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92441 Contemporary Indigenous Health And Wellbeing
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92441 Contemporary Indigenous Health And Wellbeing
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Course Code: 92441
University: University Of Technology Sydney
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Country: Australia
Question:
You are to write a brief explanation of what “Closing the Gap” (CTG) policy is including the history and data that influenced the policy’s creation. You are then to discuss the significance of this policy on Aboriginal & Torres Strait Islander People’s health outcomes using relevant literature and statistics. Please include any challenges and/ or barriers which may have affected the changes.
Answer:
Introduction
Closing the gap abbreviated as CTG is an Australian policy that targets to reduce disadvantages among the indigenous Australians to achieve health status and expectancy to life (World Health Organization, 2011). The system was made by the Australian state to attain indigenous health equality within twenty-five years. This essay shows how the nurses are helping close the gap in aboriginal’s health. It follows a case study of an elderly patient, Judy, an indigenous woman to be precise who is diagnosed with Type II diabetes, has leg ulcers and she is supposed to receive daily dressings at her home.
The essay follows a case study of a registered nurse working at a community health center that does home visits. A new patient Judy, an elderly indigenous mother of two, is discharged in the hospital with type 2 Diabetes and has been assigned to daily dressings. The patient is a widow who lives by herself except his two sons who live nearby and comes to visit her. The referral is from a local AMS, and the plea for dressings was from the aboriginal liaison officer for the nurses to do daily dressings during home visits. The liaison officer cannot come for the first visit for an introduction and an accompanying discharge letter from the hospital states that she may be eligible to be registered for CTG.
Closing the gap policy was made in response to call for the social justice report of 2005 as well as the gap for social justice policy. In 2008, the aboriginals and the Australian government agreed Australian council of governments had put targets to control developments in the health as well as the wellbeing of the indigenous Australians (WHO, 2008). Each year, the Australian Prime Minister releases a closing the gap report to the parliament and provides the continuity on such target. The targets identity some of the challenges experienced by aboriginals, where the attainment of improvement in health & wellness depends largely on the effective implementation of the approaches to attain the targets. According to Wallace e al., (2012) a time frame for the policy target recognize the enormity of the barriers facing the nation and government, integrated, efficient, detailed strategies, as well as policies, will need to be sustained for an extended period to allow targeted improvements be attained.
From the case study, it is mentioned that the patient is eligible to be registered for CGT. The early death of aboriginals is related to the long-term policy of removal of children as well as removal from land culture plus region (Camargo, 2011). Because of these activities, different issues have been raised such as chronic illness like diabetes as evident from the case of Judy, cardiac diseases, and lung diseases. The leading cause of this has been poor nutrition and not getting a proper diet for proteins. Moreover, they are affected by mental health plus abuse of substance which has increased the cases of suicide apart from lacking access to infrastructure, health funding and education. Since the policy keeps changing, the structure remains idle plus small developments are made to live a long life with improved morbidity as well as maternity rates. Marmot et al., (2008) holds that chronic diseases like diabetes are one of the common illnesses that affect the aboriginals more than any other Australians. This is because of the CVDs chronic respiratory complications well as cancer. The illness can be managed though finding the earlier identification as well as management of the risk factors. A CGT can promote good health especially for the case presented through interaction with the local communities as well as the lifestyle of health programs. Besides, it is vital to remove the barriers that help the client access essential services like specialist or healthcare. Moreover, it is much better to build some healthcare systems to attain a high number of patients as well as the workforce of the aboriginal people. According to Meatherall et al., (2005) a CGT should, therefore, understand the need or concept of respectful health system plus cultural safety. They need to be professionally trained to provide care in a way that will not inflict any harm dopant the indigenous Australians .the technicians should also ascertain the primary health care as well as infrastructure for the aboriginals to bring them to standards.
Patient’s eligibility to the CTG aims at providing the aboriginals with existing chronic condition in the view of the prescriber could have impediments in the cure of the ongoing management condition if the prescribed medication was not taken (Campbell et al., 2006). Also, they are unlikely to conform to their treatment regimen without help through the measure. Eligible patients can be registered at indigenous health services in rural and urban areas under the practice incentives program. The closing the gap report shows a tremendous success being attained across the Aboriginal and Torres Strait Islanders, organizations, communities as well as the government at large (Wallace et al., 2012). Registering of Judy on the CTG would improve her health as well as wellness by closing the gap in life expectancy within her generations. Other benefits would be reducing the gap in mortality rate especially for the aboriginal children under the age of five years within ten years. Access to early childhood education would be another key benefit of registering to the CTG especially for those in remote areas within five years. This would ensure the development of the communities due to the knowledge attained from education thus leading to improvements to the social determinants of health (McDermott et al., 2001). The employment gap would be reduced between the non-indigenous and indigenous Australians within the year hence lead to an improvement in their social lives. In attaining such benefits for the Aboriginal and Torres Strait Islanders, the Australian Council of governments has allocated over $4.0 billion over a period of four years across early childhood development, housing, health, economic participation as well as remote service delivery (Santamaria et al., 2004). Besides, the government has received support from the community and corporate sectors. Also, there was an agreement to the creation of national aboriginal representative food, the country’s Congress of austral first people. Therefore, registering to the closing the gap program would have a great impact not only to the life of Judy, but also to the rest of the indigenous Australians where in turn their social aspect of life would have been developed primarily when it comes to securing of employment opportunities, good housing, proper education and proper health care to mention just a few.
It is mentioned in the case study that the client would be referred from the local AMS and referred to dressing from ALO for the community nurse to attend home visits daily for the dressing of the leg ulcer. The AMS and ALO would be referred to Judy for a couple of reasons that will be discussed below.
AMS is a systematic effort to sensitize as well as persuade users of antimicrobials to pursue evidence-based prescribing to stem antibiotic overuse thus developing antimicrobial resistance (Mitrou et al., 2014). Ideally, AMS has been a voluntary self-regulation in the form of policies as well as appeal to conform to the prescribing self-discipline. Nurses are key to AMS approaches success at the patient level because they serve various functions, they determine the prescribing trends, identify targets for quality improvement as well as help the hospitals meet accreditation levels (Petersen & Kwan, 2011). Moreover, the AMS serve other roles including improvement of the patient outcome like patient safety, lower antibiotic resistance as well as reduce unnecessary costs. On the other hand, it is mentioned that the client has been referred to an ALO an aboriginal liaison officer. According to Shepherd et al., (2003), the officer ensures that aboriginals from the ACT as well as NSW have access to mainstream healthcare services. The ALO provides a myriad of services which include emotional, cultural and social support to patients and their families, liaison services for the clients together with their families as well as information regarding hospital services and the connection between the indigenous communities and the hospital. An ALO works in conjunction with the social workers to pursue these services.
Conclusion
Over the years, there has been an effort to close the gap in the disproportionately reduced life expectancy as well as heightened morbidity by the aboriginals compared to the non-aboriginals. Research has also shown that indigenous people are at higher risks of contracting diseases due to the condition they live in which has been attributed to their social life. For the country to progress, it has to give preferences to the issues raised by its people including every citizen. The Australian government needs to take a bold step to promote awareness of the people affected by providing health and cultural values. The aboriginals are less healthy than the non-indigenous Australians due to lack of access to some of the social determinants of health. However, without reducing the disadvantage experienced by the aboriginals even by the programs as well as the benefits health service pays more in developing health conditions. Hence, the government should make a bold move to close the gap by dealing with health matters that have a great impact on death.
References
Camargo Jr, K.R.D., 2011. Closing the gap in a generation: health equity through action on the social determinants of health.
Campbell, K., Teague, L., Hurd, T. and King, J., 2006, July. Health policy and the delivery of evidence-based wound care using regional wound teams. In Healthcare management Forum (Vol. 19, No. 2, pp. 16-21). Sage CA: Los Angeles, CA: SAGE Publications
Marmot, M., Friel, S., Bell, R., Houweling, T.A., Taylor, S. and Commission on Social Determinants of Health, 2008. Closing the gap in a generation: health equity through action on the social determinants of health. The lancet, 372(9650), pp.1661-1669.
McDermott, R.A., Schmidt, B.A., Sinha, A. and Mills, P., 2001. Improving diabetes care in the primary healthcare setting: a randomised cluster trial in remote Indigenous communities. Medical Journal of Australia, 174(10), pp.497-502.
Meatherall, B.L., Garrett, M.R., Kaufert, J., Martin, B.D., Fricke, M.W., Arneja, A.S., Duerksen, F., Koulack, J., Fong, H.M., Simonsen, J.N. and Nicolle, L.E., 2005. Disability and quality of life in Canadian aboriginal and non-aboriginal diabetic lower-extremity amputees. Archives of physical medicine and rehabilitation, 86(8), pp.1594-1602.
Mitrou, F., Cooke, M., Lawrence, D., Povah, D., Mobilia, E., Guimond, E. and Zubrick, S.R., 2014. Gaps in Indigenous disadvantage not closing: a census cohort study of social determinants of health in Australia, Canada, and New Zealand from 1981–2006. BMC Public Health, 14(1), p.201
Petersen, P.E. and Kwan, S., 2011. Equity, social determinants and public health programmes–the case of oral health. Community dentistry and oral epidemiology, 39(6), pp.481-487.
Santamaria, N., Ellis, I., Carville, K. and Prentice, J., 2004. The effectiveness of digital imaging and remote wound consultation on healing rates in chronic lower leg ulcers in the Kimberley region of Western Australia. Primary Intention, 2, pp.62-70.
Shephard, M.D.S., Allen, G.G., Barratt, L.J., Barbara, J.A., Paizis, K., McLeod, G., Brown, M. and Vanajek, A., 2003. Albuminuria in a remote South Australian Aboriginal community: results of a community-based screening program for renal disease. Rural and remote health, 3(8).
Wallace, B.C., Dahabreh, I.J., Trikalinos, T.A., Lau, J., Trow, P. and Schmid, C.H., 2012. Closing the gap between methodologists and end-users: R as a computational back-end. J Stat Softw, 49(5), pp.1-15.
WHO Commission on Social Determinants of Health and World Health Organization, 2008. Closing the gap in a generation: health equity through action on the social determinants of health: Commission on Social Determinants of Health final report. World Health Organization.
World Health Organization, 2011. Closing the gap: policy into practice on social determinants of health: discussion paper
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