Addressing Chronic Kidney Disease In Aboriginal Communities In Australia
Health of the indigenous community
You need to write a policy for advocacy. You should choose a community or health organisation and then decide upon the health issue you are advocating for, and the specific population in which this issue occurs. You are writing this policy as if you worked for this agency or peak organisation.
The Australian government is responsible to ensure well-being of every Australian citizen and undertake several measures that addresses health related issues primarily apart from the other issues (Fredericks, Adams and Edwards 2011). This is because a healthy nation is the foundation of a progressive nation. This paper aims at identifying one significant health issue of the aboriginals and indigenous group and shall highlight the best possible health opportunities for such groups by developing policies for advocacy and articulate the views to the chosen health organization. The health organization chosen to make policies for advocacy with respect to the aboriginals is the National Aboriginal Community Controlled Health Organization [NACCHO].
National Aboriginal Community Controlled Health Organization [NACCHO]
Indigenous health refers to the cultural, social, emotional and physical wellbeing of the Torres Islander or Aboriginal people. The NACCHO is a living description of the hopes of the Aboriginal group and their effort for self-determination. This health body represents the Aboriginal community controlled health services (ACCHSs) all over the country on health and wellbeing issues of the indigenous community.
The ACCHS is a primary health care service where the local aboriginal community operates and initiates the health services to deliver broad, holistic and ethnically appropriate healthcare to the community that exercises control over such body through an elected Management Board.
Aboriginals or the Indigenous group
Aboriginals or the indigenous, especially, those who dwell in remote regions are at a greater risk of developing the chronic kidney diseases compared to other Australian citizens.
Health Issue- Chronic Kidney diseases
Several Indigenous group suffer from heart and/or circulatory disease, kidney disease and diabetes/high sugar levels. Amongst these diseases the most common chronic diseases that often causes death of the aboriginals is the chronic kidney diseases. Generally, the Indigenous Australian citizens are usually vulnerable to more diseases than the non-indigenous groups of people due to variety of reasons and chronic kidney disease is not any exception. Chronic kidney disease has become an increasingly common health problem in Australia. People suffering from chronic kidney diseases, especially with end-stage kidney disease usually have poor health outcomes and a poor quality of life (Ward, Fredericks and Best 2014).
The National Aboriginal Community Controlled Health Organization
It is well known that the health conditions of the aboriginal people have undergone changes over the past decades due to the advancement of technology and rising living standards. Nevertheless, despite such development in place, the aboriginals are unable to enjoy the benefits as their health conditions persist to be poor and the living standards remain to be low (Rigney 2017).
The greater prevalence of the chronic kidney diseases amongst the indigenous group is due to the high occurrence of risk factors, which includes high blood pressure, smoking, and diabetes along with alcohol abuse, inadequate levels of nutrition, skin infection, streptococcal throat and poor as well as unhygienic living conditions.
Urgency of the issue
Chronic diseases are responsible for more than two-third of the total health gap and a significant percentage of the total disease burden is seen amongst the indigenous Australians. In remote areas in the rural regions, in particular, the occurrence of the chronic kidney diseases especially the end-stage kidney diseases which is commonly prevalent amongst the indigenous group of people (Hendrickx et al. 2016). Almost 18 percent of the group suffers from the end-stage kidney diseases, which is approximately 20-time higher rate than the non-indigenous group of eople.
Apart from the low living conditions and lack of treatment of the other diseases, which often causes the kidney diseases, the other significant factor, which attributes to the growing prevalence of the issue amongst the indigenous group, is the lack of accessibility to medical services. This is evident from the fact that majority of the patients have to be relocated to cities or regions or even countries where there are availability of appropriate medical facilities to treat their diseases.
Presently, the indigenous and the aboriginals do not have access to sufficient support and the patients are deprived of any medical care that is required to assist the patients during their renal dialysis journey and by support, it implies both social and emotional. The patients who are lucky enough to receive treatment are moved away from their families, homeland, and apart from their health sufferings they suffer mentally as well.
The lack of a funding model in the areas where the aboriginals dwell compels patients to move far away from their families and home. The incline in the number of people suffering from chronic kidney diseases especially, end-stage kidney diseases are compelling the indigenous people to travel into town centers for undergoing medical treatment away from their country, culture and family.
The chronic kideny issue in Indigenous group of people
Every indigenous person belonging to remote community, when they are directed to undergo dialysis, the first thing that they ask for is if they can undergo such treatment near their homes. This will not only help them receive family support but will also save them from significant expenses that is incurred when they move away to towns, cities, away from their homes (Ferguson 2015).
Impact of such issue on the Aboriginals
The aboriginals and the Torres Islanders group experience disproportionate levels of chronic kidney diseases that too of high level irrespective of the rural, region and urban locality compared to the general population of the country. The Islanders or the aboriginals group is four times more vulnerable to the chronic kidney diseases out which majority of them suffer from end-stage kidney diseases.
As mentioned above, due to lack of medical facilities within the rural regions where majority of the aboriginals dwell, they are often shifted to other places to undergo medical treatment. The separation of the patients from their homeland often have a psychological, biological, socio-economic consequences on the wellbeing and health of the patients, their communities, families, wider health as well as the welfare system.
The impact of kidney failure in almost every people, severely affects the family along with the patients in the form of loss of job opportunities, heavy symptomatic burden, financial hardship, real social disruption as well as ability to work (Reilly et al. 2016). Further, the relocation of the aboriginals to other countries, regions for undergoing a dialysis often detaches them from their families. This is one of the most significant issues that pose a threat to the health and social support area for Aboriginals and the islanders who have accessibility to dialysis services at places that is far from their homes. This is further very confusing, burdensome, fragmented and isolating for the aboriginal patients.
Aims and objectives of Policy for Advocacy
The aims and objectives of policy for advocacy is not confined to the number of decisions that are made by both non-governmental as well as governmental organizations. In the present case, in order to bring about changes in the health related issues associated with the aboriginals, policy advocacy is crucial to bring about such necessary changes with respect to the aboriginals health. Policy advocacy has been proved advantageous in order to bring about changes in other health related issues like malnutrition, diabetes, mental health, etc.
Prevalence of chronic kidney diseases
Further, it must be understood that an effective, efficient and equitable health system is a fundamental element for government as well as for the non-governmental organizations to address the health issues of the aboriginal and islander people (Webster et al. 2017). Despite the commencement of the funding streams which includes child and maternal health program, primary healthcare base funding, Aboriginals and Islander Chronic Disease Fund introduced by the Australian Government Indigenous Australian’s Health program in 2014, shortage of chronic fund model in the rural areas are compelling patients to move away from their family and care to undergo medical treatment.
There are evidences of significant evidence-practice gaps in the management of pre-dialysis of the chronic kidney diseases. As mentioned earlier that the aboriginals lack accessibility to effective medical assistance, hence, most of the times, their health issues often go unchecked. With an incline in the medical assessments, facilities that would ensure that every aboriginal undergo a checkup might reduce the incidence of chronic diseases chronic kidney diseases (Zhao et al. 2014).
The aims and objectives of this advocacy for policy can be summarized as follows:
- to ensure that dialysis treatment is funded by the government in rural and remote areas;
- to ensure adequate medical facilities within such rural and remote areas;
- to ensure that the aboriginals living within rural and remote communities have access to medical assistance;
- to provide a better understanding of how better and positive clinical results can be achieved;
- to establish medical facilities or programs that will provide cost-effective care to indigenous Australians suffering from chronic kidney diseases as well as end-stage kidney diseases;
- to ensure better primary healthcare services is rendered in the rural and remote areas of the country;
- to make sure that a healthy workforce is adequately trained and is competent in dealing with intricate social and health issues that are being experienced by the Aboriginal group of people;
Recommendations (min 3)
The lack of medical facilities to conduct dialysis has made the lives of the aboriginals more difficult leading to high mortality rate, hence, it has become a national issue, which requires a national response of State, Federal and Territory government to develop approaches to address the non-health as well as that of the health issues. The first and foremost objective of such approaches must ensure effective accessibility to medical treatment. For the aboriginals living within the rural and remote areas, lack of accessibility to the medical treatment like renal dialysis closer to their homes which ultimately leads to the decision of relocating to other places for treatment are essential determinants that often makes people avoid undergoing treatment.
The fear of being away from their families, carers and high expenses often causes a significant proportion of patients not to undergo any medical treatment. Further, as stated above those inadequate trained medical professionals who lack language competency, kidney diseases fails to assess the disease at early stages leading to deterioration of health. Under such circumstances, it is important to adopt measures that ensure better health outcomes for the aboriginal group (Webster et al. 2017). In order to achieve better health standards for the aboriginals and Islanders group, policies must be modified and following are some measures that are recommended that the government may consider with respect to improvement in the health standards of the Aboriginals.
Reasons behind growing prevalence
There is a need to develop ethnically appropriate educational resources that shall enable the aboriginals learn about their kidney health, functions of kidney and the causes of chronic kidney diseases. The primary target group in this respect should be the youths and the adolescents. For patients already at the early stage of chronic kidney diseases must also be provided with adequate information about the dialysis treatments;
Primary healthcare services, ACCHSs and improved general practice must be facilitated in order to detect the disease at its inception amongst the aboriginals and islanders group. This can be achieved by establishing health checkup and health assessment sessions which includes kidney testing, maintaining a separate register for those detected with chronic kidney diseases so that it opens the scope for national reporting. Further, with adequate information provided to the aboriginals about the chronic kidney diseases will enable them to take care of their health and restrain from factors which might cause such problems.
The lack of accessibility to renal treatment and dialysis treatment for aboriginal patients suffering from chronic kidney diseases has an adverse impact upon the socio-economic as well psychological factor upon several Aboriginals and Islanders groups and families. Under such circumstances, it would be effective if a place-based model is established that would determine the level of social support assistance required to the aboriginal kidney patients and their families with respect to relocation of such patients for undergoing kidney treatment. In order to provide the aboriginal patients with treatment to the aboriginals, it is equally important to consider the huge expenses that are usually incurred to undergo such treatment (Rigney 2017). Therefore, in order to achieve this approach, a needs-based funding model must be established that will coordinate and address the growing needs of the aboriginals for social support as well the model shall provide cost-effective treatment.
In order to implement the measures and bring a change in the policies that shall ensure a better health outcome for the aboriginals, it is important to overcome the challenges that act as impediments to a smooth implementation of the measures. Firstly, to maintain and develop a knowledgeable and skilled workforce poses a significant challenge while working with the health of the Islander and aboriginals (Hoy 2013). Further, the aboriginals not only suffer from chronic kidney diseases but also from other chronic diseases such as diabetes, mental health, cancer, obesity, etc. Apart from establishing models that addresses the issues of kidney diseases, it is important, that equal strong models are established to deal with the other health issues as well which, immediately seems to be a difficult task.
Difficulty in accessing medical facilities
However, since chronic diseases like kidney diseases are mostly prevalent amongst the aboriginals therefore, it is of utmost importance that the measures for addressing the kidney disease issues. The patients suffering from kidney diseases have distinct social, economic and cultural needs which must be fulfilled immediately as it might reduce the incidence of such chronic diseases and result in better health outcome.
References
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