Target 2
By 2031, increase the proportion of Aboriginal and Torres Strait Islander babies with a healthy birthweight to 91%.
Nationally in 2021, 89.6% of Aboriginal and Torres Strait Islander babies born were of a healthy birthweight (figure CtG2.1).
This is an increase from 88.8% in 2017 (the baseline year). The proportion increased each year between 2017 and 2020, decreased in 2020, but increased again in 2021 (figure CtG2.1).
Nationally, based on progress from the baseline, the target shows good improvement and is on track to be met. This assessment is provided with a low level of confidence. Please refer to the How to interpret the data page for more information.
The state and territory assessments below reflect progress from the baseline (improvement, worsening or no change). There are no state and territory targets. The Australia assessment reflects progress from the baseline towards the national target.
| NSW | Vic | Qld | WA | SA | Tas | ACT | NT | Aust | |
|---|---|---|---|---|---|---|---|---|---|
| Assessment of progress 2017 to 2021 |  |  | | | | | |  |  |
| Confidence level | Low | High | High | High | Low | Low | High | Low | Low |
improvement no change worsening not applicable as required data not available. good improvement and target on track to be met (Aust only). 
improvement but target not on track to be met (Aust only).
Note: These assessments of progress are provided with a 'High' or 'Low' level of confidence. An assessment reported with a High level of confidence is considered to be more reliable than one reported with a Low level of confidence. Please see the 'How to interpret the data' page for more information.
Historical and ongoing target context
Aboriginal and Torres Strait Islander babies are typically born with healthy birthweights, yet the prevalence of healthy birthweight remains relatively low compared with non-Indigenous babies. Healthy birthweights reduce the risk of child mortality and contribute to better outcomes later in life including fewer chronic conditions (AIHW 2011).
The health and wellbeing of a baby are closely linked to that of their mother and surrounding environment (Comino et al. 2012; Healing Foundation 2020). Maintaining cultural practices and ties to Country, along with family support plays a crucial role in promoting healthy birthweights and children’s wellbeing (Dudgeon et al. 2014; Kildea et al. 2017; Roy 2014).
Colonisation has had deep intergenerational effects for Aboriginal and Torres Strait Islander families and communities, affecting cultural and social determinants of health and leaving babies vulnerable to low birthweights (Batchelor et al. 2021; Kildea et al. 2019). In particular, the displacement of people from traditional lands and disruption of traditional networks, birthing practices, knowledges and diets, has obstructed practices central to promoting healthy birthweights (Kildea et al. 2019).
Empowering Aboriginal and Torres Strait Islander families through a holistic approach to health that centres culture and community can support improved birthweights. The factors that affect healthy birthweights include:
- Connection to culture, access to language and a strong sense of cultural identity, which involves access to traditional lands, and participation in community practices. These serve as protective factors against low birthweight, promoting maternal social and emotional wellbeing (Healing Foundation 2018). Birthing on Country, a culturally significant practice, offers holistic care rooted in traditional knowledge and provides healing from intergenerational trauma resulting from colonisation (Kildea et al. 2019).
- Access to early and regular culturally appropriate antenatal care, particularly within community-controlled settings. This is critical for addressing pregnancy-related health issues early on, overcoming language and other cultural barriers, as well as experiences of racism and discrimination in mainstream health services (Batchelor et al. 2021; Doyle et al. 2022; Karger et al. 2022).
- Racism is a particular issue affecting appropriate antenatal care, as many Aboriginal and Torres Strait Islander mothers hold fears their baby will be removed by child protection (Hine et al. 2023). This fear is well grounded given the high number of reports to child protection involving unborn babies of Aboriginal or Torres Strait Islander mothers in mainstream services (Hine et al. 2023). These reports often stem from racism and systemic biases within the health system and frequently lead to the removal of babies (Yoorrook Justice Commission 2023). Aboriginal Community Controlled Health Organisations (ACCHOs) play a vital role in abating these fears and delivering culturally safe antenatal care (Nolan-Isles et al. 2021; Reibel et al. 2015; SNAICC 2023).
- Improving the health and nutrition of mothers by using best practices from community-controlled settings (SNAICC 2023). Behaviours are often influenced by broader social determinants like inadequate housing, high unemployment, and low education (Batchelor et al. 2021; Karger et al. 2022).
References
Australian Institute of Health and Welfare (AIHW). ‘Headline Indicators for Children’s Health, Development and Wellbeing, 2011, Summary.’ Australian Institute of Health and Welfare, July 29, 2011, https://www.aihw.gov.au/reports/children-youth/headline-indicators-for-childrens-health-2011/summary.
Batchelor, M, Brown, SJ, Glover, K and Gartland, D 2021, ‘A Systematic Review of Child Health and Developmental Outcomes Associated with Low Birthweight and/or Small for Gestational Age in Indigenous Children from Australia, Canada and New Zealand’, International Journal of Environmental Research and Public Health , vol. 18, no. 23, , pp. 1-15.
Comino, E, Knight, J, Webster, V, Jackson Pulver, L, Jalaludin, B, Harris, E, Craig, P, McDermott, D, Henry, R, Harris, M, and The Gudaga Research Team 2012, ‘Risk and Protective Factors for Pregnancy Outcomes for Urban Aboriginal and Non-Aboriginal Mothers and Infants: The Gudaga Cohort’, Maternal and Child Health Journal , vol. 16, no. 3, pp. 569–578.
Doyle, M-A, Schurer, S and Silburn, S 2022, ‘Unintended consequences of welfare reform: Evidence from birthweight of Aboriginal children in Australia’, Journal of Health Economics , vol. 84, p. 4.
Dudgeon, P, Hart, A and Kelly, K, eds. 2014, Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice , 2nd edn, Department of the Prime Minister and Cabinet.
Healing Foundation 2018, Working with Aboriginal and Torres Strait Islander young people and their families .
—— 2020, Improving the social and emotional wellbeing of Aboriginal and Torres Strait Islander children .
Hine, R, Krakouer, J, Elston, J, Fredericks, B, Hunter, S-A, Taylor, K, Stephens, T, Couzens, V, Manahan, E, DeSouza, R, Boyle, J, Callander, E, Cunningham, H, Miller, R, Willey, S, Wilton, K and Skouteris, H 2023, ‘Identifying and dismantling racism in Australian perinatal settings: Reframing the narrative from a risk lens to intentionally prioritise connectedness and strengths in providing care to First Nations families’, Women and Birth , vol. 36, no. 1, pp. 136–140.
Karger, S, Bull, C, Enticott, J and Callander, EJ 2022, ‘Options for improving low birthweight and prematurity birth outcomes of indigenous and culturally and linguistically diverse infants: a systematic review of the literature using the social-ecological model’, BMC Pregnancy and Childbirth , vol. 22, no. 1, p. 3.
Kildea, S, Hickey, S, Barclay, L, Kruske, S, Nelson, C, Sherwood, J, Allen, J, Gao, Y, Blackman, R and Roe, YL 2019, ‘Implementing Birthing on Country services for Aboriginal and Torres Strait Islander families: RISE Framework’, Women and Birth , vol. 32, no. 5, pp. 466–475.
Kildea, SV, Gao, Y, Rolfe, M, Boyle, J, Tracy, S and Barclay, LM 2017, ‘Risk factors for preterm, low birthweight and small for gestational age births among Aboriginal women from remote communities in Northern Australia’, Women and Birth , vol. 30, no. 5, pp. 398–405.
Nolan-Isles, D, Macniven, R, Hunter, K, Gwynn, J, Lincoln, M, Moir, R, Dimitropoulos, Y, Taylor, D, Agius, T, Finlayson, H, Martin, R, Ward, K, Tobin, S and Gwynne, K 2021, ‘Enablers and Barriers to Accessing Healthcare Services for Aboriginal People in New South Wales, Australia’, International Journal of Environmental Research and Public Health , vol. 18, no. 6, p. 3014.
Reibel, T, Morrison, L, Griffin, D, Chapman, L and Woods, H 2015, ‘Young Aboriginal women’s voices on pregnancy care: Factors encouraging antenatal engagement’, Women and Birth , vol. 28, no. 1, pp. 47–53.
SNAICC, Family Matters Leadership Group, Monash University, and University of Technology Sydney 2023, Family Matters Report 2023 , pp. 49–51.
Yoorrook Justice Commission 2023, Report into Victoria’s Child Protection and Criminal Justice Systems , p. 134.
Disaggregations
Data tables appear under figures
By sex of the baby
Nationally in 2021, 90.1% of Aboriginal and Torres Strait Islander boys born and 89.0% of girls born were of a healthy birthweight (figure CtG2.2).
By remoteness area
Nationally in 2021, the proportion of Aboriginal and Torres Strait Islander babies born of a healthy birthweight was similar across major cities (90.9%) and inner regional and outer regional areas (90.1% and 89.5% respectively). The proportions were lower in more remote areas (86.1% in remote areas and 85.6% in very remote areas) (figure CtG2.3).
By Index of Relative Socio-economic Disadvantage (IRSD) quintile
Nationally in 2021, the proportion of Aboriginal and Torres Strait Islander babies born of a healthy birthweight was highest for babies from the least disadvantaged areas of Australia (92.1%). The proportion declined for babies from more disadvantaged areas, to 88.2% in the most disadvantaged socio‑economic areas of Australia (figure CtG2.4).
Target data specifications
Outcome: | Aboriginal and Torres Strait Islander children are born healthy and strong. |
|---|---|
Target: | By 2031, increase the proportion of Aboriginal and Torres Strait Islander babies with a healthy birthweight to 91%. |
Indicator: | The proportion of Aboriginal and Torres Strait Islander babies with a healthy birthweight. |
Measure: | The measure is defined as: Numerator – number of live born singleton Aboriginal and Torres Strait Islander babies who weighed between 2,500 and 4,499 grams at birth Denominator – total number of live born singleton Aboriginal and Torres Strait Islander babies and is presented as a percentage. |
Target established: | National Agreement on Closing the Gap July 2020 |
Latest dashboard update: | 6 March 2024 |
Indicator type: | Target |
Interpretation of change: | A high or increasing proportion is desirable. |
Data source(s): | Name: AIHW National Perinatal Data Collection (NPDC) Frequency: Annual (2017 data for state and territory revised (previously np) and a small number of other cells revised throughout in the March 2023 dashboard update) Documentation (links): https://www.aihw.gov.au/about-our-data/our-data-collections/national-perinatal-data-collection |
Data provider: | Provider name: Australian Institute of Health and Welfare (AIHW) Provider area: Perinatal |
Baseline year: | 2017 |
Latest reporting period | 2021 |
Target year: | 2031 |
Disaggregations: | State and territory and Australia, by birthweight range, by Indigenous status of the baby. State and territory and Australia, by birthweight range, by Indigenous status of the baby, by sex of the baby. State and territory and Australia, by birthweight range, by Indigenous status of the baby, by remoteness area. State and territory and Australia, by birthweight range, by Indigenous status of the baby, by Index of Relative Socio‑economic Disadvantage (IRSD) quintile. |
Computation: | Numerator divided by Denominator multiplied by 100. Counting rules Data relate to live births. Births both less than 20 weeks gestation and less than 400 grams birthweight are not included in the NPCD. Healthy birthweight is defined as babies who weighed between 2,500 and 4,499 grams at birth; low birthweight (400 grams to less than 2,500 grams). The data is by geographic area of usual residence of the mother. Indigenous status is of the baby. Includes (denominator):
Excludes (both numerator and denominator):
Disaggregations: Sex relates to biological primary sexual characteristics. Births classified as ‘indeterminate/not stated’ are excluded from the analysis by sex. Remoteness area is classified according to the ABS 2016 Australian Statistical Geography Standard (ASGS) using SA2 as the building block. Births to mothers whose usual residence is categorised as ‘migratory’ are excluded from the analysis by remoteness. Data exclude babies where the information on the usual residence of the mother was not sufficient to identify her geographic area and assign a remoteness area. Socio‑economic status of the locality is classified according to the Socio‑economic Indexes for Areas (SEIFA): Index of Relative Socio‑economic Disadvantage (IRSD), 2016 using SA2 as the building block. Data are reported by IRSD quintile that are determined at the Australian level. Data excludes babies where the information on the usual residence of the mother was not sufficient to identify her geographic area and assign a socio‑economic status of the locality. Supporting calculations Variability bands (provided for proportions). See the How to interpret data page for further information. |
Data quality considerations: | In the NPDC, Indigenous status is a measure of whether a person identifies as being of Aboriginal and/or Torres Strait Islander origin. All jurisdictions have a data item to record Indigenous status of the mother and Indigenous status of the baby on their perinatal form, although there are some differences among the jurisdictions. Birthweight data on Aboriginal and Torres Strait Islander babies born to mothers residing in the Australian Capital Territory should be viewed with caution as they are based on small numbers of births. Please refer to the How to interpret the data page for more information. The AIHW does not provide data for proportions based on denominators of less than 100 for reliability reasons (mostly births with Indigenous status not stated). Proportions based on numerators of less than five are also not provided (np), with the exception of ‘not stated’ categories. Consequential suppression (np) has been applied to prevent back‑calculation of small numbers. However, relevant data are included in the calculation for Australian totals. |
Future reporting: | Future reporting will seek to include the following additional disaggregations:
|
Supporting indicators
Driver
- Proportion of mothers who smoke during pregnancy by age groups
Any time, or after 20 weeks
- Proportion of mothers who consume alcohol during pregnancy by age groups
- Proportion of pregnant mothers with a pre-existing health condition
Gestational diabetes, obesity, hypertension, other
- Use of antenatal care by pregnant women
- proportion with five or more antenatal visits
- proportion with at least one antenatal care visit in the first trimester
- Proportion of pre-term births
Contextual information
- Progress towards parity
Material for download
- Children are born healthy and strong data tables (XLSX - 143 Kb)
- Children are born healthy and strong dataset (CSV - 421 Kb)
To assist with interpretation of the data provided (Excel data tables and CSV dataset) please refer to the target data specification (above) and the indicator data specifications (provided in each supporting indicator page – linked above).