PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...

Two communities in Arnhem land were selected to form case study sites. These communitieswere selected on the basis that they represented two quite different situations as regards tohealth service delivery. Also the researchers had already established good contacts in thecommunities. This is important as the time frame of this study allowed one week in eachcommunity. This is very minimal for an in-depth ethnographic study if the researchers had noprior experience in these specific communities.A number of methods were used including group discussions, semi structured interviews andparticipant observation. These were conducted generally within the community and specificallywithin the health centres and council offices. We also conducted interviews with health centrestaff, to obtain their perspective on the barriers to successfully engaging with the community.Permissions was sought from the Community council and the health board of each community.The settingsBoth communities were in Arnhem Land and were closely related in terms of movement of peopleand cultural beliefs and practices. Their current systems of health care delivery were quitedifferent.Community A has a population of approximately 900. The health services are provided by theNorthern Territory Department of Health and Community services through the health centreclinic. The clinic has a staff of two registered nurses, one doctor, four health workers, one driverand a receptionist.The clinic has a verandah which serves as an outside waiting area, a central consultation area, awomen‟s room, dentist‟s room, doctor‟s office, an emergency room and a tea room. The nursesand health workers consult initially in the central open area of the clinic and minor illnesses andchronic disease checkups are dealt with here. Patient files, which are filed under first name, arekept in the reception area. There is another separate set of files which are for the chronic diseasepatients; these are kept in the central consultation area.As an institution the clinic is an important focus of community attention. It is the place wherepeople put up posters and flyers advertising community events, for example while we were at theclinic, students from the school brought in posters advertising adult education. Because peopletend to drift in and out of the clinic building, it is difficult to determine who the patients actuallyare.Appendix 4: Ethnographic Field Study – Evaluation of the NT Preventable Chronic Disease Strategy 2007 122