Primary Healthcare in Aboriginal and Torres Strait Islanders

This article discusses the significance of primary healthcare in Aboriginal and Torres Strait Islanders, focusing on the initiatives designed to meet their specific needs. It explores the challenges faced and provides recommendations for improving healthcare outcomes.

Running head: Primary healthcare in Aboriginal and Torres Strait Islanders
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Primary Healthcare in Aboriginal and Torres Strait Islanders
Student’s Name
University

Primary healthcare in Aboriginal and Torres Strait Islanders
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Primary Healthcare in Aboriginal and Torres Strait Islanders
Introduction
Primary healthcare is regarded as the first contact that a patient has within the health
system. This means that it relates to the patients who are not admitted to the facility but rather
it’s the care received either outside the facility or by the general practitioner. This type of care is
not limited to the general practitioner but can also be provided by other healthcare professionals
like nurses, midwives, dentists and even Aboriginal health workers who are specifically fitted to
provide such services to the group.
The reason why it is mostly termed as primary healthcare is that it is provided either in
the home or in community-based settings and is not provided in hospitals. This implies that for
primary healthcare to be effective the nurse has to work in partnership with the patient, their
families or the community to develop clinical outcomes that improve the condition of the
affected persons. This system has been highly attributed to increased access to healthcare by
keeping people well and reducing the rate of hospital admissions by supporting the community to
manage the healthcare issues that they face at home. This program does not only relate to simple
conditions but rather includes the management of complex conditions chronic conditions like
diabetes, mental illness, asthma, and even cardiovascular diseases. Thus the services to be
included in primary healthcare include screening, prevention, early intervention, treatment and
management of the conditions.
Findings and discussion
According to the Australian Government Department of Health (2018), primary
healthcare works well if it is adapted and tailored to meet the specific needs of the local

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community that it targets. This means that they can be specifically created to address the gaps in
primary healthcare that exist and affect the people. For example, Aboriginal people have been
described as having many healthcare challenges as compared to the rest of the population. These
people have been described as having a higher incidence of eye and ear disease since they live in
conditions that make it difficult for them to access better healthcare services (DiGiacomo,
Davidson, Abbott, Delaney, Dharmendra, Mcgrath, Delaney & Vincent, 2013). This calls for the
design of primary healthcare outcomes that specifically target them and are done in rural areas to
meet their needs. One health promotion program tailored to meet the needs of the eye surgical
support program that is designed to expedite access to surgery for eye health conditions of the
Aboriginal and Torres Strait Islander patients in rural and remote areas who have been on the
high waiting list. Research has shown that the indigenous people experience six times more
blindness and three times vision impairment as compared to the rest of the non-indigenous
population. On the other hand, a similar education program is the care for kid’s ear resources
which provides a wide range of resources to increase the awareness of Aboriginal and Torres
Strait Islander on the risk factors that relate to ear disease and how they can seek treatment to
prevent ear loss (Care for Kids' Ears, 2018).
RANZCO (2019) has a mission of implementing eye healthcare in Australia with the
commitment of the best education and dedication of an eye health for Aboriginal and Torres
Strait Islanders by planning for population-specific modes of delivery, support of outreach
services and at the same time ensuring that the programs are flexible to the local needs of the
people. On the other hand, NACCHO (2016) every year, almost 30,000 Aboriginals and Torres
Strait Islanders require spectacles to correct refractive errors while at the same time 35% of the

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adults have never been examined before and 20% of this population require eyeglasses. This
reflects the lack of uniform access to eye services for the indigenous children which leads to dire
effects in adulthood (Razavi, Burrow, & Trzesinski, 2018). This can be attributed to the fact that
healthcare in Australia is driven by insurance which requires paying to pay. This has made most
of these population members to suffer these challenges and be unable to progress well.
One way that the Australian government has made strides in achieving improved eye and
hearing objective is through the Vision 2020 The Right to Sight Initiative. This project seeks to
ensure that eye health becomes one of the priorities for the Australian government through health
support, promotion and research to achieve the intended objectives (Harfield, Davy, MaAthur,
Munn, Brown & Brown, 2018). Despite the challenges that the Aboriginal and Torres Strait
Islanders present, the government is still committed to achieving this objective by all means.
This calls for the application of specific primary healthcare initiatives that target this population.
In several occasions, NACCHO has been effective in delivering the required patient-centred care
since it allows a NACCHO driven health program that ensures the people receive the required
services (Burnett, Morse, Naduvillah, Boudville Taylor & Bilie, 2016). For example in
Queensland, the Wuchopperen Health Service is an example of an Aboriginal Community
controlled health service and through the support of the Queensland government, the people are
able to receive a free pair of spectacles after every two years to solve the problem of eyesight.
Gramenz (2018) the kid’s ears project seeks to ensure that there is adequate knowledge in
the population on how to reduce the effects of otitis media. The resources are produced for early
childhood and community groups, teachers, health professional, and parents. The resources are
uniquely designed to meet the primary healthcare needs of the indigenous people to the gaps in

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ear health (Miller, 2017). The primary healthcare initiatives for ear education include health
promotion awareness, focus on reduced exposure to passive smoking, increased knowledge of
identifying ear challenge problems and increasing the health-seeking behaviour.
In a report, by The Cultural & Indigenous Research Centre Australia, (2013) it was
reported that the cultural appropriateness of these materials makes it easy for the Aboriginal and
Torres Strait Islanders to understand the primary healthcare initiative. This means that through
the delivery of easy to understand messages, different people involved in the primary healthcare
process of caring for children’s ear are able to relate well with the indicators that such messages
pint to. For example, in rural remote areas, value the cultural imagery in the images used in
messages and thus when the images and messages reflect the cultural knowledge that they have,
then it becomes easy to understand such messages thus achieving the intended outcomes
(Farnbach, Eades, Fernando, Gwynn, Glozier & Hecket, 2017).
Further, it has been argued that the resources produced were easy for professionals to use
since they provided a wide range of resources allowing flexibility to use. This means that the
resources offer better primary healthcare outcomes since they enable care providers, parents and
teachers to understand the ear problems that the children face based on the resource kits (Burnett,
et al., 2016). This means that even the illiterate parents can gain greatly from these resource
since they have visual elements that they can relate to the conditions that their children face thus
seeking early intervention.
In another study, the Australian Institute of Health Welfare (2014) reported that 71.5% of
parents were able to utilize the promotional materials and speak to the care providers about their
health. Another 63.5% reported that they had taken their children for medication when they

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realized the signs that they had been advised to watch out by the primary healthcare practitioner.
This means that the primary healthcare initiatives that have been developed are bearing the
required benefits by increasing the response to medication. One of the challenges that these
people have been facing in accessing the primary healthcare services for the ear and eye is the
issue of transport. This is because, in most rural areas that the Aboriginal and Torres Strait
Islanders live, the services are available at specific locations which means that they have to travel
long distances to access such services. Jaggernath, Overland, Ramson, Kovai, & Chan (2014)
argue that poverty is one of the determinants of health that make it difficult for people to access
healthcare. Being constrained by the burden of the diseases, it becomes difficult for these people
to travel in search of the services that they seek.
Another challenge that has been noted in achieving the collective eye and ear needs of
these people through primary healthcare is the poor roadmap, coordination and case management
of the initiatives directed towards the healthcare challenges. Napper, Fricke, Anjou, & Jackson
(2015) argue that despite the fact that the Australian government has pumped in a lot of
resources to ensure that primary healthcare objectives are achieved there is lack of adequate
support to ensure that the services reach the furthest rural areas. The most affected people live in
distant rural areas and sometimes lack the knowledge of the existence of such services. This
means that they need to be accessed by the services. Since primary healthcare is only successful
if designed according to the needs of the specific population, it means that the services have to be
tailored to meet the population-specific needs of the Aboriginal and Torres Strait Islanders
people.
Recommendation

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One recommendation that needs to be addressed is the lack of a comprehensive national
profile of the prevalence and impact of ear disease and eye problem. This calls for the need for
the government to develop a clear database that can identify the children who are affected and
how the primary healthcare plans have been designed for them (Jackson-Barret & Lee-
Hammond). In this case, healthcare budgets have to clearly reflect the primary healthcare needs
of the population. A database will make it easy for the government to plan and track the
achievements that projects like vision 2020 are yielding.
Secondly, Burnett, et al. (2016) suggests that there is a need to localize the services
through increased outreach so that they can reach the most remote people. Since primary health
care needs to be focused on the needs of the population, then it is important to recognize the
mobility challenges that the Aboriginal and Torres Strait Islanders face and design outreach
services that can take care of their needs. For example, localization of services can mean having
regular remote visits where the healthcare professionals can reach out to the affected people and
address their primary healthcare needs.
Another recommendation is the need to develop a comprehensive primary care approach
for indigenous children needs through family, maternal and child health processes that are
embedded in the system. This entails working with other healthcare providers to provide better
health services to the affected population and at the same time ensuring that the receive relevant
primary healthcare information on how to deal with the health challenges (Farnbach, et al.,
2017). To address the challenges better primary healthcare approaches need to be started from
newborn babies where their mothers are taught how to take care of their needs. As such they will
be responsive to the first early signs of the condition.

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Conclusion
The Australian government has invested a lot in facilitating the improved earing and sight
conditions of the Aboriginal children. This is through the investment in different primary health
care options that include capacity building and also direct treatment avenues that have increased
the wellbeing of these children. However, there is the need for proper consideration of increasing
outreach so that more indigenous children can access the services and at the same time ensuring
that promotional and educational materials are remotely available to parents and educators who
are in contact with the children for most of the time. This will reduce the burden of disease and
allow the government to achieve success in projects have been designed to reduce the burden of
disease like the vision 2020- The Right to Sight Initiative

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References
Australian Government DepartmentofHealth. (2018, June). Fact Sheet: Primary Health Care.
Retrieved from Australian Government Department of Health:
https://www.health.gov.au/internet/main/publishing.nsf/Content/Fact-Sheet-Primary-
Health-Care
Australian Instute of Health Welfare. (2014). Closing the gap- Clearing the house: Ear disease
in Aboriginal and Torres Strait Islander children. Australian Government.
Burnett, A., Morse, A., Naduvilath, T., Boudville, A., Taylor, H., & Bailie, R. (2016). Delivery
of Eye and Vision Services in Aboriginal and Torres Strait Islander Primary Healthcare
Centers. Frontiers in public health, 4(276).
Care for Kids' Ears. (2018). Strong ears, strong start. Retrieved from Care for Kids' Ears:
http://www.careforkidsears.health.gov.au/internet/cfke/publishing.nsf/Content/Home
DiGiacomo, M., Davidson, P. M., Abbott, P., Delaney, P., Dharmendra, T., McGrath, S. J., . . .
Vincent, F. (2013). Childhood disability in Aboriginal and Torres Strait Islander peoples:
a literature review. International Journal of Equity Health, 12(7).
Farnbach, S., Eades, A., Fernando, J., Gwynn, J., Glozier, N., & Hackett, M. (2017). The quality
of Australian Indigenous primary health care research focusing on social and emotional
wellbeing: a systematic review. Public Health Research Perspective, 27(4).
Gramenz, E. (2018, August). 'Glue ear' project to fight hearing loss and improve outcomes for
Aboriginal children. ABC News.
Harfield, S. G., Davy, C., McArthur, A., Munn, Z., Brown, A., & Brown, N. (2018).
Characteristics of Indigenous primary health care service delivery models: a systematic

Primary healthcare in Aboriginal and Torres Strait Islanders
10
scoping review. Global Health, 14(12).
Jackson-Barret, E. M., & Lee-Hammond, L. (n.d.). Strengthening Identities and Involvement of
Aboriginal Children through Learning On Country. Australian Journal of Teacher
Education, 43(6).
Jaggernath, J., Overland, L., Ramson, P., Kovai, V., & Chan, V. F. (2014). Poverty and Eye
Health. Health Promotion Journal Australia(6), 1849-1860.
Miller, S. (2017). Examine Australian Government Indigenous Ear and Hearing Health
Initiatives. IEHE.
National Aboriginal Community Controlled Health Organization-NACCHO. (2016). National
ACCHO Sector Report on Eye Health Service Delivery for Aboriginal and Torres Strait
Islander people. NACCHO. Retrieved from
https://www.naccho.org.au/wp-content/uploads/2016_FINAL_NACCHO_Eye_Health_R
eport.pdf
Napper, G., Fricke, T., Anjou, M. D., & Jackson, J. (2015). Breaking down barriers to eye care
for Indigenous people: a new scheme for delivery of eye care in Victoria. Clinical and
Experimental Optometry, 98(5).
The Royal Australian and Newzealand College of Ophthalmologists-RANZCO. (2019).
RANZCO Pre-Budget Submission 2019-2020. The Royal Australian and Newzealand
College of Ophthalmologists .
Razavi, H., Burrow, S., & Trzesinski, A. (2018). Review of eye health among Aboriginal and
Torres Strait Islander people. Australian Indigenous Health Bulletin, 18(4).

Primary healthcare in Aboriginal and Torres Strait Islanders
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TheCultural&IndigenousResearchCentreAustralia. (2013). Australian Government Department
and Ageing: Evaluation of the National Indigenous Ear Health Campaign-Final Report.
Sydney: The Cultural & Indigenous Research Centre Australia. Retrieved from
http://www.circaresearch.com.au/wp-content/uploads/Consultation-and-testing-underpin-
success-of-Indigenous-ear-health-campaign.pdf