A Model of Partnership for Outreach Optometry Service Delivery in Central Australia, Northern Territory
Central Australian Aboriginal Congress Aboriginal Corporation (Congress) is an Aboriginal community controlled health organisation, a member of the peak body NACCHO, the National Aboriginal Community Controlled Health Organisation and the largest Aboriginal community controlled health organisation in the Northern Territory.
Congress was established in 1973 to support and advocate for Aboriginal people in the struggle for justice and equity
Map of Central Australia (image source, click here to zoom in): https://ocpe.nt.gov.au/__data/assets/pdf_file/0005/243887/nt_ps_remote_localities_as_at_March_2010.pdf
Congress provides comprehensive primary health care to Aboriginal people in and nearby Alice Springs including five remote health clinics in Central Australia.
Aboriginal people represent just over 3% of the Australian and 30% of the Northern Territory (NT) population. Prevalence of eye and vision problems is far greater among Aboriginal Australians, who experience blindness and vision loss 3 times more commonly than the wider Australian population. Almost all (>90%) of that vision loss is preventable or treatable, yet nearly 40% of the Indigenous needs for eye exams is not provided.
Access to eye care practitioners is infrequent and limited for Aboriginal Australian living in remote areas, due in part to insufficient availability of both optometrists and ophthalmologists. In fact, the relative number of, and therefore, rates of eye exams, by ophthalmologists and optometrists are generally lower in areas where there are more Indigenous people.
These access barriers clearly contribute to the 'gap in vision'. Heather Wilson, Eye Health Coordinator, Congress
Pictured: Heather Wilson, Eye Health Coordinator, Congress
The current inequality in eye health outcomes for Australia’s Indigenous population can be attributed to issues such as the challenges of service delivery in remote areas; difficulties accessing public cataract surgery; real and perceived cost of services (e.g. of spectacles) and care; affordability; cultural barriers to accessing mainstream care; transport issues; community eye health awareness; and health literacy.
The Congress Regional Eye Health Program, supported by a dedicated eye health coordinator, grew from servicing 8 remote communities in 2004 to servicing 27 remote communities twice a year, up to 2015. The program now serves the Congress clinics of Alice Springs and five remote communities and is still able to support the other 21 remote communities who now receive optometry services without Congress staff.
From 2009, Congress and Brien Holden Vision Institute (BHVI), a non-government, not for profit organisation, worked in partnership to increase access to eye care for Central Australian region over 27 remote communities through enhanced optometry service delivery. Congress and BHVI from 2015 then worked together providing optometry for the five Congress auspice communities and through the Congress Gap Clinic, where 12 weeks per year was being provided to meet demand.
There has been an increased number of optometry visits since the establishment of this service and an improvement in eye health services for patients seen. In 2009 approximately 208 clients were seen in 11 communities over 6 weeks from the Visiting Optometrists Scheme (VOS), resulting in 31 referrals to ophthalmology. In comparison, by 2017 there were over 1,700 clients seen in 27 communities with over 40 weeks of VOS, and over 400 referrals.
In recent years, Congress communities alone through the VOS provided with BHVI was reaching over 1000 clients (60% with diabetes, nearly 20% requiring ophthalmology referral and glasses being provided for over 70% of patients). Days of optometry service provided for Congress reached nearly two days per week on average.
The highlight of my trip to Central Australia was working effectively with the eye health coordinator to provide eye health care efficiently. Visiting Outreach Optometrist
This significant improvement, is highlighted by improved eye health service practice to Aboriginal people in their own communities. The program’s success, evidenced by the data, demonstrates the ‘strength of partnership’ where two organisations have played complementary roles in program development and delivery. The approach of working together in partnership is particularly useful where eye care services might be limited and infrequent, such as in rural and remote areas, and when maximising effectiveness is critical for greatest community care. Future models of service delivery will emerge and be developed over time and this story reminds us and illustrates the ‘strength of partnership’.
If you have any questions relating to this ‘story’ please contact Heather Wilson, Eye Health Coordinator at Central Australian Aboriginal Congress via email email@example.com or by telephone 08 89528589.
This 'Share your Story' article was published 28 Nov 2019.