Executive Summary
The mission of this project is to facilitate fulfillment of health sector goals that are key to eradication of poverty among less privileged communities in Australia. Apparently, health challenges facing aboriginal communities include increased reduced fertility rates, maternal and child mortality, malnutrition, tuberculosis and the burden of HIV/AIDS. To attain goals set out in this project, the program will follow the goals outlined in health sector strategic plan (HSSP) that covers a period from 2012 to 2017. The overall goal of HSSP is to achieve good standards of health for all people in Australia in order to promote productive life and individual health. HSSP outlines the priority activities that both the government and private sector should address. Regrettably, the funding of health sector has always been inadequate and marginalized people tend to suffer most. In order to ensure that marginalized families access quality health care, education on best living practices is very critical. The government has spelt out minimum package for healthcare that should be availed to every citizen. This package is based on cost effective and evidence based interventions that address diseases that face majority of Australians. However, many families from marginalized communities know little if none of the importance of services such as polio vaccination, good nutrition, family planning, importance of education, activities envisaged to raise income levels and hence improved living standards among others. Therefore, this project is envisaged to enlighten the marginalized communities on the importance of these services that are paramount to decent modern life. Implementation of this program is expected to raise awareness among aboriginal families that are heavily affected by the traditional ways of living making them lack some of the critical and basic necessities in life. It is believed that with successful implementation of this program, the marginalized communities will be able to adjust their living standards and work towards a more healthy and modern life.
Introduction to the program
Many families across the globe are still faced with numerous health challenges in 21st century. In Australia, the hardest hit is aboriginal families who have defied modernized way of living. The traditional set up denies them some basic facilities that are paramount for a decent and healthy life. In the face of modernization, a lot of inventions have taken place and the main aim of such inventions is to improve people’s lives. However, any community that defies such benefits of modernization continues to wallow in life challenges that date back to origin of humankind (Freemantle, Officer, McAullay & Anderson, 2007). In Australia, the Aboriginal families still live in forests with no learning and basic medical facilities. This has led to majority of such families suffer from simple ailments that can be prevented through vaccination and good nutrition. This program will enlighten such communities on primary healthcare services that can help in preventing avoidable loss of lives. The program will include community organizer, traditional birth attendant, and nutritionist cum health educator, public health supervisor and supervisory technical staff. The main focus of the program is to educate marginalized people on health services including family planning, immunizations, nutrition, and mother and child healthcare. The program will devise innovative training, recording, reporting and monitoring system. This paper focuses on accessibility of primary healthcare amongst marginalized communities in Australia.
Situational Analysis
Rationale
Even with the emergence of numerous rural health initiatives over the recent years, health needs of many marginalized Australian communities have not been adequately met. Many residents in remote areas continue to live in deplorable health conditions compared to other residents in metropolitan areas. The government and other providers of primary health care are working tirelessly to enhance accessibility of primary healthcare by millions of residents in remote and rural areas (Sridhar & Batniji, 2008). However, lack of education and impact of culture has been a significant impediment in enhancing accessibility. For instance, the Aboriginal people prefer using traditional herbs to cure common ailments. In addition, expectant mothers shun medical facilities and instead get assistance from traditional birth attendants for fear of being attended to by male nurses.
Lack of basic education and reduced awareness on the importance of basic health care causes many families not to take advantage of the available health care services. According to Victora, et al., (2008), the number of indigenous people increases as you enter the remote areas. As aforementioned, lack of awareness, lower incomes, and poor education contributes to poor health outcome. In this vein, the government has put in place health care facilities, but primary health for indigenous Australians still lags behind compared to those of other Australians (Tobias, et al., 2006). Primary healthcare is cost effective and seeks to prevent rising common and chronic ailments. There is compelling evidence that primary healthcare is critical for improved health outcome.
Recent data indicates that government has increased spending on Aboriginal families’ health care. According to Condon, Barnes, et al. (2004), through the new primary health care program, it is evident that funding was increased from £ 233 in 1999 to £ 426 in 2010 per indigenous person. Although the number of people seeking medical services still remains low, these figures indicates a real increase in primary health care spending which also led to significant increase in staffs to facilitate service delivery. However, as the government continues to invest in primary health for all, morbidity and mortality rates for indigenous people continue to rise. Bertozzi, et al. (2007), argues that avoidable mortality rates are used to assess the impact of failure to utilize primary health care services on marginalized communities. The data from figure 1 below indicates a marginal decline in mortality rates amongst indigenous people. However, the number of people dying of avoidable ailments still remains high compared to those of other Australians. These trends indicates that despite provision of primary health care, majority of aboriginal communities still do not utilize them properly hence continued loss of lives from preventable ailments that could otherwise be avoided. Figure 1 below indicates a marginal decline of about 22% between years 2001 and 2003. This rate indicates a favorable effect of conventional health care system on the health of marginalized communities.
Figure 1: Mortality rates from avoidable causes
Mortality per 100,000 Persons
Period in years
Figure 2: Gender distribution in avoidable mortality
Mortality per 100,000 Persons
Period in years
Figure 2 above indicates how females are vulnerable to avoidable ailments than their male counterparts. This is because females are highly vulnerable to various ailments that can cause death if not treated in good time. In addition, culture seems to affect women more than men since according to traditions; women are not allowed to expose their nakedness to other men other than their husbands. This cultural requirement prevents many women from seeking medical care particularly when giving birth considering that most of the attendants are men. Another observation from figure 1 and two above is that large number of children succumbs to avoidable ailment compared to adults. Notably, most children from aboriginal families are not vaccinated against common life threatening diseases such as polio, tuberculosis, measles and diphtheria. However, faced with such deplorable living conditions, most of these children are susceptible to ailments and due to parents’ perceptions against conventional medical care; they hardly get proper medical attention and end up losing life. Evidently, as life expectancy gap between indigenous and non-indigenous people widens, so is the mortality and morbidity rates. According to Australian Institute of Health and Welfare (2007), the mortality rate for indigenous people stood at 11.6% against 3.4% for non-indigenous people in 2007. Nevertheless, it is worth noting that the mortality rate amongst the indigenous communities is currently on the decline following expansion of primary health care, although more needs to be done to raise awareness amongst these communities in order for them to fully utilize the available medical facilities.
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