Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care

Just Accepted

This article has been peer reviewed and accepted for publication. It is in production and has not been edited, so may differ from the final published form.

Transition to adult care for Aboriginal children with rheumatic fever: a review informed by a focussed ethnography in northern Australia

Alice Mitchell , Suzanne Belton , Vanessa Johnston , Anna Ralph


Aboriginal children in northern Australia have high rates of rheumatic fever and rheumatic heart disease which are chronic conditions due to the need for long term treatment and monitoring. This article critically reviews the literature on transition to adult care for children with chronic conditions and considers applicability to the care of these children. The review was merged with findings from a focussed ethnography conducted in four remote Aboriginal communities with young people who have these conditions. Transition care aims to support adolescents on a health care trajectory to facilitate best long-term health and personal outcomes. Characteristics of the two medical conditions, the children, and their local health services in northern Australia were generalized and merged with principles from the transition care literature including policies governing transition clinics in urban locations. In this setting, the challenge is to transition Aboriginal children safely through to adulthood without rheumatic heart damage rather than to a separate health service on reaching adulthood. Recommended tailoring of transition care involves engaging and valuing local navigators who can address language and cultural barriers to provide a sustainable alternative to transition coordinators in mainstream programs. This has potential to improve care without further burdening overstretched clinical resources.

PY17069  Accepted 28 September 2017

© La Trobe University 2017