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THE “OUTREACH” PROGRAM: A CONSULTANCY TO REDUCE CHRONIC DISEASE MORBIDITY AND MORTALITY IN ABORIGINAL PEOPLE
Author(s) -
We Hoy,
A Kelly,
M. Carmody
Publication year - 2000
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1046/j.1440-1797.2000.005003a113.x
Subject(s) - medicine , outreach , life expectancy , workforce , socioeconomic status , health care , patient education , intervention (counseling) , disease , gerontology , nursing , family medicine , population , environmental health , pathology , political science , law , economics , economic growth
Background: Aborigines in remote Australia are experiencing an epidemic of chronic disease. The “metabolic syndrome”, type 2 diabetes, hypertension cardiovascular, renal and chronic lung disease contribute to a 20‐25 yr reduction in life expectancy, and vast increases in renal failure. Prevention depends on socioeconomic advancement, education and better primary health care. However, modification of disease in people already afflicted is critical to stabilise families and communities. The Tiwi program has shown how quickly lives can be saved and dialysis avoided by timely intervention. The Outreach Program. will extend to other communities principles of risk factor identification, early diagnosis and treatment, that are already included in most regional & national guidelines. The program is supported by Rio Tinto and OATSIH, through the Australian Kidney Foundation. Diabetes Australia and the National Heart Foundation are collaborating for a unified approach. Program elements include education, training, algorithms for testing and treatment that emphasise simplicity, on‐site testing, familiarity with a limited number of medicines, ongoing medical support, help with recall & information systems and evaluation of process and outcomes. Participation of communities might be based on need (deaths and ESRD rates), unanimous request, and commitment of staff to participate in training, so that practices will be subsequently maintained in health care plans. Mechanisms of support will vary, based on the specific needs of each community: eg health worker training, local coordinators, facilitation of screening, refinement of medical management, and support of Aboriginal health promotion officers. A similar program, with a somewhat different approach, will operate from Flinders University. The program's reach and impact could be multiplied by establishing regional centres or reinforcing existing regional strategies nationwide, and asking local governments, NGOs and universities to bring additional support.