Change In Australian Healthcare System To Control Non-Communicable Diseases

Prevalence of Non-Communicable Diseases in Australia

Discuss about the Rise of NCDs Necessitates a Range of Adjustments by Health Systems in Australia.

Prevention and control of infectious disease, financial improvements and technological advancement in the healthcare domain have contributed to the overall increase in the life expectancy and improved quality of life of the people. This in turn has increased the likelihood of living up to the age of 60 years and beyond. Apart from this notable achievement, there are lifestyle-related shifts, epidemiological changes. This modification in the socio-demographic structure has increased the burden of non-communicable diseases (NCDs) (Chaker et al. 2015). Non-communicable diseases (NCDs) are chronic conditions which manifests with slow progression and are difficult to cure. The four most common NCDs include cancers, cardio-vascular disease diabetes and chronic respiratory disease (Kroll, Phalkey and Kraas 2015). In Australia, NCDs account to 91% of the total deaths. This increase in the rate of occurrence and mortality of non-communicable disease in Australia is attributable to the increase in total percentage of aged population, rapid urbanization and lifestyle changes.

According to the World Health Organisation [WHO] (2017), prevalence of NCDs is overburdening the healthcare system which is further aggravating the impact of NCDs. It is estimated that the NCDs as cast a cumulative economic loss of 13.2 billion USD per year in Australia during the tenure of 2011 to 2015 (Chaker et al. 2015). This rising economic and health burden of NCDs necessitates the certain adjustments in the health care system along with proper institutionalization surveillance system to track the trends of NCDs along with the evaluation of the outcomes (Chaker et al. 2015). The following essay aims to analyse the change in the healthcare system undertaken by the Australian government in order to cope up with the increase rate of occurrence of the NCDs.

The World Health Organization (WHO)’s Global Action Plan for the Prevention and Control of Noncommunicable Diseases (2013–2020) is mainly based on the modifiable risk factors that are associated with the course of development of the NCDs. The government of Australia has made adjustments in their healthcare system based on the global action plan drafted by WHO.

One of the prime targets towards reduction of the premature deaths arising out of the non-communicable disease includes tobacco smoking. Smoking of tobacco accounts for about majority of the casualties arising out of the non-communicable diseases like cardiovascular diseases, chronic respiratory diseases, diabetes and cancer (Glantz and Gonzalez 2012). Lowering the consumption of tobacco reduces the susceptibility of developing NCDs, delayed onset and decrease in the overall healthcare cost (Glantz and Gonzalez 2012). The WHO Convection of Tobacco Control is mainly based on reducing the affordability of the tobacco, banning smoking in public, banning advertisements related to tobacco and banning sales of tobacco to and by the children via effective monitoring and enforcement. Apart from these changes in the administrative and the policy level, WHO has also drafted change in the health care system in order reduce the threats coming from the tobacco smoking in the development of NCDs. The WHO proposed to implement affordable treatment for tobacco dependence along with supporting interventions for smoking cessation in primary care and affordable pharmacological therapies (Magnusson and Patterson 2015). The Government of Australia has implemented special smoking cessation therapy in order to decrease the rare of tobacco dependence and this includes Nicotine Replacement Therapy. Nicotine Replacement Therapy or bupropion slow release is considered as an effective aid to motivate the smokers to quit smoking. This therapy is devoid of significant contradiction and thus is considered to be helpful interventions for decreasing tobacco dependence. Australian Government mainly offers NCT to people who smoke more than 10 cigarettes per day at affordable rates. However, there are certain contradictions in offering NCT which the Australian government abides by while procuring care to patients who fall under the category of adolescent smokers, pregnant women, cardiovascular patients and women who are breast-feeding (Australian Government Department of Health 2017). In order to reduce the rate of smoking and the development of the NCDs among the Australian aboriginals the government of Australia has special program targeted towards indigenous population under the regional grants (since 2011). This program is further supported by the complementary role of the primary health care services in procuring interventions directed towards aboriginals and Torres Strait Islanders (Australian Government Department of Health 2017a). The target towards change in the healthcare system in controlling addiction has been found to procure effective results towards the possible prevention of NCDs in Australia (Australian Government Department of Health 2017).

Global Action Plan for Prevention and Control of Noncommunicable Diseases

According to Parry, Patra and Rehm (2011) alcohol is another leasing cause behind the development of the NCDs like the coronary heart disease and cancer. The ill-effects of alcohol are more prominent among the people who belong from low to middle income families and the aboriginals. Towards the reduction of the effects of alcohol over the the development of the NCDs, the government of Australia abides by the WHO global Alcohol Strategy. This strategy main promotes the increase in the tax over the alcoholic beverages, implementation of high penalties against smuggled or informal alcohol and restrictions on alcohol advertising and promoting through the audio-visual media and print media. The WHO also vouches for health warnings on the alcohol products and strict drink driving measures (like random breath testing) (Australian Government Department of Health 2012). Australian Government Department of Health has special commonwealth funding for alcohol and drug related activities and this encompass a range of prevention activities guided by the National leadership (Australian Government Department of Health 2012b). One of the main preventive activities undertaken for the reduction in the use of the alcohol consumption among the Australian population includes family based protective programs, school based protective programs and community based approach. Under these protective programs, the government of Australia aims to increase the sense of awareness against the harmful effects of alcohol and its consequences among the target population and thereby plans to reduce the consumption of alcohol (Australian Government Department of Health 2012a). The government of Australia, Department of Health has special alcohol prevention programs directed towards the aboriginals and this includes National Drug Strategy (NDS) and the National Drug Strategy Aboriginal and Torres Strait Islander Peoples Complementary Action Plan (CAP). However, Australian Government is planning to replace CAP by the National Aboriginal and Torres Strait Islander Peoples Drug Strategy, which is based on broad strategic planning framework for the provision of alcohol, tobacco and other drugs treatment services Australian Government Department of Health 2012a).

According to Melaku et al. (2018), dietary risk factors are the major contributors towards the morbidity and mortality associated with the NCDs. Despite these findings, the food consumption in the developed or developing countries are mainly dominated by the intake of unhealthy diet. Melaku et al. (2018) is of the opinion that the improvement of the dietary consumption can be effectively done via the effective involvement of the stakeholders. Promotion of the healthy diet will help to decrease the overall rate of the premature death by the end of 2030. However, the information and contribution in the domain of the dietary risk factors behind the development of the NCDs is limited. Melaku et al. (2018) further reported that the despite a decrease in the diet associated NCDs  burden during the last 25 years in Australia, there still exists significant dietary risks behind the development of NCDs. Interventions directed towards reducing NCDs should be focused over the dietary behaviours of the individuals and the population groups (Melaku et al. 2018). According to the report published by WHO, over NCDs, the metabolic risk factor associated with development of NCDs include over-weight/ obesity, hyperglycemia, hyperlipidemia and raised blood pressure. In order to promote healthy diet among the overall population as a whole, the government of Australia has special dietary guidelines known as Australian Dietary Guidelines. Guideline-1 promotes consumption of nutritional food, Guideline-2 encourage the intake of specific five groups of food each day and this includes adequate vegetables, whole grains, lean meats, egg and fish, fruits and milk. Guideline-3 mainly limits the intake of saturated fats, sugar and alcohol. Guideline-4 and Guideline-5 do not directly promote any specific diet plan but encourage breastfeeding and proper storage of food. Thus Australian dietary pattern mainly promotes the consumption of food and drinks and simply not nutrition. The main dietary choices include vegetables, fruits, grains, cereals, milk, meat, fishes, eggs and nuts along with high intake of water (Australian Government Department of Health and Ageing 2013). Health care department of Australia via the regulation of specific diet plan aims to reduce the chances of occurrence of NCDs.

Reduction of Tobacco Dependence

Physical inactivity is another risk factor behind the development of NCD and thus falls under the global action plan of WHO towards preventing the NCDs. Proper level of physical activity is associated with 30% decrease in the overall risk of ischemic heart disease along with 27% reduction in the risk of developing diabetes and 21% reduction in the vulnerability of colon and breast cancer. The government of Australia in order to promote practice of physical activity among the Australian population have undertaken communication strategies, fiscal measures and other regulatory measures for communication and marketing of the health information that promotes healthy eating and physical activity. This has found to yield substantial along with cost effective health gains (Lachat et al. 2013). Australian Institute of Health and Welfare (2017) has national guidelines that outline the minimum level of physical activity that is required to promote health benefits among the children between the age group of 5 to 12 years. These guidelines include minimum of 60 minutes to moderate to vigorous physical activity per day, engagement of muscle strengthening activity 3 days per week, reduction in the sedentary mode of life via reducing the use of social and electronic medium less than 2 hours per day. For adults who are aged between 18 to 64 years, minimum level of physical activity will be helpful in securing the health benefits and thereby reducing the chance of occurrence of NCDs include 75 minutes of vigorous physical activity or 15 minutes of moderate physical exercise per week. Adults are also encouraged to undertaken muscle strengthening activities for 2 days per week (Australian Institute of Health and Welfare 2017).

One of the principal adjustments undertaken by the Australian healthcare system is joining the NCDs global monitoring framework. This framework helps to target the venerable group of population who are at an increased risk of developing NCDs. The main classification of the framework is mainly based on the level of physical activity, hypertension, tobacco smoking, and dietary intake of salt, obesity, diet plan and inclusion of palliative care (Australian Government Department of Health 2012). 

Apart from the healthcare system, the prevalence of NCDs has also caused a transition in the medical practice in Australia (McNab, Schneider and Leeder 2014).

The Australian healthcare system has experienced significant technological advances in order to skilfully manage the NCDs. For example, increase in the prominence of cardiovascular disease during the later part of the 20^th century has promoted innovative technological advances like electrocardiography. Further advancement during the beginning of the 21^st century include imaging and scanning technologies like stents in order to effectively diagnose and treat NCDs like cardiovascular complications. In the field of cancer therapy there are innovations like chemotherapy and radiation therapy. Moreover, rapid technological advancement also prompted training of the medical professionals in order to get accustomed with the technological application of NCDs. In the domain of treating diabetes, the use of insulin spread throughout Australia along with urine and blood sugar testing (McNab, Schneider and Leeder 2014). The review of the Health Technology Assessment (HTA) in Australia has lead to the elucidation that the government of Australia apart from implementing new policies towards the control of the healthcare system and reviews the effectiveness of the approaches in order to make stringent modifications (Australian Government Department of Health 2014).

Reduction of Alcohol Consumption

The most predictable change in the health workforce during 20^th century is increase in the number of specialised doctors. In order to manage various components of treatment, new levels of co-ordination between the generalists, specialists and allied healthcare professionals were developed. The nurses and their role in health workforce gradually gained prominence in the domain of successfully managing respiratory problems, cardiac complications and high blood sugar level. Apart from the role of the nursing professionals, there also occurred increase in the popularity of the concepts like multidisciplinary team in successful management of the disease. The main members of the multidisciplinary team include physiotherapists, dieticians, and occupational therapists, community health nurse and psychologists (McNab, Schneider and Leeder 2014). According to Atun et al. (2013), the healthcare professionals who are under the multidisciplinary team plays an important role in effectively regulating NCDs. Atun et al. (2013) further opined that the introduction of the multidisciplinary team in managing NCDs helped in improving disease responsiveness.

The health workforce of Australia responded to the increase in the prevalence of NCDs via conceptualising the diseases in an innovative way and via changing and defining the roles of the healthcare professionals. These changes not only had implications for the patients but also for the overall healthcare systems. During 20^th century, like most other western countries, Australia established health insurance coverage for its citizens along with greater integration of multiple services via co-ordination, flexibility, continuity along policy change in order to manage the outbreak of the NCDs (McNab, Schneider and Leeder 2014).

In the domain of policy towards prevention and effective control of NCDs, the government of Australia have Australian National Preventive Health Agency Act which was established in the year 2010 (Australian Government Federal Register of Legislation 2011). The main objective of the Act is establishment of an Agency in order to advise on and critically manage the national health programs (Australian Government Federal Register of Legislation 2011). The National Preventive Health Agency Act also has numerous other objectives. First and foremost is effective monitoring and evaluation of the preventive health strategies. The second is facilitation of the national health prevention research infrastructure in order to elucidate more innovative interventions in the successful management of the NCDs. The third objective includes development of partnership for workplace, school and community based interventions. Fourth objective include proper assistance in developing sound and nimble health prevention workforce and co-ordination and implementation of national approach towards social marketing for the generation of preventive healthcare programs (Australian Government Federal Register of Legislation 2011).

Promotion of Healthy Diet

According to Vision 2020 – The Right to Sight Australia (2018), 80% of the vision loss arising out of diabetic retinopathy is either treatable or preventable. The organisation in Australia like Fred Hollows Foundation provides global leadership in tackling the vision loss arising out of diabetes. During the 2008, the government of Australia have recognised the common sense in funding blindness prevention programs and acknowledging that limited sum of money can cast dramatic impact in disease control. This has lead to the origination of the Global Consortium of Australian eye care organisation which work in association with the Australian government and other stakeholders across the region and share experience and expertise sho that the raised fund is spent as efficiently as possible.

Framework legislation is important but neglected tools used to improving the health governance in country. Framework legislation is defined as a set of legislation that sets out a series of executive deliberations and government actions in order comprehensively guide the decision making process. Framework legislation helps to create an enabling environment for improved decision making process in the control and management of the NCDs. Australian Government has a versatile framework legislation model in its different province in order to control and co-ordinate the NCDs (Khan, Kalsoom and Khan 2017). Australian State of Queensland has special legislation in order to crate Healthy Futures Commissions. The role of these commissions is to support the families and the children towards adopting a healthy lifestyle and contributing towards reduction in the in the health inequalities. The legislation also promotes commission to spend at least 55% of its budget over the grants to community and industry organisations and local government bodies in order to support the functions of commission (Khan, Kalsoom and Khan 2017). Australia also has special National Preventive Health Agency which encourages prevention of NCDs under active partnership with industry, community sector and non-government organisations. This active collaboration between different sectors help in generating effective community based approach towards the prevention of the NCDs. The State of South Australia empowers the ministry of health to announce the a particular medical condition or disease is entitled under the non-communicable disease and thereby issuing special code of conduct in order decrease or reduce the rate of occurrence of that particular NCD (Khan, Kalsoom and Khan 2017).

Conclusion

Thus from the above discussion, it can be concluded that in Australia at least 91 % of death that rise from the development of NCD. These NCDs also cause increase in the rate of premature death. Some of the common NCDs include diabetes, cancer, cardio – vascular diseases and respiratory diseases. So in order to fight against the outbreak of the NCDs at an explosively high rate, the government of Australia abide by the  the Global Action Plan proposed by WHO. This plan promotes restriction over tobacco and alcohol use along with the promotion of healthy diet and physical activity. The governent of Australia, Department of Health also work in favour of proper health work force management and education along with the promotion of the technological advancement in order to reduce the chance of occurrence of NCDs. WHO is of the opinion that change in the lifestyle factors help in the successfully prevention of non-communicable disease and this what the Australian Government is abiding bide.  The Australian government also has their own National Health Prevention Program to bring changes in the healthcare system, especially financially via raising and proper utilization of funds.

Promotion of Physical Activity

References

Atun, R., Jaffar, S., Nishtar, S., Knaul, F.M., Barreto, M.L., Nyirenda, M., Banatvala, N. and Piot, P., 2013. Improving responsiveness of health systems to non-communicable diseases. The Lancet, 381(9867), pp.690-697.

Australian Government Department of Health and Ageing. 2013. Australian Dietary Guidelines. Access date: 12^th July 2018. Retrieved from:  https://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n55a_australian_dietary_guidelines_summary_book.pdf

Australian Government Department of Health. 2012. Submission from Australia to WHO on Non-Communicable Diseases global monitoring framework and targets – 2nd Discussion Paper 19 April 2012. Access date: 12^th July 2018. Retrieved from:  https://www.health.gov.au/internet/main/publishing.nsf/Content/sfwnc

Australian Government Department of Health. 2012a. Guide to Australian Prevention Strategies. Access date: 12^th July 2018. Retrieved from: https://www.rch.org.au/uploadedFiles/Main/Content/ctc/CTC%20Report%20March%202012.pdf

Australian Government Department of Health. 2014. Review of Health Technology Assessment in Australia (HTA Review). Access date: 12^th July 2018. Retrieved from:  https://www.health.gov.au/htareview

Australian Government Department of Health. 2017. Smoking Cessation Guidelines for Australian general practice. Access date: 12^th July 2018. Retrieved from: https://www.health.gov.au/internet/main/publishing.nsf/content/21A287831207BB16CA257BF0001E0159/$File/smoking_flip.pdf

Australian Government Department of Health. 2017a. Tackling Indigenous Smoking (TIS). Access date: 12^th July 2018. Retrieved from:  https://www.health.gov.au/internet/main/publishing.nsf/content/indigenous-tis-lp

Australian Government Department of Health. 2017b. The Drug and Alcohol Program. Access date: 12^th July 2018. Retrieved from:  https://www.health.gov.au/internet/main/publishing.nsf/content/drug-and-alcohol-program

Australian Government Federal Register of Legislation. 2011. Australian National Preventive Health Agency Act 2010. Access date: 16^th July 2018. Retrieved from: https://www.legislation.gov.au/Details/C2010A00134

Australian Institute of Health and Welfare. 2017. Physical Activity. Access date: 16^th July 2018. Retrieved from: https://www.aihw.gov.au/reports-statistics/behaviours-risk-factors/physical-activity/about

Chaker, L., Falla, A., van der Lee, S.J., Muka, T., Imo, D., Jaspers, L., Colpani, V., Mendis, S., Chowdhury, R., Bramer, W.M. and Pazoki, R., 2015. The global impact of non-communicable diseases on macro-economic productivity: a systematic review. European Journal of Epidemiology, 30(5), pp.357-395.

Glantz, S. and Gonzalez, M., 2012. Effective tobacco control is key to rapid progress in reduction of non-communicable diseases. The lancet, 379(9822), pp.1269-1271.

Khan, M.N., Kalsoom, S. and Khan, A.A., 2017. Food Exchange List and Dietary Management of Non-Communicable Diseases in Cultural Perspective. Pakistan journal of medical sciences, 33(5), p.1273.

Kroll, M., Phalkey, R.K. and Kraas, F., 2015. Challenges to the surveillance of non-communicable diseases–a review of selected approaches. BMC Public Health, 15(1), p.1243.

Lachat, C., Otchere, S., Roberfroid, D., Abdulai, A., Seret, F.M.A., Milesevic, J., Xuereb, G., Candeias, V. and Kolsteren, P., 2013. Diet and physical activity for the prevention of noncommunicable diseases in low-and middle-income countries: a systematic policy review. PLoS medicine, 10(6), p.e1001465.

Magnusson, R.S. and Patterson, D., 2015. How Can We Strengthen Governance of Non?communicable Diseases in P acific Island Countries and Territories?. Asia & the Pacific Policy Studies, 2(2), pp.293-309.

McNab, J., Schneider, C.H. and Leeder, S., 2014. Non-communicable diseases and implications for medical practice in Australia: a framework for analysis. Med J Aust, 201(1 Suppl), pp.S29-S32.

Melaku, Y.A., Renzaho, A., Gill, T.K., Taylor, A.W., Dal Grande, E., de Courten, B., Baye, E., Gonzalez-Chica, D., Hypp?nen, E., Shi, Z. and Riley, M., 2018. Burden and trend of diet-related non-communicable diseases in Australia and comparison with 34 OECD countries, 1990–2015: findings from the Global Burden of Disease Study 2015. European journal of nutrition, pp.1-15.

Parry, C.D., Patra, J. and Rehm, J., 2011. Alcohol consumption and non?communicable diseases: epidemiology and policy implications. Addiction, 106(10), pp.1718-1724.

Vision 2020 – The Right to Sight Australia. 2018. Leading the Fight against Non Communicable Diseases. Access date: 16^th July 2018. Retrieved from: https://www.vision2020australia.org.au/media/2011-10-20/leading-the-fight-against-non-communicable-diseases

World Health Organisation. 2017. Australia – NCDs. Access date: 12^th July 2018. Retrieved from: https://www.who.int/nmh/countries/aus_en.pdf