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Introduction
Primary healthcare is a system that seeks to bring health services closer to the people (Green, 2007). The system is mostly used outside the conventional hospital setting. As such, it forms an integral part of the healthcare system. Primary healthcare can also be described as a community based initiative intended to improve the health standards in the society. This is made possible by the collaboration between health practitioners and community members. The system helps in illness prevention, detection, treatment, and control of epidemics. The participation of individuals from diverse disciplines helps in creating a pool of skills that can be utilized to improve the health of members of the community. Given that this is a community-based initiative, healthcare is brought closer to people, which leads to equity. The government should make efforts to support such initiatives to ensure they are successful.
Australia can be described as one of the countries in the world that have embraced comprehensive primary healthcare systems. Health workers in the community work hand-in-hand with the community members to improve their health conditions. The high rate of Type 2 Diabetes among the indigenous Australian population, as compared to that among non-indigenous Australians, has prompted the Australian government to develop systems to try and close the gap between the two groups (Dixon, Scully, Wakefield, White & Crawford, 2007). Type 2 Diabetes is a chronic condition. It is important for the members of the society and the government to take action to address this worrying trend. Primary healthcare is one of the most appropriate remedies used to address this problem. This is considering the fact that all communities will be empowered to deal with the health issues affecting them.
The author of this paper seeks to analyse existing primary healthcare initiatives in Australia. The author will also propose key primary healthcare initiatives that, if implemented, are likely to improve the health of individuals in Australia. This is especially the indigenous Australian population. Given that Type 2 Diabetes is a lifestyle disease, the initiatives should place emphasis on empowering the individual to lead a healthy life (Lantz, 2005). Obesity is largely associated with Type 2 Diabetes. As such, eradicating it would ultimately translate into the reduced prevalence of Type 2 Diabetes among indigenous Australians.
An Analysis of the Initiatives
Current Primary Healthcare Services Targeting Type 2 Diabetes
Several initiatives have been taken in the past to reduce the prevalence of Type 2 Diabetes among indigenous Australians. Health practitioners, as well as the local communities, have taken several initiatives to reverse this worrying trend (Goss, 2009). Below is an analysis of some of these initiatives:
National Action Plan to Reduce the Rate of Smoking among Indigenous Communities
The Australian government has made efforts to reduce the susceptibility of indigenous Australians to chronic diseases, such as Type 2 Diabetes (Schulz & Krieger, 2008). For instance, the government has embarked on a nationwide campaign aimed at reducing the rate of smoking among citizens. There are national and regional tobacco coordinators who coordinate the campaign in an attempt to curb chronic diseases among indigenous Australians (Israel, 2005).
The initiative is highly effective given that tobacco accounts for close to 20% of all deaths occurring among indigenous Australians. Statistics show that more than half of indigenous Australians are tobacco smokers. As such, the entire population is at risk of contracting tobacco related disorders (Galea, 2006). Smoking reduces life expectancy among indigenous Australians by approximately 2.5 years in males and 1.7 years in females.
However, the initiative is not effective enough since smoking is more of a habit than a sickness. Tobacco users find it quite hard to stop the practice. Measures put in place by the government alone will not stop individuals from smoking. There is need for the individual to make the decision to stop the habit.
Helping Indigenous Australians Reduce the Risk to Chronic Diseases
The initiating is achieved through the introduction of learning models in schools and in the community. In using these models, members of the community are advised to maintain a healthy lifestyle to reduce their dependence on health workers (Ring, 2008). The initiative is based on the primary health care policy, which states that primary healthcare practices should be designed to prevent rather than treat conditions.
The initiative is largely effective. The success is attributed to the fact that it is designed to provide people with insights on how to avoid contracting illnesses, as well as cope with such illnesses (Saggers & Gray, 2007). Education about chronic diseases is important in empowering indigenous Australians. Members of the community are advised on how to cope with the diseases. Education addresses one of the objectives of primary healthcare, which is bringing about sustainable developments in the healthcare system. Information gained is passed down from one generation to the other, which leads to a lasting solution. Helping people remain physically fit lowers their chances of contracting chronic diseases, such as Type 2 Diabetes.
Education is, however, limited to the elite group. Such a scenario is averted if the education is offered using the local language. People tend to forget. They need to be constantly reminded to stay on the right track (Scarlett, 2009).
Campaigns by Indigenous Communities to Promote Better Health
The campaign is a community based initiative involving the provision of primary healthcare services to the entire community. It has helped in achieving one of the objectives of primary healthcare, which is easing access to primary healthcare services (Seidel, 2007). Community based health practitioners provide such services as counselling and treatment of minor illnesses. The trend has gained popularity over the years. The government has recruited more nurses to work in other communities and learning institutions, such as primary and secondary schools.
Introduction of primary healthcare services in the community will help in the prevention of chronic diseases, such as Type 2 Diabetes. It ensures that members of the community remain healthy by avoiding situations that lead to this condition. As a result, the children will have reduced chances of contracting such illnesses. Individuals who are already suffering from the illnesses are able to access quality healthcare services from professionals, thus increasing their chances of recovering fully. The nurse is able to monitor the progress of the patients closely. Having primary health care services provided in school ensures equality. Equality is brought about considering that all schools are provided with nurses (Healy & Braithwaite, 2006). As a result of this, all children in Australian have access to primary healthcare. The children access healthcare by attending school.
The initiative, however, has several weaknesses. It is quite expensive and requires large sums of money to sustain it (Holman & Smith, 2009). At times, members of the community regard the government’s initiative as a norm. As a result, they fail to exploit it fully.
Proposed Primary Healthcare Services
Improving the Management of Chronic Diseases and Follow-Up Care
When implemented, the act will emerge as one of the most effective initiatives in the war against chronic diseases among indigenous Australians (Roberts, Letcher & Gason, 2010). The reason for this is that the initiative focuses on chronic diseases affecting indigenous Australians holistically. It does not address selected conditions only. There are various ways through which the management of chronic diseases and follow-up care can be improved. One of them is subsidising the cost of PBS drugs. Subsidising the cost of drugs ensures that medical services are made accessible to all members of the society. Enhancing the participation of indigenous communities in the provision of healthcare provision helps them become self-reliant. Other strategies include, among others, increased follow-up, evaluation, and monitoring.
However, the method has several limitations. For example, it is a very expensive venture, which will cost the government a lot of money. The money to fund the initiative is collected from citizens in the form of levies and taxes. What this means is that the government will raise tax rates and levies (Skully, 2007).
Rationale
The government taxes people to raise money to deliver services to them. In the United States of America and other democratic countries, the government has an elaborate tax system. Given that chronic illnesses are some of the most serious illnesses, managing them will go a long way in winning the war against the disease.
Workforce Expansion and Support
Overview
The initiative has seen health workers work hand- in- hand with members of the society (LaMontagne, 2006). It has helped the communities in dealing with health issues specific to them. In this case, members of indigenous Australian communities are empowered to deal with such chronic diseases as Type 2 Diabetes effectively. The initiative is important considering that Type 2 diabetes is one of the major chronic illnesses affecting this community.
Community health workers help in providing healthcare services to people at the local level. Therefore, they act as a bridge between local communities and hospitals (Oates, Blades & Gunter, 2008). To empower and encourage them, the government should improve the community’s access to primary healthcare. Training the health practitioners properly improves the quality of the services they provide to the community.
Community health workers are, however, expensive to hire and maintain. Services provided by the health workers are of low quality due to the inadequacy of the resources and facilities at their disposal (Purnell, Knopp & Brunzell, 1999). The poor quality has made many people opt to visit hospitals rather than seek the assistance of local health workers.
Rationale
In the United States of America, the issue of primary healthcare is adequately addressed. To this end, the US government has employed a large number of nurses and health practitioners to serve in the community. However, many people continue to seek medical services from large hospitals. As a result, the services of the community health workers are underutilised. One explanation for this is the fact that facilities in the hospital are of high quality.
Summary
Indigenous Australians are known to be more susceptible to many chronic diseases among them Type 2 Diabetes as compared to non- indigenous Australians. Recent studies, such as those conducted by Willet in 1998, have established a close relationship between Type 2 Diabetes, obesity and other lifestyle aspects. The Australian government has come up with measures to reverse this trend (Holman & Smith, 2009). This is in an attempt to provide high quality healthcare services to the indigenous Australians.
References
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LaMontagne, A. (2006). Assessing and intervening on OSH programs: Effectiveness evaluation of the Wellworks- 2 intervention in 15 manufacturing worksites. Journal of Occupational and Environmental Medicine, 61(9), 651-660.
Lantz, P. (2005). Can communities and academia work together on public health research? Journal of Urban Health, 78(3), 495–507.
Oates, C., Blades, M., & Gunter, B. (2009). Children and television advertising: When do they understand persuasive intent? Journal of Consumer Behaviour, 43(3), 238-245.
Ring, I. (2008). Reducing indigenous mortality in Australia: Lessons from other countries. Medical Journal of Australia, 169(10):528–529.
Roberts, L., Letcher, T., & Gason, A. (2010). Health concern that warrants population wide prevention programs. Medical Journal of Australia, 110(8), 269-340.
Saggers, S., & Gray, D. (2007). Aboriginal health and society: The traditional and contemporary aboriginal struggle for better health. Sydney, Australia: Allen and Unwin.
Scarlett, M. (2009). Successful community-based skin health initiatives. The Australian Health Consumer, 2(1):31–32.
Schulz, A., & Krieger, J. (2008). Addressing social determinants of health: Community-based participatory approaches to research and practice. Health Educ Behav, 29(3), 287–295.
Seidel, J. (2007). Obesity, insulin resistance and diabetes: A worldwide epidemic. Australian Journal of Nutrition, 9(3), 83-92.
Skully, J. (2007). Early childhood education programs. Journal of Economic Perspectives, 15(2), 213- 214.
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