System performance

Childhood immunisation

The level of immunisation coverage reflects the capacity of the health-care system to provide vaccinations to children.

More than 9 in 10 (93%) 2-year-old children in Australia were fully immunised in 2011.

Children who are not fully immunised are at risk of contracting vaccine-preventable diseases, such as diphtheria, tetanus, measles and polio, and the short- and long-term health consequences associated with these. Immunisation also plays a role in protecting individuals who are not immunised, through the concept of ‘herd immunity’. Immunisation coverage needs to exceed 90% in order to achieve and maintain the level of herd immunity needed to interrupt the spread of vaccine-preventable diseases.

How many children are immunised? 

According to the Australian Childhood Immunisation Register, 92% of 1 year olds and 93% of 2 year olds were fully immunised in 2011. There was no difference in coverage between boys and girls, and little difference between Indigenous and non-Indigenous children.

What about older children? 

At 89%, the coverage of 5 year olds was well below the near-100% target for children at school-entry age in 2011. However, it has increased from 79% in 2008.

How does Australia compare internationally?

Internationally comparable data is available only for 1 year olds. In 2010, Australia’s coverage at 92.5% was slightly behind the OECD average of 94.6%. The leading countries were Hungary (99%) and the Czech Republic and Slovak Republic (98.8%). Immunisation coverage was lowest in Canada (83.3%) and Austria (81.3%).

Trends in immunisation coverage, 1999–2011

 

Note: Includes children who have received the scheduled doses of vaccines for DTP, MMR, poliomyelitis; hepatitis B; and Hib, appropriate for their age.

Source: Australian Childhood Immunisation Register, unpublished data.

Survival for leukemia

The number of children who survive leukaemia continues to improve through advances in detection, treatment, research and technology, and the development of specialised treatment centres and protocols.

Five-year relative survival for children with leukaemia increased from 67% to 87% between 1983–1989 and 2004–2010.

Successful treatment of leukaemia depends on the effectiveness of the health-care system in a number of areas, including early detection, access to appropriate treatment, collaboration between health-care professionals, and ongoing medical research and clinical trials. Despite improvements in survival, leukaemia remained one of the largest contributors to childhood cancer deaths in 2008–2010.

How many children survive leukaemia? 

According to the AIHW National Cancer Statistics Clearing House, 5-year relative survival for all leukaemia during the period 2004-2010 was 87% for children aged 0–14. Relative survival was higher for children aged 0–4  (90%) than for those aged 10–14 (79%).

Does survival vary across leukaemia types? 

The 5-year relative survival for acute lymphoblastic leukaemia was 90%, which was higher than for acute myeloid leukaemia (75%).

How has survival changed over time? 

Five-year relative survival for all leukaemia increased from 67% to 87% between 1983–1989 and 2004–2010. Relative survival for acute lymphoblastic leukaemia increased from 73% to 90% in that period. While relative survival for acute myeloid leukaemia more than doubled in the same period (from 37% to 75%), the results need to be treated with caution due to the large confidence intervals.

Trends in 5-year relative survival for leukaemia among children aged 0–14

 

Note: Refer to A picture of Australia's children 2012, Table B.2 for ICD-10 codes.

Source: AIHW Australian Cancer Database 2007.

Child protection re-substantiations

Rates of child protection substantiation and children on care and protection orders are key indicators of reported levels of child abuse and neglect. The underlying factors that lead to some families repeatedly coming into contact with child protection systems include low income, substance abuse, mental health issues, sole parenting and a lack of access to support.

How many cases are re-substantiated within 3 months? 

Rates of children and young people aged 0–17 who are the subject of a child protection re-substantiation vary across jurisdictions. According to the National Child Protection Data Collection, in 2009–10, re-substantiations within 3 months of the original substantiation ranged from 1.1% to 11.9%.

How many cases are re-substantiated within 12 months? 

Across jurisdictions, re-substantiations within 12 months of the original substantiation ranged from 3.1% to 25.1%.

What factors affect re-substantiation data? 

Cases of re-substantiation do not necessarily imply that child protection agencies have failed to protect children from repeated abuse. The re-substantiation rate is affected by investigations into notifications of child abuse or neglect, and by factors beyond the control of the child protection system, such as changes in family situations, which may place children in danger of being re-abused or neglected.