There is documented correlation between parental substance abuse, child\nmaltreatment, and poor outcomes. In two health districts in Sydney, Australia (Site A and B),\nspecialised clinics were established to provide comprehensive assessments for infants of\nsubstance abusing mothers (ISAM). We aimed to determine whether there was a difference\nin outcomes between infants who attended clinic versus those who did not; and to identify\ndifferences in the pathways to care between sites. We analysed child protection reports and\navailable health markers of all ISAM referrals in 2011. We held stakeholder meetings with\nservices involved with ISAM in both sites; to describe service components; strengths and\nweaknesses of pathways. Fifty-five per cent (11/20) attended clinic in Site A; 80% (25/31)\nin Site B. Three-quarters of ISAM had at least one referral to child welfare; child\nprotection service involvement was more common in those who attended. Immunisation\nstatus was lower than the national Australian average; approximately half were seen by\ncommunity nursing services. Gaps in services, lack of database, and differences in\npathways between sites were identified. Attending clinics correlates with child protection\nservice involvement and may afford health protection. Transparent communication, service\nintegration, and shared learning can improve outcomes for this vulnerable group.
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