NACCHO Programs ” What Works ” Aboriginal Health : #FASD , Ear and Hearing , #Safeeyes and #Qumax

fasd

 ” The package of FASD Prevention and Health Promotion resources also include data system resources to facilitate routine screening and monitoring for alcohol and tobacco use in pregnancy, and screening of non-pregnant women of childbearing age, at risk of having a prenatal alcohol exposed pregnancy.”

NACCHO Report 1 below

 “The Safe Eyes trial program relies on the effective facilitation of engagement, ownership and leadership within each community to address hygiene and environmental health factors that lead to the spread of trachoma and other communicable disease.

The Safe Eyes program has been developed and implemented by each community with the success of each program evaluated and owned by those communities.”

NACCHO Report 2 Below

 ” The Ear and Hearing Health Skill Set Training was conducted over a two-week period and provided a pathway for Aboriginal and Torres Strait Islander health workers to specialise in the provision of ear and hearing health.

NACCHO coordinated 100 Aboriginal Health Worker Ear and Hearing Training which were delivered in Brisbane, Darwin, Melbourne, Cairns, Perth, Dubbo, Sydney, Kalgoorlie, Albany and Adelaide.”

NACCHO Report 3 Below

 ” The QUMAX Program aims to improve health outcomes of Aboriginal and Torres Strait Islander people who attend participating Aboriginal Community Controlled Health Organisations (ACCHOs) in major cities, inner and outer regional areas.

QUMAX achieves this through the allocation of funding to participating ACCHOs to reduce barriers experienced by their clients to Quality Use of Medicines.”

NACCHO Report 4 below

Articles are from Page 5,18,19,20 NACCHO Aboriginal Health Newspaper out Wednesday 16 November , 24 Page lift out Koori Mail : or download

naccho-newspaper-nov-2016 PDF file size 9 MB

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NACCHO Report 1 of 4 :Prevent and reduce the impacts of Fetal Alcohol Spectrum Disorders (FASD) 

NACCHO partnered with the Menzies School of Health Research and the Telethon Kids Institute (TKI) to develop and implement health promotion resources and interventions to prevent and reduce the impacts of Fetal Alcohol Spectrum Disorders (FASD) on Aboriginal and Torres Strait Islander families and young children.

FASD is an umbrella term used to describe the range of effects that can occur in individuals whose mother consumed alcohol during pregnancy. These effects may include physical, mental, behavioral, developmental, and or learning disabilities with possible lifelong implications.

Fetal Alcohol Spectrum Disorder Prevention and Health Promotion Resources (FPHPR) were developed for the 85 New Directions: Mothers and Babies Services (NDMBS) across Australia. These resources primarily focused on prevention of FASD, but also provide information about sexual and reproductive health, smoking and substance abuse.

The FASD project was announced by Senator the Hon Fiona Nash in June 2014 and forms part of the National FASD Action Plan to address the harmful impact of FASD on children and families.

The FPHPR Project seeks to achieve the following broad outcomes by 30 June 2017:

  • Reduced alcohol consumption during pregnancy.
  • Reduced tobacco smoking and substance misuse during pregnancy.
  • Reduced unplanned pregnancies.

The Project Partnership and Research team developed and implemented a flexible, modular package of health promotion resources and interventions based on the key components of the approach developed by the Ord Valley Aboriginal Health Services.

This includes a set of discrete FASD education and awareness modules targeting key New Directions: Mothers and Babies Services (NDMBS) client groups, including:

Pregnant women using NDMBS antenatal and other services, including  their partners and families.

  • Aboriginal and Torres Strait Islander women of childbearing age.
  • Aboriginal and Torres Strait Islander grandmothers.
  • NDMBS staff (including but not limited to administrative and clinical staff).
  • Aboriginal and Torres Strait Islander men.

The package of FASD Prevention and Health Promotion resources also include data system resources to facilitate routine screening and monitoring for alcohol and tobacco use in pregnancy, and screening of non-pregnant women of childbearing age, at risk of having a prenatal alcohol exposed pregnancy.

Participating NDMBS use this system to evaluate the impact of the FPHPR on target groups of pregnant women using NDMB antenatal and other services, including their partners and families and Aboriginal and Torres Strait Islander men.

The FPHPR Project team facilitated FASD train-the-trainer workshops with participants from NBMBS in each State and Territory.

Approximately 100 NDMBS staff – a diverse combination of clinical service providers and administrative staff, actively participated.

Workshops included information on FASD and its prevention by content experts; orientation to the FPHPR package; interactive training and rehearsal in the use of each component of the FPHPR package developed for each key NDMBS target groups; networking opportunities and strengthening links with other relevant service providers within each jurisdiction to reduce the impact of FASD.

NACCHO 2 Report : Australian Trachoma Alliance – Safe Eyes Program

In 2014 the Australian Trachoma Alliance (ATA) assembled a forum of Aboriginal Community Controlled Health Organisations ACCHOs) to develop an Aboriginal led, community owned action plan to address hygiene and environmental health factors to reduce the incidence of trachoma and other communicable diseases.

In 2015 three trial community sites were selected with guidance through the NACCHO Board of Directors in agreement with the relevant ACCHO:

  1. Yalata (South Australia) – services provided by Tullawon Health Services Inc.
  2. Kiwirrkurra (Western Australia) – services provided by Ngaanyatjarra Health Service
  3. Utju (Areyonga, Northern Territory) – services provided by Central Australian Aboriginal Congress

The criteria for the selection of each site included trachoma prevalence rate, population and available facilities (e.g. school, health service and sporting activities).

The Model: Engagement, Ownership and Leadership

The Safe Eyes trial program relies on the effective facilitation of engagement, ownership and leadership within each community to address hygiene and environmental health factors that lead to the spread of trachoma and other communicable disease.

The Safe Eyes program has been developed and implemented by each community with the success of each program evaluated and owned by those communities.

Moving from ownership of the problem to leading the development of a solution, empowers each community to drive the change process. Furthermore, owning the problem as well as understanding the benefits of addressing it are both necessary elements to embed behaviour change processes within families, organisations and whole communities.

The Safe Eyes program model continues to require a methodical and principled approach to its ongoing implementation.

The following three program stages demonstrate the programs continuing commitment to community engagement, ownership and enabling Aboriginal Leadership.

  1. The three trial community program sites were selected with the direct guidance of the national Aboriginal health leadership through the NACCHO Board of Directors and then through following the direction and agreement of the relevant Aboriginal Community Controlled Health Organisation (ACCHO).
  2. Following the site selection phase, each trial community program has been developed through the engagement, ownership and leadership from the relevant ACCHO and other key community organisations.
  3. All three trial community sites are developing their own Safe Eyes Action Plan to address the elimination of trachoma and other hygiene-related disease. These action plans will also include locally-developed, owned and led program indicators to ensure each community will measure its own success.

The three trial communities are currently at different stages of the planning process and implementation of their action plans. However, establishing and maintaining engagement with each of the trial communities continues to require a flexible and responsive approach.

Initially, formal and informal meetings occurred across each community to discuss the objective of Safe Eyes and to facilitate discussions about issues relating to hygiene and environmental health factors.

This has led to a broader group discussion about the health benefits to the community in addressing factors to stop the spread of germs and possibilities to address the issues identified.

From this starting point, these discussions developed into action plans in each of the three trial communities which provided answers relating to necessary actions, outcome measures, required resources and identifying those needed to be responsible for the actions.

The key elements of this approach undertaken by the Safe Eyes facilitators involve:

  • Demonstrating an ongoing commitment to reinforce community ownership of the action planning.
  • Respecting traditional knowledge and values.
  • Supporting rather than directing the change process.
  • Allowing time for change to occur.

The Safe Eyes program assumes that each community’s attempt to lead and own the elimination of trachoma and other communicable disease through hygiene and environmental health actions is based on the following principles:

  • Long term investment in, and commitment to change in public health behaviours at the individual, family (home) and broader community levels.
  • Community-led and owned solutions are sustainable because they are embedded in the community itself, since these solutions have actively valued and included local context within their development.

Evaluation

An external consultant has been engaged to evaluate the Safe Eyes model of Aboriginal leadership, community engagement and ownership within the three trial community sites.

This evaluation is essential to understanding and articulating how such a model of engagement, ownership and leadership may be applied and replicated within the 140+ trachoma-at-risk communities throughout remote and regional Australia.[1] The evaluation will document and assess the significant contextual factors at each of the three trial sites that have contributed to the successful development of community engagement, ownership and Aboriginal leadership in regard to the Safe Eyes program.[2]

[1] Australian Trachoma Surveillance Report 2013. Kirby Institute. University of New South Wales: p.10.

[2] The external evaluation of the ATA’s model of engagement, ownership and leadership will be completely distinct from the identification and development of measures of success undertaken within each trial community’s action plan.

NACCHO Report 3 of 4 . Ear and Hearing Health Project

Aboriginal and Torres Strait Islander people experience some of the highest levels of ear disease and hearing loss in the world, with rates up to 10 times more than those for non-Indigenous Australians.

Children and adolescents are particularly vulnerable to ear infections. The most common ear disease among Aboriginal Children is otitis media (OM), which is inflammation or infection of the middle ear, typically caused by bacterial and viralpathogens.

Ear infections are responsible for the bulk of hearing problems with lifelong consequences, many of which are preventable and treatable if diagnosed early.

Overview

NACCHOs Ear and Hearing Project, aimed to coordinate the development and delivery of Ear and Hearing Health Skill Set Training for up to 115 Aboriginal and Torres Strait Islander Health Workers.

The Project was funded under the Commonwealth Governments ‘Improving Eye and Ear Health Services for Indigenous Australians for Better Education and Employment Outcomes’ – a COAG measure, which also supported its implementation. The overall measure aimed to improve the early detection and treatment of eye and ear health conditions in Aboriginal and Torres Strait Islander people, leading to improved education and employment outcomes.

NACCHO received funding for five phases of the project by the Aboriginal and Torres Strait Islander Health Workforce Section of the Department of Health.

Selecting Registered Training Organisations

Registered Training Organisations (RTOs) were selected through a rigorous selection panel process with representatives from NACCHO, Department of Health and Hearing Services Australia.

The selection process was strict and services had to meet the following criteria:

  • Be a registered training provided – preference was be given to Aboriginal and Torres Strait Islander Health Registered Training Organisations (RTOs).
  • Have the capacity and scope to deliver the Ear and Hearing Skill Set for Aboriginal and Torres Strait Islander Primary Health Care training.
  • Provide qualified trainer and assessors to deliver Ear and Hearing Skill Set training.
  • Deliver the training within the required timeframe – April – October 2015.
  • Provide confirmation of training dates.
  • Be willing to take on bursary scheme participant/s as part of the delivery of training.
  • Take on eligible students to complete the training (list supplied by NACCHO).
  • Deliver training within the allocated budget.
  • Supply RTO details and provider number.
  • Lodgement of proposal by the closing date.

Outcomes

Four Registered Training Organistations rated as suitable to deliver training on behalf of NACCHO.

The successful organisations were:

  1. Central Australian Remote Health Development Service Ltd, Alice Springs, Northern Territory.
  2. Aboriginal Health Council of Western Australia, Perth, Western Australia.
  3. The Aboriginal Health College, Sydney, New South Wales.
  4. Nunkuwarrin Yunti of South Australia Inc.

Ear and Hearing Health Training

The Ear and Hearing Health Skill Set Training was conducted over a two-week period and provided a pathway for Aboriginal and Torres Strait Islander health workers to specialise in the provision of ear and hearing health. Additionally, the skill set units provide credit towards Aboriginal and Torres Strait Islander Primary Health Care qualifications at the Certificate IV level or higher.

NACCHO coordinated 100 Aboriginal Health Worker Ear and Hearing Training which were delivered in Brisbane, Darwin, Melbourne, Cairns, Perth, Dubbo, Sydney, Kalgoorlie, Albany and Adelaide.

Due to Sorry Business, minimal trainees participated in Darwin with training in Katherine cancelled all together.

NACCHO Report 4 of 4 Quality use of Medicines Maximised for Aboriginal and Torres Strait Islander People

The Quality Use of Medicines Maximised for Aboriginal and Torres Strait Islander Peoples (QUMAX) program is a collaboration between NACCHO and the Pharmacy Guild of Australia (PGoA) with funding provided by the Commonwealth Department of Health (DoH) under the Sixth Community Pharmacy Agreement (6CPA). Through the 6CPA, the QUMAX program received 12 months funding.

What is QUMAX?

The QUMAX Program aims to improve health outcomes of Aboriginal and Torres Strait Islander people who attend participating Aboriginal Community Controlled Health Organisations (ACCHOs) in major cities, inner and outer regional areas.

QUMAX achieves this through the allocation of funding to participating ACCHOs to reduce barriers experienced by their clients to Quality Use of Medicines. There are seven support categories specified under the 6CPA:

  1. a) Dose Administration Aids Agreements b) Flexible Funding
  2. Quality Use of Medicine Pharmacy Support
  3. Home Medicine Reviews (HMR) models of support
  4. Quality Use of Medicine Devices
  5. Quality Use of Medicine Education
  6. Cultural Education
  7. Transport

In 2015-2016, QUMAX engaged with over 50 per cent of NACCHO member organisations. This equated to 76 ACCHOs across each State and Territory participating in the program reaching 219,486 Aboriginal and Torres Strait Islander clients.

Challenges

The 2015-2016 QUMAX cycle has been a particularly challenging. The delay in notification of the 6CPA caused significant delays to the time sensitive QUMAX program cycle, placing additional administrative burden on NACCHO from a National Coordination stand point; and also at the ACCHO grassroots service delivery level.

The QUMAX program team supported ACCHOs through the completion and submission of their work plans and reporting requirements for this period. Despite these challenges, all program deliverables were met.

NACCHOs, QUMAX Programme: Quality use of Medicines Maximised for Aboriginal and Torres Strait Islander People report was published in March 2016 highlighting the value and effectiveness of QUMAX for Aboriginal and Torres Strait Islander clients of participating ACCHOs.

Funding for QUMAX is and remains capped at 11 million dollars for the five year (2010-2015) 5CPA agreement. Although funding has increased annually, it has not been sufficient in meeting the ongoing needs of patients requiring support through the program. Coupled with additional financial investment provided by ACCHOs across the 2013-2015 financial years, the report indicated that a higher level of funding is needed.

Key outcomes from the report:

  • 81 organisations participated in the QUMAX program from 2010 to 2015.
  • ACCHOs reported greater uptake of QUMAX supported activities for which funding has not kept pace.
  • Program participants are evenly distributed across major cities and inner and outer regional areas.
  • Across the seven support categories:
  • The highest proportion has been allocated to Dose Administration Aids for complex medications (50 per cent).
  • Asthma masks and spacers, nebulisers and peak flow meters are the most highly used device with over 22,500 being provided.
  • 21 per cent of funds have been used for transport assistance for clients to acquire medications. It was noted that 80 per cent of contracted pharmacies are located over one kilometre away from ACCHO clinics.
  • 508 community pharmacies participated as Dose Administration Aids contracted pharmacies.
  • Community Pharmacies actively participated in improving their own cultural awareness and support for client education on medications.

NACCHO continues to work towards ensuring the QUMAX Program, and quality use of medicine support to ACCHOs continues throughout the 6CPA.

The full report is available on the NACCHO website http://www.naccho.org.au/wp-content/uploads/QUMAX-Report-Final-2016-04-10-hiq.pdf

Learn more about these NACCHO programs  at the  NACCHO Members Conference in Melbourne

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1. NACCHO Interim 3 day Program has been released -Download
2. The dates are fast approaching – so register today
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