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

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CHAPTER 5. KEY RESULT AREASThis chapter reports on the progress being made towards meeting the NTPCDS ten-year goal –to reduce the projected incidence and prevalence of the five common chronic diseases in the NTand their immediate underlying causes (13) . The key result areas are:5.1 Maternal healthThe Health and Well Being of Northern Territory Women: from the Desert to the Sea waspublished in November 2005. Apart from data on child protection reports and children in care,the report highlights that women represent 67% of all victims of manslaughter, 60% of victims ofassault and 95% of sexual assault victims. The report also highlights the barriers to reporting,particularly for Aboriginal women.5.1.1 Improving infant birthweightOne major program developed in the NT to address low birth weight in Indigenous communitieswas the Strong Women, Strong Babies, Strong Culture Program (SWSBSC). The aim of theSWSBSC was for senior women within Aboriginal communities to help younger Aboriginal women:‣ prepare for pregnancy‣ to support pregnant Aboriginal women by encouraging them to visit clinics for antenatalcare early in their pregnancy‣ by providing advice and encouragement about healthy pregnancy management inrelation to nutrition (including greater use of bush foods)‣ by promoting the adoption of safe practices such as not taking alcohol and smokingduring pregnancy, and‣ by reinforcing the need to seek adequate and timely medical help and to take prescribedmedicines (90) .The program began in 1993 as a pilot project in three Top End communities of the NorthernTerritory that were interested in participating and that had poor peri-natal health. Between late1996 and early 1997, it was implemented in a second group of communities that also had poorperi-natal health status. In 2003, the program was reviewed and concluded that, although theprogram had shown significant results in the communities in which it was first trailed, it had littleeffect when the other communities were included (90, 91) .Chapter 5: Key Result Areas – Evaluation of the NT Preventable Chronic Disease Strategy 2007 78
The NTDH&CS also collect birthweight data across the NT in its Midwives‟ collection. Results arepublished 1-3 yearly by the Health Gains Unit. The proportion of low birthweight in NT indigenousnewborns has improved from about 16-18 per cent in the late 1980‟s to 13-15 per cent in the fiveyears from 1998 to 2002 (3) .This proportion remains about double that for the non-indigenousnewborns.Table 5.1Percentage comparison of babies by birth weight and Indigenous status in theNorthern Territory, 1986-2003. Data from NT Midwives collections 1986-2002 (3) .Year 1986 1987 1988 1989 1990 1991 1992 1993 1994Aboriginal 16.4% 16.3% 17.9% 14.1% 17.0% 15.2% 16.9% 13.6% 14.4%Non-Aboriginal 6.6% 6.7% 6.5% 5.8% 7.4% 7.9% 8.2& 6.7% 6.7%Year 1995 1996 1997 1998 1999 2000 2001 2002Aboriginal 13.7% 15.5% 16.4% 12.7% 14.0% 14.7% 13.1% 14.0%Non-Aboriginal 6.2% 7.2% 6.8% 8.1% 7.5% 7.3% 6.5% 5.8%Figure 5.1Low and mean birth weights for Indigenous and non-indigenous babies in the NT1986-2002 (3) .Per cent20Low birthweightBirthw eight(gm)3500Mean birthweight1834001614123300320010310086420198619871988198919901991199219931994YearIndigenousNon-Indigenous1995199619971998199920002001200230002900280027001986198719881989199019911992199319941995YearIndigenousNon-Indigenous19961997199819992000It is important to note that an improvement in birthweight per se will not always be associatedwith less chronic disease in the long term. There is increasing recognition that large babies dueto mothers with gestational diabetes may be more likely to develop diabetes themselves inadulthood. Gestational diabetes is more common in Indigenous mothers. Therefore an increasein Aboriginal birthweight due to maternal gestational diabetes would not be an ideal outcome.20012002Chapter 5: Key Result Areas – Evaluation of the NT Preventable Chronic Disease Strategy 2007 79
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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
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List of AbbreviationsABCDACCHOsACIC
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ACKNOWLEDGEMENTSWe would like to ac
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However the extraordinary number of
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the establishment of the Sunrise He
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RECOMMENDATIONSGeneral recommendati
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Exploration of joint funding arrang
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CHAPTER 1. INTRODUCTION1.1 Backgrou
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Choosing the 5 chronic conditionsTh
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Table 1.1Key Result Areas + Best Bu
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prior to the launch of NTPCDS, such
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Year * Action Outcome1999 S NT Prev
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Year * Action Outcome2005 P Aborigi
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CHAPTER 2.EVALUATION METHODOLOGYThe
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2.2 Evaluation StagesThe NTPCDS eva
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chronic disease activities funded t
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internal project team. It was very
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Situation at Baseline1. The Guideli
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3.1.2 Patient information and recal
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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 and 58: career development, and retention i
Page 59 and 60: are. Indigenous employment is NTDH&
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: A recent ten-year follow-up of a co
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
Page 109 and 110: Hoy et al in 1995-2000 (100) , and
Page 111 and 112: 5.6 Best practice management5.6.1 P
Page 113 and 114: disease care in urban areas regardi
Page 115 and 116: PCIS was developed by NTDH&CS as th
Page 117 and 118: emote staff can access training and
Page 119 and 120: In the Top End there appeared to be
Page 121 and 122: APPENDIX 1EVALUATION OF THE NT PREV
Page 123 and 124: 2.10 Generally speaking, on a scale
Page 125 and 126: 4.4 Briefly recount any anecdotes y
Page 127 and 128: 5.9 Generally speaking, on a scale
Page 129 and 130: Section 8 • Summary questions8.1
Page 131 and 132: Preventable Chronic Disease Program
Page 133 and 134: Year Type Background What is it? /
Page 135 and 136: Year Type Background What is it? /
Page 137 and 138: An important background to this stu
Page 139 and 140: New beliefs do not replace the old,
Page 141 and 142: Other services are provided to the
Page 143 and 144: ecame the main priority in many peo
Page 145 and 146: 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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