Open Access Research article

A case study of physical and social barriers to hygiene and child growth in remote Australian Aboriginal communities

Elizabeth McDonald1*, Ross Bailie1, Jocelyn Grace2 and David Brewster3

Author Affiliations

1 Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Australia

2 National Drug Research Institute, Curtin University of Technology, Perth, Western Australia, Australia

3 School of Medicine, James Cook University, Cairns, Australia

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BMC Public Health 2009, 9:346  doi:10.1186/1471-2458-9-346

Published: 18 September 2009



Despite Australia's wealth, poor growth is common among Aboriginal children living in remote communities. An important underlying factor for poor growth is the unhygienic state of the living environment in these communities. This study explores the physical and social barriers to achieving safe levels of hygiene for these children.


A mixed qualitative and quantitative approach included a community level cross-sectional housing infrastructure survey, focus groups, case studies and key informant interviews in one community.


We found that a combination of crowding, non-functioning essential housing infrastructure and poor standards of personal and domestic hygiene underlie the high burden of infection experienced by children in this remote community.


There is a need to address policy and the management of infrastructure, as well as key parenting and childcare practices that allow the high burden of infection among children to persist. The common characteristics of many remote Aboriginal communities in Australia suggest that these findings may be more widely applicable.