Health Sector Strategic Plan in Australia - Assignment Example

? Health program Plan and Contents Executive Summary 3 Introduction to the program 4 Situational Analysis 4 Identify existing & emerging environmental factors that may affect the program 8 Speculate future issues that may be considered 10 Identify stakeholders who may be involved or consulted 10 Review competitive environment in which the program will be implemented 10 Describe any additional data that need to be collected to complete feasibility 11 Describe how additional data will be collected 11 Target Group 11 Goal and Objectives 12 Program activities 13 Timeline 15 Evaluation 16 Budget and Resources 16 Risk Analysis 17 References 18 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. Feasibility Assessment Identify existing & emerging environmental factors that may affect the program Political factors Provision of primary healthcare has been an issue of concern amongst the political circles. It has been established that many marginalized communities lag behind in development because of more inclination to their culture. However, to shift from the current way of living creates the need to synchronize marginalized communities with the modern society (Australian Institute of Health and Welfare, 2007). These communities have previously shown resistance in an attempt to introduce modernized ways of living. Similarly the same challenges are expected to be witnessed when rolling out this program. Nevertheless, we shall incorporate influential people from the community including community leaders who are capable of wooing them to attend our training sessions. Economic The funding for this program is restricted to AUD ? 150, 000. This means that we have to restrict our spending to this amount and therefore the program which could have otherwise run for an extended period of time will be short lived (Australian Institute of Health and Welfare, 2008). Staff hired to train the community on importance of primary healthcare needs to be paid. There are also other incidental costs to be incurred making funds provided to be insufficient. Social Undeniably, most marginalized communities suffer high illiteracy level that is among the main reasons contributing to low utilization of conventional healthcare. In this regard, teaching local communities will be a big challenge as most of them cannot understand English language. According to Australian Health Ministers Advisory Council (2006), another challenge likely to be faced concerns the appalling poverty levels. People targeted to benefit from the program may fail to attend the training sessions due lack of transport. Most of them are poor and may not afford travelling fee to sites where training sessions will be taking place. Nonetheless, this could add to program cost as we shall be needed to not only mobilize them to participate, but also arrange for their transport to the training centers. Technological Considering the level of development in marginalized communities, technological development is lagging far much behind. This means program accessibility will only be restricted to physical attendance as other means such as social media cannot be utilized (Aguilera and Marrufo, 2007). Environment With many families from marginalized communities living in slums and forests, it will be such a daunting task to roll the program. This is because the program requires facilities such as halls where people can be assembled for training. However, program organizers will hold training from open social grounds though still faced with problem of weather change which could hamper training sessions. Legal To roll out the program, a legal permit needs be acquired from the authorities. In addition, the program must be cleared by medical board that requires training team to comprise of qualified personnel. Speculate future issues that may be considered Since it has become evident that marginalized communities fail to seek conventional primary health care due lack of information, the program may in future organize to train local community member who can be moving across villages training community members on the need to seek conventional healthcare services (Hall, et al., 2009). We can also use the results of this program to entice the government to not only provide primary healthcare, but also engage in similar campaigns to sensitize people on the need of seeking services availed to them. Identify stakeholders who may be involved or consulted Stakeholders includes the government that will provide policy framework on training marginalized communities, the program sponsors to provide finances, public health officials and nutritionist to oversee the program and train community members, village leaders to mobilize people and an accounting officer to manage resources provided. Review competitive environment in which the program will be implemented It has been witnessed that lack of information and effect of culture are the major contributing factors to marginalized community health problems. Therefore, people are expected to turn out in large numbers to attend training seminars at designated areas. At these points, participants will listen to training sessions that will be administered in local languages. They will also get an opportunity to consult doctors. The doctors will take this opportunity to enlighten them by giving advice using charts while at the same time providing counseling services. Describe any additional data that need to be collected to complete feasibility Considering that most marginalized families have overtime used traditional medicines, many families prefer using traditional medicines at the expense of conventional ones. Therefore, it is important to collect data on various herbal medicines that different communities have been using and assess their efficacy (Read, et al., 2006). This will help in making decision on how such traditional medicines can be integrated within the healthcare system in order to help in countering ever-increasing ailments. Describe how additional data will be collected The entire training session should be recorded. This will also include one to one interaction between trainers and community members. The health professionals should have a pre-prepared set of questions to be administered to the participants on one to one basis. In this case the response from participants can be recorded and later analyzed to provide additional data. Target Group The program is aimed at marginalized communities with family size of between five to eight members. This is because such families were found to suffer most from health problems facing marginalized communities. The program will concentrate on remote areas where superstition is extreme, illiteracy levels rampant and poverty is an accepted fact in the community daily live hood. Following our observations, in-depth interviews and group discussions, it was established that these communities suffer some serious social economic challenges. Zhao and Dempsey (2006) argue that child mortality and morbidity is on the rise due to increased cases of malnutrition and dehydration. Many people are ignorant of the family welfare due to high levels of illiteracy. Areas to be cover include three villages located in South Australia, where health problems are more severe. The three areas were found to have a single government health facility each that is underutilized. These areas were also found to lack basic amenities such as wells for water (Vos, Barker, Stanley & Lopez, 2007). Naturally, most of people were found to rely on pond water that was highly polluted. Training sessions will be established at Yankunytjatjara, Anangu, Pitjantjatjara villages that are believed not only to be the focal points, but also highly populated. At these three training camps, the program will try to target approximately 6,000 people who will benefit directly from the program while another 2,000 benefit indirectly. Nevertheless, the program will ultimately help in achieving the goal of better health for all besides serving as a model program. Goal and Objectives The main goal of this program is to achieve better health for all. To attain this, the program will identify volunteers who can be trained towards educating the community on the need to seek primary health care for better health. Such volunteers will work together with public health supervisor, traditional birth attendants and community organizers in raising awareness amongst marginalized communities. With increased families as a result of uncontrolled births, the program will also try to encourage the communities to use family planning methods available in health facilities (Wilson, Condon, et al., 2007). Although, many people may not be willing to adopt modern health care systems, the program will use mechanisms that will help in bringing out the importance of having controlled families not only to individual families, but also the community and society at large. With such understanding, people will gain confidence in adopting family planning controls. Another fact that is difficult to ignore is that traditional medicines are deep rooted amongst marginalized communities. Considering this fact, the program will try to integrate both westernized and traditional systems of healthcare. On the other hand, the objectives of this program include minimizing incidences of maternal mortality, malnutrition, dehydration and more importantly child morbidity and mortality. In addition, the program seeks to increase number of people seeking immunization services for their children, ante natal and post natal care. According to Muller and Gregory (2001), the other important objective is to educate mothers on the need to meet nutritional needs of their children for normal health through nutritional education. Further to enhance better health, the program will support health related activities such as provision of low cost clean drinking water, proper sanitation, literacy levels among others. Lack of basic education has been identified as one of the reasons why marginalized communities still lag behind particularly in social development. The data collected in this program will be used to influence the government to construct more educational facilities and intensify campaigns to sensitize marginalized communities on the need to educate their children. Program activities Setting up training centers The program will be run in three villages by three different groups. Due to lack of basic amenities, training sessions will be conducted from open ground which will be hired from respective local authorities. The organizers will also hire facilities such as tents, chairs, table and public address system. We will also hire three four wheel drive vehicles that will be able to travel on rough remote terrain. The community organizers, public health supervisors, nutritionist cum health educators will be issued with materials to train mothers on nutrition and importance of child immunization. The three training centers will also serve as counseling centers. Community training and education To realize a paradigm shift from the old odd practices, the program seeks to impart marginalize communities the required training in order to equip them with adequate knowledge to enable them lead a better quality life. As observed by Thomas, Condon, et al. (2006), lack of basic education has been one of the greatest contributing factors to poor living conditions. In this vein, the communities do not understand the need of having safe drinking water, good nutrition for children, proper sanitation, all of which are paramount for a good life. Counseling Maintaining manageable families is necessary for better living standards. This is because parents will be able to use the resources available to provide decent living standards for their families. However, this has not been the case for many marginalized families. Notably, these families were found to lack control for enlarged families. The program therefore aims at educating mothers on various birth control methods available at government hospitals. Other areas where counseling services will be important includes early identification of high risk pregnancies in order to avoid child and maternal mortality, the need for child vaccination and more importantly the need for low cost nutritious food for children to prevent cases of malnutrition (Starfield & Shi, 2002). Training community organizers, volunteers and traditional birth attendants These are members of local communities who are sought to help whenever a problem arises. The program will equip them with necessary skills to continue training the communities even after the end of this program. Undeniably, was it not for limited resources, the program could run for an extended period of time in order to reach many people. Timeline Gantt chart: shows time to be taken to complete the program Week 1 week 2 week 3 week 4 week 5 Setting up and organizing the training Community training and Education Counseling Training local organizers, Volunteers and TBA’s During the first week, program organizers will spend much of their time setting up the training centers while at the same time moving across villages inviting people to attend. At the start of the second week, the organizers will embark on their main activity of training and educating marginalized community members on the importance of primary healthcare. Counseling will be done on the forth week and it is at this time that the organizers will meet face to face with participants and therefore will be able to collect more valuable information. By end of forth week, the program will have wound up engaging with participant and the fifth week will solely be dedicated to training local organizers, volunteers and traditional birth attendants who will be left to continue training the local communities. Evaluation This program is aimed at educating and creating awareness amongst the indigenous communities on the importance of primary health care. Evidently, massive loss of live has been witnessed amongst the communities due to poor living conditions. In addition, this problem has been aggravated by high degree of illiteracy which has led to enlarged families that are difficult to provide for. In this light, the program seeks to influence the marginalized communities to shift from their traditional way of life to more civilized living standards. According to Shi, Macinko, et al. (2004), sound mechanisms should be put in place to help assess the impact of this initiative. For instance, the program organizers should monitor turnout in health facilities to determine if people are changing from traditional to modern health systems. In addition, they should from time to time monitor child immunization records to find out if parents are having their children vaccinates. Further, future visits to the villages will also be critical as the program organizers can assess the number of homesteads with proper sanitation systems, clean and safe drinking water and more importantly healthy children. Budget and Resources Budget AUD ? AUD ? Available amount 150,000 Hiring three open grounds 12,000 Hiring of furniture, public address system and tents for use by program organizers 9,500 Preparation of training materials 13,500 Organizers transport costs 7,500 Refreshments 3,000 Allowances for trainers a, organizers and program accountant 76,250 Cost of training local organizers, volunteers and TBA’s 22,000 Miscellaneous costs 6,250 Total expenditures (150,000) The program has been financed to a tune of AUD? 150,000. This amount will be utilized in hiring open ground where participants will be assembled. Furniture, public address system and tents will also be hired for used by the program administrators. Further, since the main goal of this program is to train the indigenous people, training material including pictures, sample food stuffs, food supplements, drinking water purification chemicals among other will be necessary. The program administrators will be required to travel around the villages announcing about the training program and therefore transportation will also be critical. In addition, moving trainers from the urban centers together with their training materials will also need means of transport. Notably, the program involves service delivery and therefore, a huge chunk of the program budget will go to allowances for trainers, organizers and the program accountant. Nevertheless, to encourage local to volunteer the program organizers will also provide them some allowances. Finally, AUD 6,250 will be set aside for any other expense that may arise. Risk Analysis With endemic illiteracy levels, lack of information and orientation towards culture, many villagers do not understand the need for low cost nutrition, immunizations, birth control, and importance of sanitation. More so, majority of them are believed to be superstitious coupled with wrong treatments aggregates their health problems. In this vein, the incidences of child morbidity, mortality, maternal mortality, malnutrition and dehydration continues to increase (Peabody, and Liu 2007). However, lack of proper education and increased belief in culture and traditional way of living continues to hamper the benefits carried by this program. In this sense, proper mechanisms must be devised to ensure that the program is administered in a way that realizes optimal benefit to the marginalized people. In this case, the program accommodated influential locals who can trust be trusted by local communities. Another major risked faced by this program is reduced impact within the entire marginalized communities. Due to limited resources, the program will only cover three villages hence not able to access many areas in dire need of such training services. This may cause little effect in the marginalized society hence failure to achieve the desired goals of better health for all. References Aguilera, N. and Marrufo, G.M., (2007). Can better infrastructure and quality reduce hospital infant mortality rates in rural Australia? Health Policy, 80 (5), 239-252. Australian Health Ministers' Advisory Council (AHMAC), (2006). Aboriginal and Torres Strait Islander Health Performance Framework Report 2006. AHMAC. Canberra. Australian Institute of Health and Welfare (AIHW), (2007). Aboriginal and Torres Strait Islander Health Performance Framework Report 2006: detailed analyses. Canberra, AIHW. Australian Institute of Health and Welfare, (2008). Expenditures on health for Aboriginal and Torres Strait Islander peoples 2004–05. AIHW. Canberra. Tobias, M., et al., (2006). Australian and New Zealand Atlas of Avoidable Mortality. Adelaide, PHIDU, University of Adelaide. Bertozzi, S.M.,et al., (2007). The Costs, Benefits and Cost-Effectiveness of Interventions to Reduce Maternal Morbidity and Mortality in Mexico. PLoS ONE 2(8), 750 -755. Condon, J. R., Barnes, T. et al., (2004). Long term trends in cancer mortality for Indigenous Australians in the Northern Territory. Medical Journal 180 (19), 504-507. Freemantle, J., Officer, K., McAullay, D. & Anderson, I., (2007). Australian Indigenous Health—Within an International Context. Cooperative Research Centre for Aboriginal Health, Darwin. Hall, A. et al., (2009). The costs and cost-effectiveness of mass treatment for intestinal nematode worm infections using different treatment thresholds. Neglected Tropical Diseases 3 (3), 402-410. Peabody, J.W., and Liu, A., (2007). A cross-national comparison of the quality of clinical care using vignettes. Health Policy Plan 22(5), 294-302. Read, C. et al., (2006). Patterns, trends, and increasing disparities in mortality for Aboriginal and non-Aboriginal infants born in Western Australia, 1980–2001: population database study. Lancet 367(9524), 1758-1766. Shi, L., Macinko, J. et al., (2004). Primary care, infant mortality, and low birth weight in the states of the USA. J Epidemiol Community Health 58(5), 374-80. Sridhar, D. and Batniji, R., (2008). Mis-financing global health: a case for transparency in disbursements and decision-making. Lancet 55(23), 372: 375. Starfield, B., and Shi, L., (2002). Policy relevant determinants of health: an international perspective. Health Policy 60(3), 201-218. Thomas, D. P., Condon, J. R. et al., (2006). Long-term trends in Indigenous deaths from chronic disease in the Northern Territory; a foot on the brake, a foot on the accelerator. MJA, 185(45), 145-150. Muller, T and Gregory, J., (2001). Avoidable mortality in New Zealand, 1981-97. Australian and New Zealand Journal of Public Health 25(1), 12-20. Victora, C.G. et al., (2008). Maternal and Child Under nutrition Study Group. Lancet. 371(9609), 340-357. Vos, T., Barker, B., Stanley, L. and Lopez, A.D., (2007). The burden of disease and injury in Aboriginal and Torres Strait Islander peoples. Brisbane School of Population Health, The University of Queensland. Wilson, T., Condon, J. R. et al., (2007). Northern Territory indigenous life expectancy improvements. Australian and New Zealand Journal of Public Health 31(2), 184-188. Zhao, Y. and Dempsey, K., (2006). Causes of inequality in life expectancy between Indigenous and non-Indigenous people in the Northern Territory 1981-2000: a decomposition analysis. MJA 184 (36), 490-494. Read More