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positions in the Preventable Chronic Disease team were existing positions transferred from otherprograms. Most of the new positions established appear to have been in nursing. In fact inrecent years there has been a net decline in the number of Aboriginal health workers employedin the Northern Territory. Recruitment and retention of Aboriginal Health Workers has been anongoing issue. To address this an apprenticeship model of training has been developed forAboriginal Health Workers which is due to commence at Batchelor Institute in July 2007 with 24apprentices employed by the NTDH&CS (53) .Where new funding has been made available to enhance primary health care services such as the5 regions in Central Australia, staff reported that there was an increase in Aboriginal employmentin roles such as drivers, community workers, and clerical staff. However, no new Indigenousemployees were reported in decision-making processes, policy development, and service deliveryto ATSI people, which was the aim of the Indigenous Employment and Career DevelopmentStrategy of 2002-2006.ACCHOs reported that many new Aboriginal positions have been established through the Healthyfor Life program. The Division of Primary Health Care in Central Australia is actively targetingAboriginal people to recruit up to 15 Aboriginal community mental health worker positions.DiscussionAboriginal and Torres Strait Islanders made up 28 per cent of the NT population but only 6.9 percent of the NT public sector workforce (4) . While this is an improvement in general, it is unclear ifthese data are accurate, as 30 per cent of staff do not complete this section of the HR collectionsystem. It is therefore not possible to establish if there has been an actual increase in numbersof Indigenous employees, especially those working in chronic disease. The stakeholder interviewsreveal that there has been no increase in the number of Aboriginal Health Worker positions orthose filled for PCD programs and many reported a drop in numbers as well as numerouspositions as vacant. The Aboriginal Health Worker apprenticeship program commencing in July2007 and the CADPHC mental health program, is pleasing and they are expected to expand.These however will rely on strong support, resourcing, and Indigenous leadership.Assessment against objectiveIndigenous education, employment and health status are worse than non-Indigenous NTpopulations and this worsens with geographic remoteness. There is evidence that a whole ofgovernment approach is being attempted at some levels, though it is unclear what the outcomesChapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 40
are. Indigenous employment is NTDH&CS is reported as having increased in lower level roles butthis is not evident in the area of chronic disease.3.3 PREVENTION AND HEALTH PROMOTION PROGRAMSPrevention is one of the three key platforms of the NT Preventable Chronic Disease Strategy.Objective 5: Programs aimed at encouraging healthy living will be operating in urban,rural and remote communities. They may be run from health centres, schools, women‟scentres, community councils or elsewhere, but will be supported by health centre stafftaking a primary health care approach and using a health promotion model.The EvidenceTargeting a whole population through the design of preventative programs to improve health willhave a greater impact than individual care (54) .Situation at BaselineHealth promotion has been a key strategy within the NTDH&CS since the late 1980s. The focusfrom the early 1990s to 2000s was a capacity building approach, with a major emphasis onworkforce development. This was done through a range of accredited and non-accreditedtraining programs, support from health promotion specialists, and some additional resourcesthrough small incentive grants (55) .In 1999 a review of the health promotion activities in the NT found that the NT Health PromotionModel was soundly based on national and international experience and aimed to apply healthpromotion strategies and skills across a range of public health and primary health care issues andincorporate them into priority programs (56) . The reviewers described the model as capacitybuilding because it involved developing skills and systems within health services to enable themto increase communities‟ ability to foster good health. Its recommendations included extendingthe health promotion model with a stronger infrastructure and developing a more comprehensiveapproach. In particular, there was a need to develop systems to address each of the followingaspects of capacity: Building the capacity of health personnel – commitment and skills for working in ahealth promoting way,Chapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 41
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Pty LtdABN 82 147 637 101AN EVALUAT
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TABLE OF CONTENTSList of figuresLis
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6.6 Indigenous workforce 996.7 Prev
Page 7 and 8: List of AbbreviationsABCDACCHOsACIC
Page 9 and 10: ACKNOWLEDGEMENTSWe would like to ac
Page 11 and 12: However the extraordinary number of
Page 13 and 14: the establishment of the Sunrise He
Page 15 and 16: RECOMMENDATIONSGeneral recommendati
Page 17 and 18: Exploration of joint funding arrang
Page 19 and 20: CHAPTER 1. INTRODUCTION1.1 Backgrou
Page 21 and 22: Choosing the 5 chronic conditionsTh
Page 23 and 24: Table 1.1Key Result Areas + Best Bu
Page 25 and 26: prior to the launch of NTPCDS, such
Page 27 and 28: Year * Action Outcome1999 S NT Prev
Page 29 and 30: Year * Action Outcome2005 P Aborigi
Page 31 and 32: CHAPTER 2.EVALUATION METHODOLOGYThe
Page 33 and 34: 2.2 Evaluation StagesThe NTPCDS eva
Page 35 and 36: chronic disease activities funded t
Page 37 and 38: internal project team. It was very
Page 39 and 40: Situation at Baseline1. The Guideli
Page 41 and 42: 3.1.2 Patient information and recal
Page 43 and 44: Ferret Miwatj, Numbulwar, Marngarr,
Page 45 and 46: Medicare information is not for pub
Page 47 and 48: was in place in Central Australia i
Page 49 and 50: What orientation and ongoing traini
Page 51 and 52: programs focus on chronic disease p
Page 53 and 54: The information collected as part o
Page 55 and 56: Assessment against objectiveMost se
Page 57: career development, and retention i
Page 61 and 62: NTDH&CS Programs that encourage Hea
Page 63 and 64: 2002 Aboriginal and Torres Strait I
Page 65 and 66: delivering any prevention and healt
Page 67 and 68: The Community Services Division - A
Page 69 and 70: 1 x AHW Central Australia 2001 S100
Page 71 and 72: One clinic stated it had no care pl
Page 73 and 74: Identifies priority practices to in
Page 75 and 76: There has been a significant growth
Page 77 and 78: about 25 per cent of the hospital b
Page 79 and 80: The level of funding provided by th
Page 81 and 82: Central Australia and two zones cur
Page 83 and 84: The diabetes education teams at HLN
Page 85 and 86: maintenance group for people with l
Page 87 and 88: Rebates for participating or arrang
Page 89 and 90: Use of Medicine Programmes. Althoug
Page 91 and 92: CHAPTER 4. CLINICAL OUTCOMES OF THE
Page 93 and 94: improvements have been made to serv
Page 95 and 96: A recent ten-year follow-up of a co
Page 97 and 98: The NTDH&CS also collect birthweigh
Page 99 and 100: Figure 5.3 Vaccination coverage for
Page 101 and 102: It is also important to note that k
Page 103 and 104: eported that 50 per cent of the Ind
Page 105 and 106: The current action plan identifies
Page 107 and 108: The availability and cost of health
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Hoy et al in 1995-2000 (100) , and
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5.6 Best practice management5.6.1 P
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disease care in urban areas regardi
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PCIS was developed by NTDH&CS as th
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emote staff can access training and
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In the Top End there appeared to be
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APPENDIX 1EVALUATION OF THE NT PREV
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2.10 Generally speaking, on a scale
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4.4 Briefly recount any anecdotes y
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5.9 Generally speaking, on a scale
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Section 8 • Summary questions8.1
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Preventable Chronic Disease Program
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Year Type Background What is it? /
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Year Type Background What is it? /
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An important background to this stu
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New beliefs do not replace the old,
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Other services are provided to the
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ecame the main priority in many peo
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to be healthy, how to get rid of di
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(Draft Version - © August 2006 Jan
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References1. Dunham, H., Ministeria
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35. Smith, J.D., Progress report fo
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Research Centre for Aboriginal Heal
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114. Senior, K., 'A Gudbala Laif? h
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