Effective Healthcare For Aboriginal And Torres Strait Islander Communities And Immigrants In Australia

Evolution of Australia’s Healthcare System for Aboriginal and Torres Strait Islander Communities

Scenario 1

1. There has been a progressive change in the healthcare system of Australia with evidences that reflect that there have been government investments especially in the field of primary care. This has made changes in the life expectancy in the Aboriginal people along with the Torres Strait Islander populations. Improvements have been brought about in the ambulatory care that is sensitive to the process of hospitalization. There have been successful campaigning by the Aboriginal community-controlled health sector and other such organizations demanding the responsibility to fund the Aboriginal primary health care. This was transferred from theAboriginal and Torres Strait Islander Commission to the Commonwealth Health Department in the year of 1995, which made way for the increase in the funds contributed towards Aboriginal and Torres Strait Islander primary health care (Gubhaju et al., 2013). This also took steps to include new programs like the Primary Health Care Access Program. The data received showed that the funds for the Aboriginal community that was controlled by the health services increased from $233 per Indigenous person in 1998-99 to $426 per person in 2004-05 (Jongen et al., 2014).
2. Most of the Indigenous Australians tend to experience poorer health conditions as compared to the Australians who are non-indigenous (Duckett & Willcox, 2015). Apart from obesity, some of the common health issues they face include heart diseases along with respiratory problems, kidney diseases and more importantly mental health issues. This population of people belonging to the aboriginal Australians and Torres Strait Islanders are considered being socially, economically, culturally and politically challenged or disadvantaged (Thomas, Bainbridge & Tsey, 2014). Therefore factors like the cultural barriers and social determinants should be addressed in order to provide health equity to them. Some of the social determinants that impacts their health involves the socio-economic status, chronic stress and historical treatment especially in terms of racism.
3. The Commonwealth government along with the Queensland Government and other Australian States and Territories, in the year of 2003 projected a policy framework that was a National Strategic Framework for Aboriginal and Torres Strait Islander Health (Thomas, Bainbridge & Tsey, 2014). This policy was committed to provision of community control in terms of primary health care services. In the year 2010, the Queensland Government took steps to make tracks towards “closing the gap in health outcomes for Indigenous Queenslanders by 2033” through the Policy and Accountability Framework (Gubhaju et al., 2013).
4. In the aboriginal communities with populations which are greater than 5000, the health service model includes discrete services from local services and diagnostic services. For small or defined population, the model involves integrated services and comprehensive primary care services (Sherwood, 2013). Finally for small rural or remote areas, it includes outreach or telemedicine services.

Scenario 2

1. The health of the immigrants like Vinh is majorly impacted due to the adoption of the different eating habits or physical activities including smoking and alcohol consumption, especially in the long run (Tsai & Lee, 2016). The stress of migration along with the stress of adjustment to a new culture and problems of discrimination play a role in the impact of the deteriorating health of the immigrants. Several studies have identified these as barriers to the effective use of the health services. Chronic diseases are the major causes of the mortality and morbidity of the immigrant population apart from the mental health problems arising due to the cultural barriers (Kennedy et al., 2015).
2. A private health insurance plan is provided to the migrants who hold a 457 asylum visa. Vinh has been living in Australia for the past two years therefore he will be entitled to this healthcare plan. He is also entitled to the public healthcare service that is provided under the Reciprocal Health Care Agreements framework(Minas et al., 2013). Under this policy, immigrants from various countries receive opportunities of essential medical treatment and some subsidized medicines and health services in Australia. Another such policy that is being used by the Australian government is the Significant Cost Threshold (Claxton et al., 2015). Utilization of this has increased significantly in the recent years. The immigrants learn about this healthcare policies through the humanitarian programs. Inquiries can be carried out through the Human Rights and Equal Opportunity Commission (HREOC) (Green, 2016).
3. Several studies have suggested that in the 17^thcentury, many Vietnamese and Chinese healthcare practitioners had started identifying their colonial medicine as the Dong Y (Nguyen et al., 2016). Their aim was to distinguish their traditional medicine with that of the western medicines. Vinh belonging to the Vietnamese origin can therefore use the traditional Vietnamese Medicine (TVM) for his general healthcare and wellbeing. This TVM is different from that of the western medicines in terms that it puts emphasis on the nourishment of the vital energy and blood (Loue, 2013). Unlike western medicine is does not focus only on the specific symptoms. Another traditional method can be use of acupuncture. This implements the use of needles to the specific points on the body that are believed to channel the energy to the mind and the body.
4. The nursing profession perspectives that are important in influencing the people’s perspective of the nursing profession includes aspects such as the cultural competence. Implementation of cultural competence in nursing profession has succeeded in gaining importance in providing improved quality of care. This has also led to the reduction in the disparities which mainly arise due to the racial and the ethnic causes (Mayo et al., 2015). 

Scenario 3

1. A model of “Genuine Caring in Caring for the Genuine” has been proposed for provision of care to the patients having high risk pregnancy. There are three aspects of this model which includes a relationship of dignity and protectiveness, embodied knowledge along with the prevalence of a balance between the perspective of nature and medicine. The aspects includes the factors like mutuality, trust, shared responsibility and endurance of presence in case of the dignity-protection relationship (Hod et al., 2016). In terms of embodied knowledge, the factors include genuineness towards oneself, along with presence of theoretical, practical, intuitive and lastly reflective knowledge (Tsai & Lee, 2016).Lastly the factors of balance between the perspective of nature and medicine involves supporting of normalcy and sensitivity exhibition in case of the genuine.
2. Pregnant patients suffering from type 2 diabetes have seen to experience much elevated rates of problems like preeclampsia, cesarean delivery and shoulder dystocia in the baby (Gubhaju et al., 2013). Additional conditions involves preterm delivery, large-for-gestational-age infant and fetal anomaly. Some studies view the impact of the diabetic pregnancy as a vicious cycle (Hod et al., 2016).  The consequences of this for the offspring extends beyond the stage of neonatal. It also suggests that young woman whose mother also had suffered diabetes during pregnancy are at elevated risks of perpetuating the cycle. This increases the chances of diabetes development in years of childbearing.
3. There are several differences between the public and the private healthcare system in terms of provision of maternal health. The differences can be in terms of care providers, choosing of the appropriate place of birth and the cost (Gubhaju et al., 2013).In case of the care providers, the public hospitals tend to provide one-to-one options of midwifery along with the center of birth or homebirth. On the other hand in case of private care, there is an option of provision of a private obstetrician and midwife. In such cases the providers also engaged in providing care in their personal clinics. In terms of choosing the right place of birth, the public hospitals generally provides private or most of the times shared rooms (Hod et al., 2016). The private hospitals also provides both private and shared rooms. However in private hospitals there is an option to appoint a private obstetrician (Buchmueller et al., 2013). The hospital takes initiative to provide the patient with a list of obstetricians who are available in that respective facility. The cost of birth in public hospitals can be entirely covered by Medicare however if the patient chooses private facility then the Medicare will only cover parts of the entire cost (O’Keefe & Kushelew, 2016). 

Scenario 4

1. In Australia, healthcare and medical treatment is covered by the system of public health and Medicare along with a few for- profit and not-for organizations which provide private health funds (Buchmueller et al., 2013). These private health funds tend to compliment the Medicare by the process of paying benefits for treatment procedures that are beyond the coverage scope of the public health systems. These might include dental and optical treatments. Coverage is available in terms of hospital cover, extra cover like dental and physiotherapy along with the combined covers of hospitals and the extras (Loue, 2013). In addition to this, ambulance coverage is also received. Whereas there are disadvantages like all conditions are not covered. Sometimes it is difficult to recognize which PMI will be suitable (Tracy et al., 2014). Additionally premium costs are rising above the level of inflation which poses a limitation.
2. The Australian healthcare system has several pros and cons. The advantages of the system involves the fact that it is financially supported by the federal government. The Medicare system involves the insurance program that consists of facilities of physicians, hospitals and the medications that is provided in the prescriptions. Studies have reported that the death rate is the lowest in the medical care provided by Australia. Inspite of the several advantages, there are limitations of the system which involve the complaints of waiting in long queues for attending any medical procedures or to receive any appointment (Duckett & Willcox, 2015). There are additional problems of workforce supply and distribution in Australia which effects the quality of the healthcare services. There is still an existence ofinequality in health between Australia’s most advantaged and least advantaged population.

1. For the provision of healthcare services in the rural areas, the government-funded groups, several local organizations and healthcare professionals tend to work together with the aim to provide the community with healthcare options that are easily available (Hall & Christian, 2017).These regional hospital services consists of resources that provide a broad range of health care which includes emergency care and mental health services along with intensive care, paediatrics and rehabilitation (Tracy et al., 2014). The Australian Health Ministers’ Advisory Council (AHMAC) engaged the Rural Health Standing Committee (RHSC) to take steps for the development of a National Strategic Framework for Rural and Remote Health. This would help to define vision and for rural health and to define an agreed set of priorities of national rural health. This reflects the common issues and challenges across jurisdictions (O’Keefe & Kushelew, 2016).
2. The constraint factors includes regional health care models, matching capacity and demand, economies and diseconomies of scale and scope and the capital investment dimension (Jongen et al., 2014). The financial factors effects the care, the findings and also the profits. In absence of funding, resources will not be present therefore economic efficiency should be increased (Duckett & Willcox, 2015).

References

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Gubhaju, L., McNamara, B. J., Banks, E., Joshy, G., Raphael, B., Williamson, A., & Eades, S. J. (2013). The overall health and risk factor profile of Australian Aboriginal and Torres Strait Islander participants from the 45 and up study. BMC Public Health, 13(1), 661.

Hall, M., & Christian, B. (2017). A health-promoting community dental service in Melbourne, Victoria, Australia: protocol for the North Richmond model of oral health care. Australian journal of primary health, 23(5), 407-414.

Hod, M., Jovanovic, L. G., Di Renzo, G. C., De Leiva, A., & Langer, O. (Eds.). (2016). Textbook of diabetes and pregnancy. CRC Press.

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Kennedy, S., Kidd, M. P., McDonald, J. T., & Biddle, N. (2015). The healthy immigrant effect: patterns and evidence from four countries. Journal of International Migration and Integration, 16(2), 317-332.

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Mayo, K., Melamed, N., Vandenberghe, H., & Berger, H. (2015). The impact of adoption of the international association of diabetes in pregnancy study group criteria for the screening and diagnosis of gestational diabetes. American journal of obstetrics and gynecology, 212(2), 224-e1.

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Nguyen, L. T., Kaptchuk, T. J., Davis, R. B., Nguyen, G., Pham, V., Tringale, S. M., … & Gardiner, P. (2016). The use of traditional Vietnamese medicine among Vietnamese immigrants attending an urban community health center in the United States. The Journal of Alternative and Complementary Medicine, 22(2), 145-153.

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