and Pakistan: SPRING.
  • Examining inequities in children with Cerebral Palsy

The research team

Professor Raghu Lingam, Group leader

Raghu is Professor of Population Child Heath at UNSW, head of the research unit and a Community Paediatrician at SCHN. He is a clinical academic interested in community and technology-based intervention to promote child survival, growth and development. He has a particular interest in improving health systems and service delivery to children in under-serviced areas. For more information see Raghu's UNSW profile page.

Associate Professor Karen Zwi, Head of Community Child Health, Sydney Children's Hospital

Karen is head of the Department of Community Child Health, Clinical Director of Priority Populations across Sydney Children’s Hospitals Network and Refugee Clinical Lead. Her research interests include the service development for refugee health, Aboriginal health, child protection, mental health and adolescent services. For more information see Karen's UNSW profile page.

Associate Professor Susan Woolfenden, Senior Research Fellow

Sue is a NH&MRC funded Senior Research Fellow and a senior staff specialist in the Department of Community Child Health ,Sydney Children’s Hospital Network. She leads research that investigates the impact of inequitable health and health care for children in the early years of childhood in Australia and globally, in particular those who are at risk of or have a neurodevelopmental disorder. For more information please see Sue's UNSW profile page.

Lisa Altman, Integrated Care Manager, SCHN

Lisa is the Integrated Care Manager for SCHN and has been instrumental in attracting funding from the NSW Health Integrated Care Innovation to set up innovative models of care for children with medical complexity across NSW.

Dr Nusrat Homaira, Paediatric Epidemiologist

Nusrat is a Lecturer in Paediatric Epidemiology at UNSW with more than 10 years working experience in the field of epidemiological and population health research. Her research interests include transforming health services delivery for children with chronic illness such as asthma. She holds an honorary academic position at George Institute for Global Health where she continues to be involved in ongoing global health collaborative research. For more information please see Nusrat's UNSW profile page.

Associate Professor Shanti Raman

Shanti is a Head of Department and Consultant Paediatrician in South West Sydney. Her research and teaching interests include global maternal, newborn and child health, child rights and child maltreatment, health of migrants and refugees, poverty, indigenous child health, and quality and safety in health. Her PhD in international maternal and child health at the University of New South Wales was about socio-cultural factors influencing perinatal health in urban India. For more information please see Shanti's UNSW profile page.

Dr Monika Wadolowski, Research Fellow

Monika is an epidemiologist with expertise in parental supply of alcohol, child and adolescent alcohol use, child and adolescent health and development, parenting practices, and longitudinal cohort studies. She has an international track record in the under-researched area of parental supply of alcohol to children and adolescents and adolescent alcohol use.  Monika is passionate about research translation, and ensuring that complex scientific findings can be shared in accessible ways to inform evidence-based discussions in the international community. For more information please see Monika's UNSW profile page.

Dr Nan Hu, Research Fellow

Nan is an epidemiologist and bio-statistician by training, and has more than 10 years of professional and academic experience in public health research. His PhD examined the impact of family psychosocial factors, parental psychiatric disorders, and child maltreatment experience in the risk of deliberate self-harm behaviours among adolescents, using administrative linked data. Following his PhD, he was heavily involved in multiple projects investigating behaviour and emotional problems among children with intellectual disability and/or Autism Spectrum Disorder. Nan has a great interest in child health, with particular interests in mental health and behavioural problems, social disadvantage and vulnerability, early intervention strategies and polices, and clinical integration and innovation.

Dr Alicia Montgomery, Community, Developmental and Behavioural Paediatrician

Alicia is a paediatrician with an interest in Autism Spectrum Disorder and other neurodevelopmental disorders. She completed her paediatric training at the Sydney Children’s Hospital, and at the Royal Children’s Hospital in Melbourne. She also worked in a clinical research capacity for Columbia University (New York) in the Centre for Autism and the Developing Brain between 2016-2017, with children with Autism Spectrum Disorder and other neurodevelopmental conditions. Dr Montgomery is currently an investigator on neurodevelopmental clinical trials in Autism Spectrum Disorder and Tourette Syndrome in Australia, for the University of New South Wales. 

Nora Samir, Research Assistant

Nora is currently the coordinator of a refugee health research study and is also working on setting up and running children and young people’s research advisory groups at Sydney Children’s Hospital, Randwick and in a local school. Her research interests include improving access to health care services in refugee and migrant populations, particularly through community-based interventions.

Laurel Mimmo, PhD Candidate

Laurel is a PhD candidate with the University of NSW School of Public Health and Community Medicine, inaugural SPHERE Translational Research Fellow and Project Officer with the SCHN Clinical Governance Unit. Laurel has over 15 years clinical experience as a paediatric registered nurse, with a special interest in healthcare for children with intellectual disability. Working as a Quality Officer with the SCHN Clinical Governance Unit since 2013 Laurel has advanced her expertise in health care quality and safety (Q&S), directing her postgraduate studies with UNSW to undertake foundational research in Q&S healthcare for children with intellectual disability.

Staff within the Department of Community Child Health and project officers in the Department of Integrated Care at SCHN also form part of the Population Child Health Research Group.

Key publications

Significant reductions in tertiary hospital encounters and less travel for families after implementation of Paediatric Care Coordination in Australia, Breen C; Altman L; Ging J; Deverell; Woolfenden S; Zurynski Y, 2018, BMC Health Services Research, 18:771-781

A qualitative study of health care providers' perceptions and experiences of working together to care for children with medical complexity (CMC), Altman L; Zurynski Y; Breen C; Hoffmann T; Woolfenden S, 2018, BMC Health Services Research, 18:70-81

Aboriginal and Torres Strait Islander healthcare delivery: the views of healthcare professionals in Sydney’s tertiary paediatric hospitals. Nyanga R, Warren S, Biviano L, Zwi K, Gunasekera H, 2018, Journal of Paediatrics and Child Health 2018, 54:1023-1030

Parent-reported prevalence and persistence of 19 common child health conditions. Liu T; Lingam R; Lycett K; Mensah FK; Muller J; Hiscock H; Huque MH; Wake M, 2018, Arch Dis Child, 103:548-556.

Protective factors for social-emotional well-being of refugee children in the first three years of settlement in Australia, Zwi K; Woodland L; Williams K; Palasanthiran P; Rungan S; Jaffe A; Woolfenden S, 2018, Archives of Disease in Childhood, 103:261 - 268

A systematic review of interventions to enhance health professional contact with parents and infants to improve child development and social and emotional wellbeing in high-income countries. Hurt L, Paranjothy S, Lucas P J, Watson D, Mann M, Griffiths L J, Bellis M, Lingam R, 2018. BMJ Open, 8:e014899

Understanding child disadvantage from a social determinants perspective, Goldfeld S; O'Connor M; Cloney D; Gray S; Redmond G; Badland H; Williams K; Mensah F; Woolfenden S; Kvalsvig A, 2018, J Epidemiol Community Health, 72:223 - 229,

The impact of developmental coordination disorder on educational achievement in secondary school. Harrowell, I., Hollen, L., Lingam, R. and Emond, A, 2018. Research in developmental disabilities, 72:13-22.

Medical neglect at a tertiary paediatric hospital, Parmeter J; Tzioumi D; Woolfenden S, 2018, Child Abuse and Neglect, 77:134 - 143,

School-Based Education Programs for the Prevention of Child Sexual Abuse: A Cochrane Systematic Review and Meta-Analysis, Walsh K; Zwi K; Woolfenden S; Shlonsky A, 2018, Research on Social Work Practice, 28:33 - 55

Child survival in England: Strengthening governance for health, Wolfe I, Mandeville K, Harrison K, Lingam R, 2017, Health Policy, 121:1131-38

Audit of child maltreatment medical assessments in a culturally diverse, metropolitan setting. Raman S, Hotton PR, 2017, BMJ Paediatrics Open, 1(1).

Helping refugee children thrive: what we know and where to next. Zwi K; Woodland L; Mares S; Rungan S; Palasanthiran P; Williams K; Woolfenden S; Jaffe A, 2017, Arch Dis Child,

Taking culture seriously: Can we improve the developmental health and well-being of Australian Aboriginal children in out-of-home care? Raman S, Ruston S, Irwin S, Tran P, Hotton P, Thorne S. Child: Care, Health and Development; 43(6): 899-905.

Supporting Looked After Children and Care Leavers In Decreasing Drugs, and alcohol (SOLID). Alderson H, McGovern R, Brown R, Howel D, Becker F, Carr L, Copello A, Fouweather T, Kaner E, McArdle P, McColl E, Shucksmith J, Steele A, Vale L, Lingam R. 2017,  Pilot Feasability Study, 3:25.