NACCHO Aboriginal Health and #refreshtheCTGRefresh : Download the @AIHW National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care: results for 2017 showing improvements in 16 out of a possible 23 measures

Between June and December 2017, improvements were seen in 16 out of a possible 23 measures for which comparable data for both periods were available (see Table S1 for details). Results for a further indicator remained stable between reporting periods.

The improvements were seen in 12 of the 15 process-of-care measures with comparable data. Improvements were also seen in 4 of the 8 outcome measures, while 1 outcome measure remained stable. The largest improvements (4 or 5 percentage points) were seen in the recording practices for the measuring of:

  • influenza immunisations for clients with type 2 diabetes, which rose from 31% to 36%
  • influenza immunisations for clients with chronic obstructive pulmonary disease (COPD), which rose from 32% to 37%
  • influenza immunisations for clients aged 50 and over, which rose from 32% to 36%. ” 

 Extract from good news from AIHW Report

 Download full 158 page report HERE

aihw-ihw-200 (1)

Summary

This is the fifth national report on the Indigenous primary health care national Key Performance Indicators (nKPIs) data collection. It presents data on all 24 nKPI indicators for the first time.

Data for this collection are provided to the Australian Institute of Health and Welfare (AIHW) by primary health care organisations that receive funding from the Australian Government Department of Health to provide services to Aboriginal and Torres Strait Islander people. Some primary health care organisations included in the collection receive additional funding from other sources, including state and territory health departments.

As of the June 2017 data collection, changes have been made to the data extraction method, with the Department of Health introducing a new direct load reporting process. This allowed Communicare, Medical Director, and Primary Care Information System (PCIS) clinical information systems (CISs) to generate nKPI data within their clinical system, and transmit directly to the OCHREStreams portal. Best Practice services were provided with an interim tool while MMEx has always had direct load capability.

61.9 % our ACCHO’s

The new process was introduced to provide a greater level of consistency between CISs, but the change in the extraction method means that data from June 2017 onwards are not comparable with earlier collections.

As the June 2017 collection represents a new baseline for the collection, this report only presents data for June and December 2017.

For 2 indicators (Kidney function tests recorded and Kidney function test results) only December 2017 results are presented due to unresolved data quality issues in June 2017.

See Chapter 2 for more information on the change in extraction method, data quality, and the impact  on the collection, and Appendix E for data improvement projects and the nKPI/Online Service Reporting (OSR) review under way.

Improvements were seen for most indicators between June and December 2017. Although data from these 2 reporting periods are not comparable with earlier reporting periods, an overall pattern of improvement is in keeping with the pattern of improvement previously reported for the period June 2012 to May 2015 (see AIHW 2017). This indicates that health organisations continue to show progress in service provision.

Things to work on

For the 3 process-of-care indicators that did not show improvements—glycated haemoglobin (HbA1c) result recorded (6 months), cervical screening, and Medicare Benefits Schedule (MBS) health assessment for those aged 0–4—the changes were very small (0.5, 0.4, and 0.1 percentage points, respectively).

In the case of cervical screening, this might be due to changes to the cervical screening program, which took effect from 1 December 2017 (see Chapter 4 for details).

Three outcome measures that did not show improvements—HbA1c result of 7% or less, low birthweight, and smoking status of women who gave birth in the previous 12 months—saw changes of between 0.8 and 1.8 percentage points.

Contents

  • 1 Introduction
    • The nKPI collection
    • Structure of this report
  • 2 Data quality
    • Data quality issues
    • Additional considerations for interpreting nKPI data
  • 3 Maternal and child health indicators
    • Why are these indicators important?
    • 3.1 First antenatal visit
    • 3.2 Birthweight recorded
    • 3.3 MBS health assessment (item 715) for children aged 0-4
    • 3.4 Child immunisation
    • 3.5 Birthweight result
    • 3.6 Smoking status of females who gave birth within the previous 12 months
  • 4 Preventative health indicators
    • Why are these important?
    • 4.1 Smoking status recorded
    • 4.2 Alcohol consumption recorded
    • 4.3 MBS health assessment (item 715) for adults aged 25 and over
    • 4.4 Risk factors assessed to enable cardiovascular disease (CVD) risk assessment
    • 4.5 Cervical screening
    • 4.6 Immunised against influenza-Indigenous regular clients aged 50 and over
    • 4.7 Smoking status result
    • 4.8 Body mass index classified as overweight or obese
    • 4.9 AUDIT-C result
    • 4.10 Cardiovascular disease risk assessment result
  • 5 Chronic disease management indicators
    • Why are these important?
    • 5.1 General Practitioner Management Plan-clients with type 2 diabetes
    • 5.2 Team Care Arrangement-clients with type 2 diabetes
    • 5.3 Blood pressure result recorded-clients with type 2 diabetes
    • 5.4 HbA1c result recorded-clients with type 2 diabetes
    • 5.5 Kidney function test recorded-clients with type 2 diabetes
    • 5.6 Kidney function test recorded-clients with cardiovascular disease
    • 5.7 Immunised against influenza-clients with type 2 diabetes
    • 5.8 Immunised against influenza-clients with chronic obstructive pulmonary disease
    • 5.9 Blood pressure result-clients with type 2 diabetes
    • 5.10 HbA1c result-clients with type 2 diabetes
    • 5.11 Kidney function test result-clients with type 2 diabetes-eGFR
    • 5.12 Kidney function test result-clients with type 2 diabetes-ACR
    • 5.13 Kidney function test result-clients with cardiovascular disease-eGFR
  • 6 Discussion
    • Data improvements
  • Appendix A: Background to the nKPI collection and indicator technical specifications
  • Appendix B: Data completeness
  • Appendix C: Comparison of nKPI results
  • Appendix D: State and territory and remoteness variation figures
  • Appendix E: Data improvement projects
  • Appendix F: Guide to the figures
  • Glossary
  • References

NACCHO Aboriginal #Eye Health #refreshtheCTGRefresh : @AHCSA_ @RANZCOeyedoctor @IEHU_UniMelb has launched the 2018 Annual Update on the Implementation of The Roadmap to #ClosetheGap for Vision

“All of these improvements are very encouraging, but more needs to be done if we want to achieve our goal of giving all Aboriginal and Torres Strait Island people the same eye health as other Australians,

“It is crucial that we keep working closely with local communities through Aboriginal Community Controlled Health Organisations, and at higher levels to make sure that services are properly provided and resourced across states and territories.”

Professor Hugh Taylor, Head of Indigenous Eye Health at Melbourne University

” The feeling of restoring someone’s sight is what Taylor describes as “almost biblical”.

The surgery for restoring sight is often quite simple, but the impact of the surgery, and the emotional response that comes with it, often leaves Taylor at a loss for words.   

While 94 per cent of vision loss is avoidable, Aboriginal and Torres Strait Islander adults are six times more likely to suffer from blindness than non Aboriginal and Torres Strait Islander adults.

After working in remote Indigenous communities with the Fred Hollows Foundation, as well as overseas, and seeing little change in the statistics over a number of years, Taylor decided it was time to take serious action on closing the vision gap.

Taylor is on a mission to close the gap by 2020, through sustainable health systems that will change the landscape of Indigenous eye health, forever.  

In this months Changemaker, Prof Taylor discusses why he was inspired take charge of Indigenous eye health, creating sustainable solutions, and the feeling of restoring a human’s eyesight. See Full Interview Part 2 Below

Download 2018-AnnualUpdate_Close the Gap

Part 1:The Roadmap to Close the Gap for Vision

The 2018 Annual Update on the Implementation of The Roadmap to Close the Gap for Vision was launched on this week at the 50th Annual Scientific Congress of the Royal Australian and New Zealand College of Ophthalmologists in Adelaide by Shane Mohor, CEO of the Aboriginal Health Council of South Australia and Professor Hugh Taylor, Head of Indigenous Eye Health at Melbourne University. Dr Heather Mack, President-Elect of RANZCO hosted the launch.

Philip Roberts from the indigenous eye health unit hard at work

“It is terrific to see the progress that has been made with great work being done by the Aboriginal and Torres Strait Islander health organisations and all of our partners in eye health,” Professor Taylor said. Progress includes:

  • 19 of 42 systemic issues identified in Indigenous eyecare have been fixed and three quarters of the intermediate activities have been completed
  • In 2008 blindness and impaired vision among Indigenous people were six times the national rate. Now it is down to three times the national rate
  • A third of Indigenous adults have diabetes and are at risk of blindness through diabetic retinopathy
  • Up to 98 per cent of diabetes-related blindness can be prevented through annual eye exams and timely treatment in the disease’s early stages
  • Diabetic retinopathy cameras and trained operators are being placed in more than 150 Aboriginal health clinics across Australia
  • 53 of 63 regions across the country are now working to co-ordinate eye care for Indigenous people – covering more than 70 percent of the nation’s Indigenous population
  • The rate of trachoma, a blinding eye infection passed child to child and prevented by keeping faces clean, dropped from 21 per cent in outback children in 2008 to 3.8 per cent in 2018 and is on track to be eliminated by the end of 2020
  • Australia remains the only developed country with endemic trachoma, which is only found in Indigenous communities. Prompt repair and maintenance of washing facilities is key to helping children wash faces, while more timely data-reporting would allow targeted intervention in trachoma hot spots.

Part 2 : In this months Changemaker, Taylor discusses why he was inspired take charge of Indigenous eye health, creating sustainable solutions, and the feeling of restoring a human’s eyesight.

Republished from Maggie Coggan Article Probono

What made you want to specialise in Indigenous eye health?

Back in the 70s, when I was doing my ophthalmology training, I spent a year working with the Fred Hollows Foundation. Over a period of a year or so, we examined Aboriginal and Torres Strait Islander people across the whole country, and this gave me a real insight into some of the conditions and disadvantages of Indigenous people across the country.

It was when I did a review for the Commonwealth, in the mid 90s on Indigenous eye health, and made a series of recommendations, that I realised in 30 years, nothing had changed. I realised no one else seemed to be doing much to make a change, so I rolled up my sleeves and got on with it, moved to Melbourne University and set up the eye health unit, to really try and focus on this problem full time.

When you were working in those remote communities, at what point did you realise it was a really big problem?

I’d been brought up in middle class family, and went to school and university in Melbourne, living quite a privileged life.

Keep in mind, I was there over 40 years ago, so things have changed, but when I was working in these remote communities, many were wearing old second hand clothes, lacking facilities to wash themselves or their clothes, with eye, nose, ear and skin infections. It was very different from walking around suburban Melbourne or working in the emergency room or outpatient clinic. \

That fellow Australians were allowed to live like that was just not right and a real shock. I just couldn’t understand how that could happen in Australia. It was when I went overseas and did work in Africa, Asia, America and the Middle East, and saw what can happen and change there, that I realised things hadn’t changed in Australia and we needed to do something about it.

Dr Hugh Taylor screening for trachoma

Why did you think setting up your own clinic and area of work was more effective than the work you were doing with Fred Hollows?

The stuff I did with Hollows was really a survey, and one-off eye care, and an attempt to set up ongoing eye care. I was then one of the founding board members of the foundation, they weren’t really doing much in the Indigenous eye health space, mainly focusing their work overseas. I was also running a big clinical department and research group, and the Centre for Eye Research Australia, amongst other things, and it only left an hour or two a week to think about Indigenous eye health.

I really wanted to develop long term and sustainable changes, rather than having one-off services, that needed time and effort to identify the problems, and then working out what the solutions are, and how they could be best rolled out.

Restoring someone’s eyesight is a pretty significant act, what does that feel like for you doing the work?  

Ophthalmology is almost biblical. You’re making blind people see again, and that can be both rewarding for the patient and the family, but also for the practitioners. Sometimes it’s quite embarrassing, because all you’ve done to people, once you’re trained, is a simple operation. But taking out someone’s cataract, particularly if it’s a very advanced cataract, to take that out and do it properly, you feel very satisfied at the end of surgery.

The next day when you take off the bandage and the dressing, and the patient is bursting with emotion, and joy at being able to see, count how many toes they have or touching their nose. Sometimes they are so excited, you really don’t know what to say, and that’s really very moving and very exciting.

Are there other reasons aside from a lack of services that contribute to the high numbers of vision loss for Indigenous people?  

Well it’s interesting, because when we first set up the Indigenous eye health unit, we did a survey and found that the unmet need in the inner-city Melbourne suburb of Fitzroy, is the same as it is, in Fitzroy Crossing, up in the Kimberley.

In the Kimberley, we obviously need to get more eye services out there, but the Victorian Aboriginal health service in Fitzroy is less than a mile from the Royal Victorian Eye and Ear Hospital, the largest eye hospital in the Southern Hemisphere.

They were also having seven times less surgery to remove cataracts, and they were four times more likely to wait for more than a year to get surgery done. Some of the reasons for not using services were for simple things like cultural safety, or institutional racism that was keeping people away.

Other things were the movement of more and more surgery into private hospitals, with big gap fees. We ended up saying that the path of care was like a leaky pipe, there are lots of cracks where people can fall out of the system, and if you only fix one or two cracks, the pipe is still leaking. You actually have to address each of those issues, to fix the pipe.

Changing behaviour through education

Do you feel you’ve received enough support from government?

We’ve had a lot of support from government, and there has been a lot of things done. Of our road map, there were 42 recommendations, and more than 16 of those have been fully implemented, and we have a first step done on every one of those, and about two-thirds or more of the intermediate steps have been done.

So we are actually making really good progress.

The government has put in a whole lot of funding into quite a number of those recommendations, and made a number of those changes. There’s still more work to do, and we’ve made good progress, rolling out this improved way of delivering eye care, we have halved the gap for blindness, but more needs to be done to implement those recommendations across the country. We are hopeful this will happen in the next funding cycle, people see what progress is being made, and we live in hope that we will close the gap for vision in 2020.

Do you think vision loss receives less attention because it doesn’t immediately cause death?

Something we outlined in our report on closing the gap, is the false reasons for not doing something about blindness. People say it doesn’t kill you, but actually, if you have visual impairment you have more than a two fold increased risk of dying. Vision loss caused 11 per cent of the health gap.

The first is heart disease, the second is diabetes, equal third is trauma and vision loss. It’s actually very important. The second is people say you can’t do anything about it, and it’s just a natural part of ageing, but in fact, 94 per cent of the vision impairment is unnecessary, and it’s treatable.

Much of it can be fixed overnight. You can give someone a pair of glasses, they see right away, and if you do cataract surgery, they will see the next day. So unlike some of these other chronic problems, like alcoholism, or heart disease, or kidney failure, with vision loss, most of it we can actually fix.

What we see, is the eye care is providing a paradigm or a template on how to link primary care with the specialist services, because if we can sort it out for eyes, it can work for hearts, and lungs and kidneys.

Why exactly is it that blindness is linked to shorter life expectancy?

People who have vision impairment, have a doubling risk of falls, an eight fold increase of hip fractures, are three times more likely to have depression, and you can’t actually get around to look after yourself, or go to the doctor or participate in community and religious events.

And in addition, if you’re so blind from diabetes, you can’t check your blood sugar, you can’t check all your pills, or your feet to make sure they aren’t having problems. There are some very serious impediments that happen because of sight loss. It also prevents healthy and independent ageing.

I mean, Makinti Napanangka, who won the 2008 Telstra Art award, had to stop painting because she was blind from cataract, and after she had surgery, she took out the award, and that’s fantastic. From not being able to take yourself to the doctor, or make a cup of tea, she was able to return to her career after surgery, so it’s really important.

What are you currently working on?

Our focus at the moment is working with advocacy and government to try and get additional funding, particularly the increase in funding for the visiting outreach services for ophthalmology and optometry, and funding for case management of patients who need care referrals in their treatment. We are doing a lot of work making sure that everyone with diabetes gets the regular treatment and that’s also across the country.

In the area of trachoma, while we’ve had very good progress, there is still much more work to be done to eliminate it as a blinding disease. For that we are focusing on health promotion so that every child and family knows to keep the kids faces clean, to stop the transmission of infection, and also to make sure there’s washing facilities in the houses and schools, so the kids can actually make sure that they can wash their faces.

Do you think it’s possible to close the vision gap by 2020?

Yes! There’s a lot of work to do, but you’ve gotta back things that work, and we are actually making real progress. We’ve already halved the gap for blindness, reduced the rates of trachoma in kids from remote communities from 21 per cent in 2008 to 3.8 per cent, so I think we are making some really good progress, we just need to have the support to finish the job.

What are you doing to ensure that the organisation that is set up is sustainable and continue on?

My little group may disappear, and that’ll be fine, what we are really trying to do is develop long term sustainable changes so that this system just keeps on running.

Once it’s set up in place, they’ll be checks and balances with monitoring and reporting, and the evaluation of reporting. So it’s really about building those sustainable solutions, building things into medicare, changing government policy, so services are properly funded and coordinated.

I started 40 years ago, dropping into communities and fixing eyesight and then leaving, and that’s not what we should be doing in 2018, we need to be more sustainable.

The national Close the Gap campaign extends beyond just eye health, does the complexity of the issue overwhelm you?

It is complex, and I recognise that but no I don’t feel overwhelmed. I actually feel empowered by recognising it’s complexity. Stepping back and taking this health system approach, looking at the patient journey or the pathway of care, coming up with the notion of it being a leaky pipe with many issues to fix is important.

There’s no silver bullet, it’s not the three key priorities. I’m quite empowered by a quote from Helen Keller, who said I am only one, and I can’t do everything, but I am one, and I can do something, and because I can’t do everything, doesn’t mean that I won’t do the something that I can do.

With eye care, you can actually do it, and teasing out the real things that need to be done and as I said, most of it can be fixed, and most of it can be fixed overnight. I think we are making really good progress, and learning the lessons that we’ve been working out for eye care to apply for the provisions of other specialist health services.

How has this experience changed you?

I guess it makes me optimistic that we can change, and recognising that there’s not a silver bullet, there’s not just three things that need to be done, you need to take a health systems approach, and look at the multiple things.

And so taking a complex problem and unpacking it has been very important, and I think that has given me the optimism for when people ask if we can get it all done by 2020, because of course we can! If we can keep pushing on and kicking a few goals, it’s very doable, we will get there.

 

Aboriginal #Eye Health NEWS : NACCHO and @Vision2020 Welcomes @GregHuntMP and @KenWyattMP major investment to provide approx. 18,000 Aboriginal and Torres Strait Islander people with easier access to affordable prescription glasses

“Aboriginal and Torres Strait Islander people have three times the rate of vision impairment and blindness as compared to non-Indigenous Australians.”

“This is totally unacceptable, especially when almost two-thirds of impaired eyesight can be corrected by prescription glasses.”

Health Minister Greg Hunt said the investment would allow Vision 2020 Australia to work with state and territory governments to streamline, standardise and improve their schemes that provide subsidised glasses to First Nations people

Photo above NACCHO File : Brien Holden Vision Institute with Edwina at Danila Dilba ACCHO Darwin

“To help achieve equity of access to subsidised glasses, Vision 2020 will work with governments to ensure their schemes align with eye health principles developed by Optometry Australia and the National Aboriginal Community Controlled Health Organisation.

“These principles have been supported by Aboriginal Health Forums conducted across the nation.”

Indigenous Health Minister Ken Wyatt AM

Under some State and Territory schemes at the moment, only a third of Aboriginal and Torres Strait Islander people needing glasses are actually receiving them.

We need to do what we can to provide cost-certainty and affordable access to prescription spectacles for our people.”

Dr Dawn Casey, Acting Deputy CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO) and Chair of the Vision 2020 Australia policy committee for Aboriginal and Torres Strait Islander Health also welcomed the investment

Read over 40 Aboriginal Eye Health articles published by NACCHO over past 6 years 

Part 1 Program Puts Better Vision for First Nations People in Sight

The Turnbull Government has committed $2 million to provide Aboriginal and Torres Strait Islander people with easier access to affordable prescription glasses.

Welcomes @GregHuntMP and @KenWyattMP major investment to provide approx. 18,000 Aboriginal and Torres Strait Islander people with easier access to affordable prescription glasses.

Indigenous Health Minister Ken Wyatt AM said introducing a nationally consistent system to simplify and ensure better access to affordable glasses would significantly improve people’s vision and overall quality of life.

“Not only does poor vision adversely affect a person’s general wellbeing, it can be a significant barrier to education and employment, and can restrict a person’s mobility and social interaction,” said Minister Wyatt.

“The cost of prescription glasses often deters Aboriginal and Torres Strait Islander people from visiting an optometrist to have their sight checked.”

“This can also delay detection of other serious vision-threatening conditions such as diabetic retinopathy, cataracts and glaucoma.”

A trial to improve the provision of prescription glasses in the Kimberley and Pilbara areas of Western Australia yielded positive outcomes, including improved patient medication compliance and greater independence.

Vision 2020 Australia was established in 2000 and has an experienced board including Aboriginal and Torres Strait Islander representatives.

The Turnbull Government’s 2018-19 Budget included an additional $3 million to extend First Nations eye health activities, on top of an existing $31.3 million commitment to eye health activities

Part 2 New investment in spectacles for Aboriginal and Torres Strait Islander people welcomed by Vision 2020 Australia

Vision 2020 Australia welcomes the Australian Government investment of $2 million to increase access to subsidised spectacles for Aboriginal and Torres Strait Islander people.

The one-off funds have been allocated to Vision 2020 Australia to work with the Australian Government to encourage State and Territory Governments to enhance the existing arrangements for subsidising the cost of spectacles.

Vision 2020 Australia CEO Judith Abbott said: “Our members have been actively advocating for this investment that will help make spectacles more affordable for up to 10,000 Aboriginal and Torres Strait Islander people across our country.”

“Around 60 per cent of blindness among Aboriginal and Torres Strait Islander people is due to issues that can be corrected with glasses, so this is a very positive step. We look forward to working with the government as part of Vision 2020 Australia’s ongoing commitment with our members to reduce blindness and vision loss.”

Minister for Indigenous Health the Hon. Ken Wyatt said: “While subsidised spectacle schemes exist in all Australian states and territories, the existing schemes vary and in some cases, have limited impact in overcoming barriers to access.

This new investment is being provided to encourage State and Territory Governments to work with Vision 2020 Australia to establish a nationally consistent approach to spectacle subsidies.”

“We want to remove affordability barriers so Aboriginal people can get glasses when they need them, regardless of where they live

NACCHO and @Vision2020Aus Aboriginal Eye Health Deadly Good News : #BecauseofHerWeCan #WeCan18 ! – #Indigenous women in eye health @Walgett_AMS @BADACBallarat @AHCSA_ @IEHU_UniMelb

 ” To mark NAIDOC Week 2018 and this year’s theme ‘Because of Her, We Can!’, Vision 2020 Australia is celebrating the roles and achievements of some of the incredible Aboriginal and Torres Strait Islander women working in the eye health sector.  

These women perform a range of roles across a number of areas in the sector, but they are all proud of their cultures, passionate about their work and driven to help improve health outcomes in Indigenous communities and beyond.”

Originally published HERE VISION 2020

Read over 40 Aboriginal Eye Health Articles published over the past 9 years

 ” Vision 2020 Australia’s Aboriginal and Torres Strait Islander Committee Chair, Dr Dawn Casey (COO, NACCHO), said it will be hard to improve Aboriginal health when funding bodies and Aboriginal service providers are “not on the same page”.

Dr Casey spoke at the Close the Gap for Vision by 2020: Striving Together National Conference in March about the longevity of ACCHOs delivering clinically effective health outcomes for over 40 years: “Our mob trust us”. While medical professionals have a role to play in closing the gap, sustainable approaches must be embedded in ACCHOs ”

Read full report here Aboriginal-led solutions key to closing the vision gap

1.Robyn Bradley, Aboriginal Health Liaison Officer – Royal Victorian Eye and Ear Hospital

Robyn’s father’s ancestors emigrated from England and Scotland in the early 1800s and her mother’s family are from the Dhauwurd Wurrung peoples more commonly known as Gunditjmara in Western Victoria.

“I am proud to belong to this beautiful and ancient land. If you listen quietly you can still hear the dreamtime stories of our elders rustling through the bush, whispered over the dessert country and swirling around our brilliant coastlines. I am proud I come from this perfectly crafted tapestry of ancient first nation peoples, emigrants, convicts, pioneers, bushrangers and first fleeters.

“I am also proud to share my passion for my culture and beliefs as an Aboriginal Health Liaison Officer at the Eye and Ear. I get to meet with community and act as a steward to help them receive the highest possible level of care – care that considers what is culturally appropriate and meets their unique needs.”
Robyn Bradley, Aboriginal Health Liaison Officer at the Royal Victorian Eye and Ear Hospital

2. Aboriginal women of the Aboriginal Health Council of South Australia

Since its inception, the Aboriginal Health Council of South Australia (AHCSA) has looked to the leadership of Aboriginal and Torres Strait Islander Women as trailblazers and advocates for better health outcomes for their communities.

Currently there are seven Aboriginal Women working in various roles within the AHCSA Secretariat. The women’s kinship ties extend all over the country and all are united in their efforts to contribute to improving health for their communities, acting as advocates for increased and improved access to Hospital and Health Services and creating opportunities for their communities, particularly the next generation.

Image (L-R): Sarah Betts (Sexual Health Coordinator), Ngara Keeler (Tackling Indigenous Smoking Programme Coordinator), Jessica Koncz (Student Services Officer), Jenaya Hall, (Tackling Indigenous Smoking Project Officer), Amanda Mitchell (Deputy CEO), Debra Stead (Senior Finance Officer),
Absent from photo, Hannah Keain, (Junior Project Officer)
7 Aboriginal women who work at the Aboriginal Health Council of South Australia

3.Keearny Maher, Occupational Therapist – VisAbility

Keearny Maher is a Wiradjuri woman who specialises in vision impairment at VisAbility WA. Her cultural ties originate in Narrandera, NSW through her mother and Wiradjuri woman Ann-Maree Bloomfield.

“One rewarding aspect of my role is helping people find independence again after vision loss, particularly in the simple activities we all take for granted, like making a hot cuppa.”

Keearny’s role takes her all over WA, with some of her career highlights extending overseas, including volunteer work as an occupational therapist in Ukraine and India with children with varying disabilities.

Occupational Therapist at VisAbility, Keearny Maher

Rosamond Gilden, Research Assistant – Indigenous Eye Health at the University of Melbourne and member of Orthoptics Australia

Upon completing a Masters in Orthoptics, Rosamond worked in the private and public sector. To pursue her interest in research, Rosamond joined the Centre for Eye Research Australia as Clinical Coordinator of the National Eye Health Survey. It was during this time she became aware of the poor eye health outcomes for Indigenous Australians and wanted to make a difference.
In 2016, Rosamond commenced work with Indigenous Eye Health and is part of the Roadmap team whose goal is to Close the Gap for Vision by 2020.  Rosamond has used her experiences as a clinician to inform the current work that she is now undertaking and is grateful for the opportunity she has each day to contribute to a sector that has a sincere interest in improving eye health outcomes for Aboriginal people.
Rosamond Gilden

4. Jenny Hunt, Eye Health Worker – Walgett Aboriginal Medical Service in partnership with Brien Holden Vision Institute

Jenny is a proud Gamilaraay woman who has been providing eye care services in partnership with the Brien Holden Vision Institute Aboriginal Vision Program for the past 10 years to the Walgett community.

“I find the eye program rewarding when I see the relief and smile on my people’s faces when they first put their glasses on. I feel proud. Also, if they do not attend their optometrist or ophthalmologist appointments, I will chase them up and take them there myself because I know how important it is for them.
“I have excellent communication with the outreach location workers and they do a wonderful job getting the patients in for our clinics. I travel to Narrabri, Collarenebri, Goodooga, Pilliga and Lightning Ridge for clinics as well as the one we run in Walgett. Without the help from these workers, there would be no eye clinics.”
Jenny Hunt standing in front of a sign for Walgett Aboriginal Medical Service

5.Faye Clarke, Diabetes Educator/Care Co-ordinator – Ballarat and District Aboriginal Co-operative in partnership with Indigenous Eye Health at the University of Melbourne

Faye is a Gunditjmara, Wotjobaluk and Ngarrindjeri woman who works with Aboriginal communities in the Ballarat and wider Grampians region of Victoria to help promote eye health and help those living with diabetes. Faye is passionate about working in Indigenous eye health and was excited to work with the IEH team on the Roadmap to Close the Gap for Vision.

“Vision is such an essential part of our life and when it is threatened it makes all the difference to someone’s quality of life. My dual role as a Care Co-ordinator means I can take on roles in both education and co-ordinating their path in the health care system.

“I am passionate about Indigenous eye health because of the work I do but also because of the clients I work with who are affected by threats to their vision.”

Faye Clarke from Ballarat and District Aboriginal Co-operative

6.Simone Kenmore, Manager of South Australian Trachoma Elimination Program – Country Health South Australia

Simone is a Yankunytjatjara woman from the Anangu Pitjantjatjara Yankunytjatjara Lands in remote South Australia. Simone works with Indigenous communities and health professionals across Australia to inform a model of best practice to work towards the elimination of trachoma in South Australia, and is passionate about improving health outcomes for Indigenous communities.
“I have always been passionate about working in programs that contribute to improved outcomes for Indigenous communities. My work in trachoma is driven by the fact that it is a preventable disease. By sharing what we know about eye health, building the capacity of our communities and working in partnership across health, education and housing we can eliminate trachoma and prevent blindness for future generations.”
(Image and content provided by Indigenous Eye Health at University of Melbourne)
Simone Kenmore

7.Emma Robertson, ITC Care Coordinator – Karadi Aboriginal Corporation

Emma is a Palawa woman working in a health promotion role at Karadi Aboriginal Corporation in Tasmania, encouraging people to come in for regular eye checks. Emma believes this year’s NAIDOC Week is a great chance to honour the women who have influenced her and her work in Indigenous health.

“I thinks this year’s theme is one of the best yet. I get to honour the women who were before my time that set the path that now enables me to work in my areas of passion around Indigenous health. It also makes me feel proud as an Aboriginal mum and the role I am playing in setting what I hope is a great role model for my daughters – that with hard work, determination and good people around you, you can make a profound difference in the lives of others.”

(Image and content provided by Indigenous Eye Health at University of Melbourne)
Emma Robertson from Karadi Aboriginal Corporation

NACCHO and @RACGP Aboriginal Health #Housing #Crisis #ClosetheGap #Socialdeterminants Overcrowding leads to poorer health outcomes for our Aboriginal and Torres Strait Islander peoples

 ” In the first of a series focusing on the coming third edition of the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people, newsGP examines the effects of overcrowding on health outcomes “

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Many households in Aboriginal and Torres Strait Islander communities are deemed overcrowded, a situation that can lead to a wide range of health problems.

Author of RACGP article Morgan Liotta

The National Aboriginal Community Controlled Health Organisation (NACCHO) and the RACGP’s National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (the National Guide) and the Centre for Aboriginal Economic Policy Research’s working paper, The scale and composition of Indigenous housing need, define overcrowded households as those that do not meet the following requirements:

  • No more than two persons per bedroom
  • Children aged <5 years of different sexes may reasonably share a bedroom
  • Children aged ≥5 years of opposite sex should have separate bedrooms
  • Children aged <18 years and the same sex may reasonably share a bedroom
  • Single household members aged >18 years should have a separate bedroom, as should parents or couples

The National Guide reveals that Aboriginal and Torres Strait Islander families living in overcrowded circumstances are more susceptible to contracting infections through lack of hygiene from poor sanitation and close contact with others.

Added by NACCHOFor example, situations in which several people are sharing a single bathroom, and the bore water supply (on which many remote Aboriginal and Torres Strait Islander communities depend) struggles to maintain appropriate levels, result in inadequate fresh water for basic cleaning. Another example is the ease with which an infection can spread via bed linen when several children are sharing a bedroom.

Chronic ear infections (eg otitis media), eye infections (eg trachoma), skin conditions (eg crusted scabies), gastroenteritis, respiratory infections (overcrowding has been identified as a risk factor for pneumococcal disease), and exacerbation of family violence and mental health issues are all potential outcomes from overcrowded environments.

In remote areas, overcrowded households (more than two children aged <5 years) are associated with a 2.4-fold increased risk of the youngest child having otitis media.

According to the Systematic review of existing evidence and primary care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations, these high rates of infection could be prevented if overcrowding in Aboriginal communities was improved.

Overcrowding can also present as an environmental stressor for people living in such households, including from issues such as a lack of privacy, which can have an impact on mental health. Research from the Australian Bureau of Statistics shows that 14% of Aboriginal and Torres Strait Islander people in remote areas cited overcrowding at home as this type of stressor, compared to 9% of those living in non-remote areas.

In addition, the Y health – Staying deadly: An Aboriginal youth focussed translational action research project addresses overcrowding as a potential factor when exploring issues of Aboriginal youth mental health.

However, other significant factors to recognise are that some houses need to accommodate for overcrowding due to extended family visits to deal with illness, mourning a death in the family, or sometimes for cultural reasons.

Various government strategies are in place to combat the negative impacts of overcrowding, including the National partnership agreement on remote Indigenous housing, funded by the Federal Government. This policy aims to assess the current state of poor housing conditions in Aboriginal and Torres Strait Islander communities, as well as issues of housing shortage and homelessness.

These strategies are working towards improving housing conditions in rural and remote areas, a key part in helping to close the gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians.

NACCHO and the RACGP’s National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people, provides further information on overcrowding in the following chapters:

  • Hearing loss
  • Eye health
  • Respiratory health – Pneumococcal disease prevention
  • Mental health
  • The health of young people

How to access the National Guide:

The third edition of the National Guide will be available early 2018.

Free to download on the RACGP website and the NACCHO website:

www.racgp.org.au/national-guide/ and www.naccho.org.au

For further information, contact

RACGP Aboriginal and Torres Strait Islander Health on 1800 000 251

or aboriginalhealth@racgp.org.au

 

NACCHO Aboriginal Eye Health News : 2017 Annual Update on the Implementation of the Roadmap to Close the Gap for Vision

 

“At the beginning of this work, rates of blindness and impaired vision were up to six times higher than for non-Indigenous populations. This rate now stands at three times more than the national rate. This is a very encouraging improvement but more needs to be done.

With on-going work from all stakeholders, we are determined to close the gap for Indigenous vision by 2020,”

Professor Hugh Taylor, who last  week launched the 2017 Annual Update of the Roadmap at the Royal Australian and New Zealand College of Ophthalmologists Annual Scientific Congress in Perth.

Blindness among Indigenous communities is on track to drop to the same rate as non-Indigenous communities by 2020, thanks to work spearheaded by University of Melbourne eye health expert Professor Hugh Taylor.

The Roadmap to Close the Gap for Vision was launched by the University of Melbourne Indigenous Eye Health group in 2012 and is now active in 37 regions covering over 60 per cent of the nation’s Indigenous population.

Note NACCHO is a partner in this project

Read over 40 NACCHO Aboriginal Eye Health articles published by NACCHO over past 5 years HERE

https://nacchocommunique.com/category/eye-health/

NACCHO Note : See below :  Join in on a free eye health webinar on the 8th of November

Photo above : Thank you Jasmin Boys from the Indigenous Eye Health team for your support and engagement at our #NACCHOagm2017 in Canberra

Successes that support the Roadmap include increased funding of cataract surgery, optometry and ophthalmology visits, new Medicare listings supporting screening of eye care, health promotion, regional and jurisdictional oversight and new diabetic retinopathy cameras and training.

Professor Taylor says the 2017 update shows progress is being made on every recommendation in the Roadmap but he says ongoing systems reform and some increased funding would enable even better delivery of services within communities.

Download the report HERE : 2017-AnnualUpdate Close the Gap for Vision

The University of Melbourne team are part of the effort along with Indigenous leaders, partners and community members to eliminate trachoma from Australia, particularly through programs to encourage clean faces.

“We are the only developed nation with endemic trachoma. It is only found in Indigenous communities. We need more timely reporting of data to allow more intense targeted intervention in hot spots,” Professor Taylor says.

“There is also a need for cross-portfolio activity orchestrated by the Department of Prime Minister and Cabinet to ensure functional and safe bathrooms in these communities.”

NACCHO Promotion

Join in on a free eye health webinar on the 8th of November

 A free, one hour webinar, Eye care for Aboriginal and Torres Strait Islander people with diabetes: what can primary health care staff do? is brought to you by the Australian Indigenous HealthInfoNet and The Fred Hollows Foundation.

There is real concern about rising levels of diabetes among Aboriginal and Torres Strait Islander people, and the complications that are associated with this. Diabetic retinopathy (DR) is a serious eye condition that can lead to vision loss and blindness among people with diabetes if it isn’t managed appropriately.

Dr Fabrizio D’Esposito, Research Advisor at The Fred Hollows Foundation, will be talking with us from London about key priorities and new approaches for addressing DR among Aboriginal and Torres Strait Islander people. There will also be time to talk briefly about information on the Eye health web resource, including a new series of multimedia DR resources developed to support the primary health care workforce, and to respond to questions from webinar participants.

The webinar will be held on Wednesday, 8 November at:

  • 4pm AEDT (NSW, Vic and Tas)
  • 3.30pm ACDT (SA)
  • 3pm AEST (Qld)
  • 2.30pm ACST (NT)
  • 1pm AWST (WA).

We hope you will join us. To attend, simply click on this link about five minutes before the webinar is due to start. If you have any questions before the webinar please refer to the contact details below.

Links

 

NACCHO #WorldSightDayAU Aboriginal Health #Trachoma : Tullawon Health and our Australian Trachoma Alliance initiative to stamp out trachoma in Yalata community

The Safe Eyes program relies upon the effective engagement, ownership and leadership of the community to address hygiene and environmental health factors which lead to the spread of trachoma and other hygiene related disease.

In Yalata, Tullawon Health Service, with support from the Army and Australian Trachoma Alliance, has led the development of a community owned, culturally sensitive and sustainable program to eliminate trachoma, with significant changes in public health behaviours resulting.’

Major General Michael Jeffery, Chair of the Australian Trachoma Alliance pictured below at opening

Background : The Australian Trachoma Alliance (ATA) is a partnership between the National Aboriginal Community Controlled Health Organisation (NACCHO), Indigenous Eye Health at The University of Melbourne and Vision 2020 Australia.

*University of Melbourne, The Roadmap to Close the Gap for Vision, September 2015

 ” And the prevalence of active trachoma among children in at-risk communities fell from 21% in 2008 to 4.6% in 2015.

The Roadmap to Close the Gap for Vision has played a part in prompting actions that contribute to this improvement. The Roadmap outlines a whole of system approach to improving Indigenous eye health, and achieving equity between Aboriginal and non-Aboriginal eye health outcomes.”

Ms Patricia Turner NACCHO CEO pictured above in November 2016 launching  The 2016 Annual Update on the Implementation of the Roadmap to Close the Gap for Vision

See NACCHO Report

Read over 44 NACCHO eye health reports published over past 5 years

Last weeks handover of a public amenities building to the Yalata Aboriginal community in South Australia marks the culmination of a two-year program to address the key causes of trachoma.

A road map of Yalata : Yalata Indigenous Protected Area (The Lands) is located at the Head of the Great Australian Bight, about 1,000km from Adelaide on the West Coast of South Australia. Situated northwest of Ceduna and south of the trans-Australian railway line, and east of Kalgoorlie in Western Australia.

This is truly remote Australia and the only way to Yalata is by road.

Trachoma is a bacterial eye infection which can lead to blindness affecting 60 percent* of remote Aboriginal communities in Australia. The good news is that with effective planning and education, improvements in hygiene practices and living conditions can eliminate the spread of trachoma.

Brigadier Susan Coyle will hand over the new amenities building to the Yalata community, representing Chief of Army, Lieutenant General Campbell, AO, DSC.

The new building was designed, constructed and funded by the Army.

Through the Australian Trachoma Alliance (ATA), the Yalata community and Tullawon Health Service have implemented the ATA’s Safe Eyes Project to improve eye health and communicable disease outcomes for the Yalata community. The new amenities building forms the most visible part of this initiative.

Joanne Badke, CEO of Tullawon Health Service, says: ‘The Safe Eyes Healthy Lives program has been a successful platform towards eliminating Trachoma in the Yalata community.

The program provides education to the community on hygiene practices, provided hand sanitisation stations throughout community, addresses environmental health barriers, embedded good practices in the community’s child and maternal health program and has given us a brand new public amenities building to service the Yalata community and visiting communities to reduce the spreading of communicable disease.’

With funding secured through the ATA from the Army, Tullawon Health Services oversaw the building of the public amenities building which includes toilet facilities, showers and two club room spaces, all of which will be well utilised by Yalata community members and visiting communities.

‘This has been a huge win,’ says Ms Badke. ‘Not only do the people of Yalata have access to this facility, but they provide culturally appropriate solutions to the spreading of Trachoma.’

 

 

 

Aboriginal Eye Health #NDW2017 : Fact check: Has trachoma among Indigenous kids fallen from 20pc to 4pc ?

” On the final day of the Uluru convention on a referendum for Indigenous constitutional recognition, former prime minister Kevin Rudd spoke to the ABC about Indigenous disadvantage since his National Apology to the Stolen Generations in 2008.

Mr Rudd told Radio National on May 26: “One of the programs that we established back then was to eliminate trachoma amongst Indigenous young people. Twenty thousand kids were suffering from trachoma back then at about a 20, 25 per cent rate. We’re now down to about four per cent.”

Is Mr Rudd correct about the incidence and decline of trachoma among Indigenous young people? RMIT ABC Fact Check investigates

Originally Published HERE

NACCHO Declaration

Read over 40 NACCHO Eye Health articles we have published over 5 years

 ” The Roadmap to Close the Gap for Vision has played a part in prompting actions that contribute to this improvement. The Roadmap outlines a whole of system approach to improving Indigenous eye health, and achieving equity between Aboriginal and non-Aboriginal eye health outcomes.

There is however still work to be done on Closing the Gap for Vision. For example, half of Indigenous participants with diabetes had not had the recommended retinal examination.

NACCHO has been involved with the Roadmap from its inception, and had a long relationship with Indigenous Eye Health at the University of Melbourne, and with RANZCO. We’re pleased with the great work and good progress being made.”

 Ms Patricia Turner, Chief Executive Officer, of the National Aboriginal Community Controlled Health Organisation (NACCHO) launching  The 2016 Annual Update on the Implementation of the Roadmap to Close the Gap for Vision November 2016

 

The verdict

Mr Rudd’s claim is overstated.

In saying that 20,000 kids were suffering from trachoma, Mr Rudd appears to have used data for the number of children living in communities judged to be at risk of having endemic trachoma. The number of children estimated to have trachoma in 2009 was about 3,000.

His rate of 20 to 25 per cent “back then” is supported by a prevalence figure of 21 per cent contained in a 2008 report. However, the rates for 2007 and 2009 were each 14 per cent, and the report for 2009 cautions about the reliability of the 2008 data.

Rates of trachoma among Indigenous children in at-risk communities have declined steadily since 2009. The claim that rates have fallen to about four per cent is supported by recent reliable data.

What is trachoma?

Trachoma is a contagious infection of the eye that, with repeated long-term infections, can result in the eyelashes turning inwards and scratching the cornea, leading to blindness.

Trachoma affects children and preschool-aged children in particular. It is commonly spread through nose and eye secretions, occurs in areas with poor community and personal hygiene, and is associated with overcrowding and reduced access to water.

Australia is the only developed country where trachoma is still endemic, and it occurs primarily in remote Aboriginal communities in Central Australia.

What program did the Rudd government establish?

Professor Hugh Taylor is the Harold Mitchell Professor of Indigenous Eye Health at Melbourne University and when Mr Rudd announced the policy in 2009 he was head of the National Trachoma Surveillance and Reporting Unit, which receives funding from the Federal Department of Health.

Professor Taylor told Fact Check that “after years of either inaction or ineffective action, in 2009 Kevin Rudd committed to eliminate trachoma in Australia by the year 2020”.

Australia adopted a trachoma eradication strategy in line with the World Health Organisation’s 1998 global strategy and based on its SAFE guidelines. SAFE stands for [S]urgery to repair inward eye lashes, [A]ntibiotics, promotion of [F]acial cleanliness, and [E]nvironmental improvements in hygiene and water access.

Mr Rudd’s office told Fact Check the policy he was referring to was a $58 million commitment made in February 2009 to “help tackle eye and ear diseases in Indigenous communities”, with a major focus on trachoma eradication.

The funding was to be allocated over four years, and according to a press release at the time, included “a major increase in services to address trachoma, which will enable at least 10 regional teams to treat and help prevent the disease in NT, WA, SA and other states where trachoma is identified”.

The 2009-10 federal budget papers spell out $58.4 million in funding over four years for “improving eye and ear health services for Indigenous Australians”.

According to the National Trachoma Surveillance and Reporting Unit, in 2009 the Government committed $16 million over four years towards eliminating trachoma in Australia, and in 2013 committed a further $16.5 million.

The source of the claim

When contacted by Fact Check, Mr Rudd’s spokeswoman said reports for 2008 and 2015 by the National Trachoma Surveillance and Reporting Unit were the source of his claim.

Fact Check was unable to find another consistent, national source of data on the prevalence of trachoma in Indigenous communities. Experts confirmed that there was not any other reliable source.

In the unit’s data collection process, communities are classified as being at risk or not at risk of trachoma and screening of the disease focuses on the at-risk communities.

Screening is administered by local health officials who report the data back to the surveillance and reporting unit for collation and analysis.

Coverage of trachoma screening of at-risk communities has increased over time, due to the increasing level of resourcing of the trachoma eradication program.

20,000 kids with trachoma?

Mr Rudd’s February 2009 media release contains the sentence: “Approximately 20,000 Indigenous children suffer from trachoma in Australia.”

Mr Rudd’s office told Fact Check that “in 2009, it would appear the material provided by the Health Department to the Government referred to 20,000 kids suffering from trachoma”.

His spokeswoman pointed to a May 2009 media release from the then Indigenous affairs minister Jenny Macklin which contained the same sentence and a July 2009 speech by the then parliamentary secretary for social inclusion Ursula Stephens who said: “Trachoma affects approximately 20,000 Indigenous children — a stunning statistic and one that is confronting to government.”

However, a spokeswoman for the Department of Health told Fact Check that “the number of children screened and found to have active trachoma was 997 in 2008 and 575 in 2009”, and “we can confirm that the figure of 20,000 children relates to the number of children resident in potentially at-risk communities (population data), not those screened and found to have trachoma”.

The National Trachoma Surveillance and Reporting Unit’s report for 2009 says there were “20,155 children aged one to nine years resident in the 232 at-risk communities”.

Of these children, 4,116, or 20 per cent, were screened and 575 children had trachoma.

“If those 4,116 children screened were a representative sample of all 20,155 children resident in all at-risk communities, the additional number of children estimated to have trachoma across the three jurisdictions lies between 2,045 and 2,448,” the report said.

It appears that all three ministers were referring to statistics available at the time about the number of children at risk of contracting trachoma, not the number who were suffering from trachoma.

Professor Taylor told Fact Check that “the estimate in 2008 was that there were 20,000 kids in remote communities considered to be at risk of trachoma”.

“This is a rubbery figure because not all the communities had been examined,” he added.

The prevalence of trachoma in 2008

The executive summary of the National Trachoma Surveillance and Reporting Unit’s 2008 report says that “the prevalence of active trachoma in those communities from which data were reported was 21 per cent”.

Of 287 remote Aboriginal communities, 235 were identified as at risk of trachoma in 2008, and 121 were screened and reported data.

The 2008 report focused on the prevalence of trachoma in Indigenous children aged one to nine years old.

Fact Check notes that both the 2007 and 2009 reports show the trachoma prevalence in Aboriginal children aged one to nine years old in communities that reported data in those years to be 14 per cent.

The discussion section of the 2009 report says that “in 2008, there was an abrupt two-fold increase in trachoma prevalence in NT, and an equally abrupt seven-fold decrease in trachoma prevalence in SA, compared with past years. Both of these sudden changes were reversed in 2009”.

The report says the variation in the numbers “suggests that the data from 2008 might be problematic”.

Professor Taylor told Fact Check that “there is an inconsistency in the data and it’s appropriate to acknowledge it, but those are the data that we have, and those are the data that we must use”.

Carleigh Cowling, senior surveillance officer with the National Trachoma Surveillance and Reporting Unit, said the Northern Territory intervention had an impact on the collection of the data in 2008.

“During the intervention, the trachoma screening program was taken over by unusual bodies, whose training was questionable,” she said, adding that “data collected by those teams were not presented in the 2008 report, which does make the data presented problematic”.

The prevalence of trachoma today

The most recent report from the National Trachoma Surveillance and Reporting Unit, published in June 2016 and containing data for 2015, shows that 139 communities were identified as being at risk of trachoma, a decrease of 96 communities since 2008.

Of these 139 communities, 67 were screened and reported data.

The 2015 report focused on children aged five to nine, though reports prior to 2010 focused on children aged one to nine. “It’s an assumption that one to four-year-olds are similar,” Professor John Kaldor, the current head of the National Trachoma Surveillance and Reporting unit, now part of the Kirby Institute at the University of New South Wales, said.

Professor Taylor and Ms Cowling both told Fact Check that though the 2008 report focuses on children aged one to nine and the 2015 report on children aged five to nine, this will have little impact on the comparability of the data from those years.

The results, for children aged five to nine as against one to nine reported in 2008, reveal that the prevalence of trachoma in the communities that screened was 3.7 per cent. The prevalence “using the most recent data carried forward in all at-risk communities” was 4.6 per cent.

The 3.7 per cent is for at-risk communities that screened in 2015, and the 4.6 per cent is for all at-risk communities, meaning those that screened and those that didn’t screen that year but are considered at risk based on previous data.

Professor Kaldor said policy guidelines changed in 2014 so that if a community had high rates of trachoma several years in a row, resources were shifted towards treatment rather than screening.

He and Professor Taylor both agreed that the current prevalence of trachoma among children in affected communities was about 4 per cent.

Professor Kaldor said of hotspots that still exist in Central Australia: “While the drug azithromycin is a big part of combating the disease, there’s the whole issue of fulfilling the other parts of the SAFE strategy to sustainably improve facilities and living conditions.”

“If these are not addressed, the impact of treatment may be short-lived.”

Professor Taylor told Fact Check that “since 2008 we’ve made considerable progress”.

“If you look at closing the gap, it’s actually one area where you can say we’ve made considerable progress,” he said.

Sources

NACCHO Aboriginal Eye Health #NRW2017 : Download @aihw First National Report on Indigenous Eye Health Measures

“The three main causes of vision impairment in adults were uncorrected refractive error, cataract and diabetic retinopathy.

On the positive side, the report indicates that more Indigenous Australians are accessing eye health services provided through specific service programs.

The report finds that in 2014-15 more Indigenous Australians received an eye examination than in the previous twelve months; that the gap in accessing cataract surgery compared to non-Indigenous Australians is narrowing; and the rate of blindness for Indigenous Australians has decreased from 1.9 per cent in 2008 to 0.3 per cent in 2016.

While the report shows improvements are being made in Closing the Gap in Indigenous eye health, more needs to be done.”

Minister for Indigenous Health, Ken Wyatt

Download the  First National Report on Indigenous Eye Health Measures AIHW Indigenous Eye Health

Over 40 NACCHO articles about Indigenous Eye Health

Eye diseases and vision problems are common long-term health conditions experienced by Aboriginal and Torres Strait Islander people and the Minister for Indigenous Health, Ken Wyatt, today welcomed the release of a report that looks at the effectiveness of national eye health programs.

Launching the Indigenous Eye Health Measures 2016 report, released by the Australian Institute of Health and Welfare (AIHW), Minister Wyatt said that one-third of Aboriginal and Torres Strait Islander people reported one or more long-term eye conditions in 2016.

“This report is important because from here we can build an evidence base for monitoring changes in Indigenous eye health, and identify service delivery gaps at the regional level,” Minister Wyatt said.

Summary

Key findings in the report reveal that:

  • This first national report on the Indigenous eye health measures compiles data from a range of sources and presents findings at the national, state and regional levels.
  • In 2016 the prevalence of bilateral vision impairment for Indigenous Australians aged 40 and over was 10.5% and the prevalence of bilateral blindness was 0.3% (both affecting an estimated 18,300 Indigenous Australians aged 40 and over).
  • The 3 leading causes of vision impairment for older Indigenous adults were refractive error (63%), cataract (20%) and diabetic retinopathy (5.5%).
  • Repeated untreated trachoma infections are a cause of vision loss in some remote Indigenous communities, but the prevalence of active trachoma in children aged 5–9 in at-risk communities fell from 14% in 2009 to 4.6% in 2015.
  • The age-standardised proportion of Indigenous Australians who had had an eye examination by an eye-care professional in the preceding 12 months increased from 13% in 2005–06 to 15% in 2014–15.
  • There were 6,404 hospitalisations (4.5 per 1,000) of Indigenous Australians for eye procedures in the two year period 2013—15.
  • Between 2005–07 and 2013–15 the age-standardised Indigenous hospitalisation rate for cataract surgery increased by over 40% from 4,918 to 7,052 per 1,000,000.
  • In 2014–15, the median waiting time for elective cataract surgery was 142 days for Indigenous Australians, with 3.4% of Indigenous Australians who waited for more than 1 year for cataract surgery.
  • Hospitalisation rates for cataract surgery were higher for Indigenous Australians in Remote and Very remote areas combined, while waiting times were longest in Inner regional areas.
  • The number of occasions of service for Indigenous patients under the Visiting Optometrists Scheme (VOS) almost tripled between 2009–10 and 2014–15 rising from 6,975 to 18,890.

Comparison with non-Indigenous Australians

  • Indigenous Australians suffered from vision impairment or blindness at 3 times the rate of non-Indigenous Australians, based on age-standardised rates.
  • In 2014–15, a lower proportion of Indigenous Australians (15%) had had an eye examination by an optometrist or ophthalmologist in the preceding 12 months compared with non-Indigenous Australians (20%), based on age-standardised rates.
  • Indigenous Australians had a lower age-standardised rate of hospitalisations for eye diseases compared with non-Indigenous Australians (10 and 13 per 1,000, respectively), but 3 times the rate for injuries to the eye (1.3 and 0.4 per 1,000, respectively).
  • Indigenous Australians also had a lower age-standardised rate of hospitalisations for cataract surgery than non-Indigenous Australians (7,044 and 8,415 per 1,000,000, respectively).
  • In 2014–15, the median waiting time in days for those who had elective cataract surgery was longer for Indigenous Australians (142) than for non-Indigenous Australians (84).

“We now have a very valuable source of data we can use to improve eye health through better detection, management and treatment of eye disease in Aboriginal and Torres Strait Islander communities,” Minister Wyatt said.

The Indigenous Eye Health Measures report is the first national report on the Indigenous eye health measures.

It brings together comprehensive data from a range of sources and presents this information at the national, state and regional level.

The Australian Government is investing around $72 million over 2013-14 to 2020-21 to improve eye health for Indigenous Australians.

More information about the Indigenous Eye Health Measures 2016 report is available on the AIHW website at http://www.aihw.gov.au/publications/

 

 

NACCHO Aboriginal #EyeHealth : 10 Recommendations to improve eye health services in remote Aboriginal communities.

 eyes

” According to data from the 2016 National Eye Health Survey (NEHS), Aboriginal and Torres Strait Islander adults have a greater burden of eye disease, with three times the rate of blindness and three times the rate of vision loss than the non-Indigenous population.[1] Uncorrected refractive error causes almost two thirds of vision impairment, and cataract is the leading cause of blindness among Aboriginal and Torres Strait Islander people.

Vision 2020 Australia welcomes the opportunity to provide comment to the Productivity Commission (the Commission) regarding its Inquiry into introducing competition and informed user choice into human services (the Inquiry).

Download this full submission here :

vision-2020-australia_productivity-commission_reforms-to-human-services_feb17_final-rtf

Vision 2020 Australia’s response to the Inquiry predominantly relates to improving outcomes in relation to eye health services provided in remote Aboriginal and Torres Strait Islander communities.

Additionally, almost 40 per cent of Aboriginal and Torres Strait Islander people who need cataract surgery have not accessed specialised treatment services (compared to 13 per cent of non-Indigenous Australians), and approximately half of Aboriginal and Torres Strait Islander participants with diabetes were found not to be having an eye examination at the frequency recommended by the National Health and Medical Research Council (NHMRC).

The eye health and vision care sector supports the principle put forward by the Australian Government that refers to introducing informed user choice in these communities. However, the sector has identified a number of challenges posed by the principle of introducing competition in the provision of eye health services in remote communities; due to issues such as the fragmented or duplicated delivery of these services.

In the following submission, Vision 2020 Australia outlines ten recommendations which, if implemented fully, would ensure that eye health and vision care outcomes for Aboriginal and Torres Strait Islander people are improved through better access to effective and reliable services.

Note all 10 recommendation are in this submissions

Recommendation 8

That ACCHOs are offered fair opportunities to compete with non-Indigenous health organisations during competitive tendering processes.

Vision 2020 Australia notes that, in the context of eye health in remote Aboriginal and Torres Strait Islander communities, reforms intended to introduce greater user choice and competition do not necessarily result in positive outcomes. For example, in remote areas, increased competition when providing outreach services can in some cases lead to fragmented service coordination. Vision 2020 Australia therefore contends that mechanisms and approaches to introduce greater competition, contestability and user choice need to be carefully considered.

In remote Aboriginal and Torres Strait Islander communities delivering services collaboratively and in partnership with ACCHOs, and ensuring that the communities are consulted and involved in the design of policies and programs that impact them, is integral.

Furthermore, Vision 2020 Australia notes that the 2015 Senate Finance and Public Administration References Committee inquiry into the impact on service quality, efficiency and sustainability of the Commonwealth Indigenous Advancement Strategy tendering found that competitive tender processes disadvantage ACCHOs and do not fully take into account their value and expertise.[1] It is therefore vital that Aboriginal and Torres Strait Islander organisations are offered fair opportunities to compete with non-Indigenous organisations.

[1] “Commonwealth Indigenous Advancement Strategy tendering processes,” Parliament of Australia, accessed February 14, 2017. http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Finance_and_Public_Administration/Commonwealth_Indigenous.

Vision 2020 Australia

Vision 2020 Australia is the peak body for the eye health and vision care sector, representing around 50 member organisations involved in: local and global eye care; health promotion; low vision support; vision rehabilitation; eye research; professional assistance and community support.

This submission has been developed in collaboration with the Vision 2020 Australia Aboriginal and Torres Strait Islander Committee (the Committee).

The Committee provides a platform for members to collaborate and shape the direction of Vision 2020 Australia’s systemic advocacy related to Aboriginal and Torres Strait Islander eye health and vision care.

The Committee supports and promotes The Roadmap to Close the Gap for Vision (the Roadmap), developed by Indigenous Eye Health at the University of Melbourne, and works closely with the National Aboriginal and Community Controlled Health Organisation (NACCHO) and its affiliates to ensure its strategies are consistent with priorities identified by Aboriginal Medical Services providers in States and Territories.[2]

Vision 2020 Australia supports the submissions put forward by our member organisations, namely Indigenous Eye Health and The Fred Hollows Foundation.

Vision 2020 Australia notes that, in the context of eye health in remote Aboriginal and Torres Strait Islander communities, reforms intended to introduce greater user choice and competition do not necessarily result in positive outcomes

. For example, in remote areas, increased competition when providing outreach services can in some cases lead to fragmented service coordination. Vision 2020 Australia therefore contends that mechanisms and approaches to introduce greater competition, contestability and user choice need to be carefully considered.

In remote Aboriginal and Torres Strait Islander communities delivering services collaboratively and in partnership with ACCHOs, and ensuring that the communities are consulted and involved in the design of policies and programs that impact them, is integral.

Furthermore, Vision 2020 Australia notes that the 2015 Senate Finance and Public Administration References Committee inquiry into the impact on service quality, efficiency and sustainability of the Commonwealth Indigenous Advancement Strategy tendering found that competitive tender processes disadvantage ACCHOs and do not fully take into account their value and expertise.[1] It is therefore vital that Aboriginal and Torres Strait Islander organisations are offered fair opportunities to compete with non-Indigenous organisations.

[1] “Commonwealth Indigenous Advancement Strategy tendering processes,” Parliament of Australia, accessed February 14, 2017. http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Finance_and_Public_Administration/Commonwealth_Indigenous.

Summary of recommendations

Vision 2020 Australia has ten recommendations which, if implemented fully, would ensure that eye health and vision care outcomes for Aboriginal and Torres Strait Islander people are improved through the provision of better access to effective and reliable services.

Recommendation 1
That the Australian Government allocates additional funding to address existing barriers to accessing specialist eye health services in rural and remote areas.
Recommendation 2
That the Australian Government undertakes capacity building for ophthalmic telehealth services.
Recommendation 3
That the Australian Government modifies existing IT infrastructure in remote facilities catering to Aboriginal and Torres Strait Islander health to facilitate efficient and effective telehealth services.
Recommendation 4
That the Australian Government facilitates the introduction of electronic patient record systems targeted for use in remote Aboriginal and Torres Strait Islander communities, with linkages to the broader health system.
Recommendation 5
That the Australian Government provides funding for additional staff trained in the provision of eye health services for remote Aboriginal and Torres Strait Islander communities.
Recommendation 6
That the Australian Government regularly reviews and provides ongoing funding to the Visiting Optometrists Scheme (VOS).
Recommendation 7
That Aboriginal Community Controlled Health Organisations (ACCHOs) and Aboriginal and Torres Strait Islander communities are consulted and involved in the design of policies and programs that impact them.
Recommendation 8
That ACCHOs are offered fair opportunities to compete with non-Indigenous health organisations during competitive tendering processes.
Recommendation 9
That governments ensure that the Aboriginal community controlled sector is a key player in the delivery of culturally safe health services.
Recommendation 10
That services provided to remote Aboriginal and Torres Strait Islander communities are integrated and coordinated so as to ensure an effective patient pathway where comorbidities can be effectively assessed and treated.

 

[1] Foreman, J., et al, 2016, The National Eye Health Survey Report 2016, The Centre for Eye Research Australia and Vision 2020 Australia, Melbourne.

[2] Taylor HR, Anjou MD, Boudville AI, McNeil RJ, 2013, The Roadmap to Close the Gap for Vision, Indigenous Eye Health Unit, Melbourne School of Population Health,The University of Melbourne