Alicia Jackson is an Adnyamathanha woman, from the Far North Flinders Ranges which is located about seven hours north of Adelaide. Alicia is currently employed as an Aboriginal Health Practitioner with Pika Wiya Health Service in Port Augusta, which is about a four-hour drive north of Adelaide. Alicia commenced employment as a medical receptionist at Pika Wiya Health Service in 2011; she then set her sights on training and completed her Certificate IV in Primary Health Care Practice in 2017. Alicia is committed and passionate about improving the health and wellbeing of all Aboriginal and Torres Strait Islander people and ensuring that they are receiving the best possible holistic care. Alicia played a vital role within the Port Augusta community and surrounding areas, participating in the meningococcal ACWY mass vaccination clinics, which were undertaken at Pika Wiya Health Service in Port Augusta in 2018.
Background: The Aboriginal Health Council of South Australia (AHCSA) is the peak body for Aboriginal health in South Australia (SA) and is committed to ensuring all Aboriginal people enjoy a high quality of health and wellbeing. In late 2017, an outbreak of meningococcal W in central Australia and in parts of SA affected mostly young Aboriginal and Torres Strait Islander people.
Meningococcal disease is an uncommon but serious infection. The initial outbreak response led by SA Health offered community-wide vaccination to two regions where increased cases had been detected. Subsequently a time-limited SA Health funded program was made available to Aboriginal people aged one to 19 years in regional and remote SA. Delivery of the funded vaccine program to the population at risk was largely the responsibility of primary health care providers. Rural and remote Aboriginal health services are frequently under-resourced and support was required to make these vaccinations accessible to Aboriginal people across SA.
Aim: Support the coordination and delivery of meningococcal ACWY vaccination programs in Aboriginal community controlled health services (ACCHSs) in regional/remote SA.
Method: AHCSA public health staff consulted with local ACCHSs, councils and schools regarding support needs to ensure people were aware of and had access to the vaccine during the funded program. Analysis of support requirements was completed for each region and funding sourced.
Results: AHCSA collaborated with Umoona Tjutagku Health Service and coordinated the Coober Pedy regional response. Vaccines weren’t available prior to a three day, AHCSA supported clinic, where 130 people were vaccinated. At Pika Wiya Health Service in Port Augusta, 32 people were vaccinated prior to four-day clinics where an additional 325 people were vaccinated. In Whyalla at Nunyara Aboriginal Health Service, 154 clients were vaccinated prior to the AHCSA supported three-day clinics where a further 164 people were vaccinated.
Discussion: The funded program in SA responded to increased numbers of Aboriginal young people with the meningococcal W strain including two communities where an outbreak was declared. In this situation it is important to ensure as many people as possible are vaccinated in a short time period which requires activities beyond ‘usual’ primary care. This required stakeholders to work in partnership with local communities to increase capacity and ensure equitable access. Collaboration and extensive planning resulted in successful mass vaccination clinics across SA. Working ‘better together’ with Aboriginal communities was imperative to ensure tangible access to this time-limited vaccine.
Karen Johnson is a proud 'Birri' woman from Bowen in north-east Queensland, who now calls Goondiwindi home; she was born and raised here. Karen started working for Queensland Health in 2003 as an operational officer and it was here Karen realised she wanted to do bigger and better things for her people and went on to do an endorsed enrolled nursing course. After working part-time in both of these roles Karen was approached to take on a full-time advanced Indigenous health worker role for maternity, child and family health and has been in this role for eight years. She feels extremely privileged to be a part of the birthing and early childhood years of the women and children. Karen is part of a maternity case load model that goes across border to the women in Toomelah, for antenatal care and these moments are very engaging and opportunistic times to assist holistically. Karen has also been involved in the Advance Care Yarning APP development project over the last 18 months in reviewing with an Indigenous Reference Group the cultural aspects developed. Karen has two sons and strives to be a role model for both of them.
Aboriginal Australians view life and death differently than non-Aboriginal Australians. Observations by the DON/Facility Manager at the Goondiwindi emergency department foyer showed young and older Indigenous people interacting with technology. There was no easy to understand, ‘culturally specific’ End of Life (EOL) care resources for the Indigenous population.
The APP aims to provide a culturally sensitive way to engage with Aboriginal people to gather their information about family, health care wishes. Yarning with the Indigenous reference group assisted with the APP illustrative framework of fishing by the river in their bush setting.
This APP will be trialed with the Indigenous community in Goondiwindi Hospital.
This project was a need and fits within the Minister for Health endorsed Queensland Health’s first Statewide strategy for end-of-life care 2015 and the Department of Health endorsed associated Care at the End of Life Implementation Plan 2015-2025.
Dr Dianne Jonasson is a post-doctoral researcher with The University of Notre Dame Australia Rural Clinical School in Wagga Wagga, NSW. Dr Jonasson has extensive experience working with culturally and linguistically diverse (CALD) people as an English language teacher, IELTS examiner, coordinator of the Adult Migrant English Program (AMEP), researcher and academic. Dr Jonasson’s PhD thesis was a critical ethnographic study that explored the challenges facing international students, and their teachers, in an Australian university. The qualitative study involved 85 in-depth interviews with 74 participants from 23 countries. Dr Jonasson has presented papers on her research findings and methodology, including the interpretation of data, in both Australia and Sweden. Dr Jonasson has also worked extensively with Aboriginal and Torres Strait Islander students. As Learning Skills Adviser with Ngungilanna, Indigenous Education Centre at Charles Sturt University, she supported Indigenous students from remote and rural Australia and the Torres Strait Islands, as they undertook their tertiary studies as internal, external and mix-mode students.
It is well-documented that significant inequities exist in the health outcomes of women in Australia, influenced by a range of factors, two of which are Aboriginality and ethnicity. Research consistently reports that Aboriginal and Torres Strait Islander women (hereafter respectfully referred to as Indigenous women) and Culturally and Linguistically Diverse women (hereafter respectfully referred to as CALD women) frequently do not access breast and/or cervical screening. Reviewed literature consistently identifies barriers which prevent or hinder Indigenous and CALD women from participating in health screens, both in Australia and overseas. Despite the cultural diversity of the women studied, many barriers appear to be similar. This study focused on identifying barriers and enablers to breast and/or cervical screening for Indigenous and CALD women in regional Australia as part of a larger project to develop a model which aims to raise their awareness of breast and cervical screening services and increase their participation rates.
Working in collaboration with local Indigenous groups and multicultural organisations, initial information sessions were held for Indigenous and CALD women separately. Those eligible for breast and cervical screens were invited to join ‘yarning’ or ‘discussion’ (focus) groups, followed by free screens and post-screen interviews. Group bookings were arranged, lunch was offered, and transport was provided to and from the clinic. Feedback to date suggests that this model successfully addresses some of the barriers, by providing women from different cultural backgrounds with information and practical help to navigate the health system. The groups included Indigenous, Afghani, Yazidi, Sudanese, Burundian and Nepalese women.
Analysis of the data revealed that many barriers and enablers facing these women are similar, regardless of their cultural background. Barriers identified in the data and the literature included: lack of awareness and information; lack of health literacy; communication problems; cultural beliefs, shame and/or fear; difficulty navigating the health system; and competing health/life priorities. Likewise, similarities were identified in the enablers which included: information sessions; support from other women in the community; group bookings; provision of bilingual healthcare navigator services; transport; and reminders/prompts when screens are due.
The literature also suggests that more research is needed to provide further insights into the differences between cultural groups. Rather than focusing on the differences between cultural groups, however, focusing on the similarities of the barriers and enablers can offer greater guidance for the design of a breast and cervical screening model that may increase participation rates for more women.
Martin Jones has experience in conducting clinical trials in preparing health care professionals to practice evidence-based psychological interventions. This has involved over 1000 health care professionals involving over 1000 patients. Total grant funding (National Institute for Health Research (NIHR), European Union, NHS Trusts, Primary Health Network, BHB Bulletin, and Nurses Memorial Fund) exceeds A$1.5m. His key interests are improving access to physical health care services for people living with serious mental illness and increasing access to health services for people living with comorbid depression. Martin trained in mental health nursing at Barts College of Nursing London and Mental Health Interventions at the Middlesex University. Martin’s doctoral training was undertaken at the University of Essex. Since 2013, Martin is the Director, University of South Australia Department of Rural Health. Before acquiring an academic leadership role in rural Australia, Martin worked in mental health/health services planning, having held mental health leadership roles in the UK. He was involved in establishing Regional Community Mental Health Teams and was locality manager for a comprehensive service model for people with serious mental illness in south-east London. Martin currently chair’s the Australian Rural Health Education Network.
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Meet the editors of The Australian Journal of Rural Health in a special session designed to clarify publishing procedures and improve your chances of being published in our journal and others.
Editor in Chief Russell Roberts and Associate Editors will be available to discuss the editorial policies and priorities of AJRH and answer your publishing questions.
New and established authors are welcome!
Now in its 25th year of publication, AJRH provides research information, policy articles and reflections related to health care in rural and remote areas of Australia. Since its inception, AJRH has contributed significantly to the publication of research reports and expert opinion on rural and remote health.
Matt Jones has a passion and commitment to improving health outcomes in rural areas. Matt has acquired extensive management experience in several health care environments specifically in public health, Indigenous health, acute health and most recently primary health care all within rural, remote and regional settings throughout Australia. Matt’s professional career has been devoted towards supporting communities and their members to access better, more responsive and more connected health care. Prior to his current position as CEO with Murray PHN, Matt held the position of CEO of Loddon Mallee Murray Medicare Local for its three years of operation. Matt previously worked as a CEO within the Division of General Practice Network for seven years, including his final two years employed simultaneously as the CEO of both Murray-Plains Division of General Practice and Central Victoria General Practice Network. In addition, Matt has worked for several years in health care management in Aboriginal communities in remote NT and WA, Aboriginal health in Townsville, Queensland, public health in the Pilbara, Western Australia, senior policy development in Melbourne and acute health management in rural Victoria.
This interactive session will consider the impact PHNs have made in a rural setting.
Participants will hear about the PHN role in system change, service improvements and quality care for patients.
Participants will consider:
- capacity building—strengthening access and service provision in rural areas
- Coordination—developing models of care in markets where there are limited providers or considerable market failure
- Collaboration—how to harness the power and compound benefits of partnerships to further integrate the workforce.