With the prevalence of chronic conditions in the Northern Territory of Australia, the urgency to implement the intervention strategies were developed. Evidences have shown the incidence of developing chronic disease in all age groups including, children, adolescents, adults and older aged people, however, the susceptibility of these diseases were found to be at an alarming state in the older adults (Harrison et al., 2017). With increasing age and reduced mobility due to various diseases, comorbidities were found to be prevalent in the older adults (Jaul et al., 2018). Therefore, a framework was needed to be developed and implemented in this area, with the aim to prevent and manage chronic conditions and promote health of the individuals. Thus, The Northern Territory Chronic Conditions Prevention and Management Strategy (NT CCPMS) is developed that gives a framework and strategies that are evidence based in order to build and strengthen a system wide approach with the aim to prevent and manage chronic conditions in the Northern Territory. The strategies include a number of chronic conditions including type 2 diabetes, cardiovascular diseases, rheumatic heart disease, chronic airways diseases, chronic mental disease, chronic kidney disease and cancers associated with the common risk for other chronic conditions (Health.nt.gov.au, 2019).
Most of the studies conducted in this area acknowledge the fact that chronic conditions are developed as a result of poor lifestyle choice, poor diet, unhealthy habits and other factors that can be easily managed and prevented with self-management strategies (Willett et al., 2006). Therefore, one of the key areas that the implementation plan focus on is self-management support. The aim of this implantation program is also to make the individuals aware of their conditions and educate them on the importance of self-management strategies to promote health. Although, waking up early, maintaining a healthy diet, drinking adequate water, doing exercise and maintaining a healthy sleeping pattern are tradition strategies to promote health and found in almost all books and journal articles, evidences have shown that lack of awareness and education among individuals are responsible for developing chronic diseases in them. Thus, the implementation plan also focuses on the importance of educating people and the community to promote health and prevent the occurrence of chronic diseases (Brady, Anderson & Kobau, 2015).
The strategy aims at improving the health of the individual by reducing the prevalence and impact of chronic conditions. With the aim to promote health, the goals of this strategy involves promoting and supporting healthy lifestyle among community. This is important since a healthy lifestyle reduces the likelihood of developing chronic conditions and promote health of an individual. In order to promote health, it is important to access and address the risk factors and determinants of health and implanting strategies to eradicate the risk factors, thus reducing the possibility of occurrence of chronic diseases in individuals. Risk factors contribute and increases the chance of developing chronic diseases that could have managed easily by adopting healthy lifestyle choices (Barrett et al., 2016). Therefore, the strategy also aims to reduce the prevalence of factors in the population, for which again educating the individuals and community is important. The strategy also aims to prevent or delay the onset of chronic conditions among individuals and increase the wellbeing of those people who are living with chronic conditions. The occurrence of chronic conditions are common in people belonging from all age group and from all regions and culture. This vast variety of population, belonging from different age group and may be, communities or cultures, might be different in terms of concerns, preference and language, however, they all have a common need and expectation which is receiving a high quality care without any inequality of disparity. Every individual has the right to enjoy the privilege of getting a high quality treatment and health services that will be free from any kind of disparity. Thus, the strategy also aims to reduce health disparity among this vast variety of different individuals and with respect to the conditions and risk factors. It is also important that the the gap in life expectancy associated with chronic conditions between people from different community and ethnicity is reduced (Braveman, 2014). Therefore, minimizing the gaps in the life expectancy between the Aboriginal and non-aboriginal people is also on the goals of this strategy. Every individuals and the community must receive equal treatment and respect irrespective of their culture or ethnicity. The strategy aims to increase self-management among the individuals by educating them and making them aware of the importance and rationale of self-management strategies to prevent the prevalence of chronic conditions (Brady, Anderson & Kobau, 2015). It also aims of improving its integration and collaboration across all sectors.
Therefore, the implementation plan provides a framework by outlining strategies and actions with the aim to guide both government as well as non-government health organizations and communities through the Northern Territory to prevent and manage chronic conditions. The key action areas of this implantation plan are to focus on the Social Determinants of Health (SDoH), to focus on the primary prevention for preventing ad reducing the risk factors, self-management , facilitating early detection and secondary prevention, caring for people already detected with chronic conditions, facilitating planning and developing for workforce, to focus on the information, disease management systems and communication and to support and enable a continuous quality improvement. The action areas developed under this implementation plan mainly focuses on the two aspects, including promoting health and caring for people with chronic conditions and increasing self-awareness and education in the community on the importance of self-management strategies to reduce the risk factors and determinants of health for reducing the prevalence of chronic conditions in the community (Health.nt.gov.au, 2019).
Individuals and organization can make use of this strategy and implement it for developing local business and identifying opportunities collaboratively to work with others for implementing the National Territory Chronic Conditions Prevention and Management Strategy 2010-2020 (NT CCPMS).
The plan involves stakeholders that represent the Northern Territory chronic conditions network within the Department of Health, non?Government health services and Aboriginal community? controlled health service providers. Consultations include a range of focus group conducted in remote and urban Aboriginal communities who are attended by the health professional and consumers (Health.nt.gov.au, 2019).
Evidences have shown the prevalence of diseases at the highest rate in the Northern Territory among all jurisdictions in Australia. The leading conditions include mental cardiovascular diseases, diabetes, cancers and chronic respiratory diseases that attributes to approximately 77% of the life expectancy gap between the Indigenous and non-indigenous people in Australia. As per the data of the Department of Health, comorbidities and complications are fund to be common in among people with chronic conditions that result in an increased cost for healthcare services and rates of hospitalization. Studies have also shown that in the remote communities of the Northern Territory in approximately 40% of people have two chronic conditions before 50 years of age. After 50, 60% of people have at least two conditions and 30% with three chronic conditions. It has also been found that chronic conditions account for 40-56% of resources for public hospital and chronic conditions of hospital admissions that could have easily avoided across all populations of Northern Territory. The strategy also include plans to reduce high rates of hospital admission challenge primary health planers and the service providers for providing effective interventions focusing on the prevention. Facilitating early detection and enabling proactive and effective management of chronic conditions. The strategy response also include addressing the risk factors for chronic condition which is a priory area for care planning and delivery of care services. Department of Health suggests that the strategy is implemented by adopting the models of care that promotes a multidisciplinary approach, enable incentivise and a quality and effective management for chronic diseases (Health.nt.gov.au, 2019).
The most important strategy to promote health and manage and prevent chronic conditions include self-management strategies which can be implemented by educating and making the individual aware and by working in partnership with the healthcare providers. It is also important to understand their condition and keep them informed about the various treatment options or approaches available depending on the severity of their condition. The plan also aims to engage them in activities promoting and protecting the health of the individuals and the community as a whole. It also developed strategy for monitoring and managing their signs and symptoms by addressing the risk factors. The plan also includes the management of the impact of the chronic condition on interpersonal relations, emotions and physical functioning (Health.nt.gov.au, 2019).
The key areas include making a collaborative and supportive partnership between the client and the service providers that the expertise of the provider is shared with the client with the aim to increase awareness ad educate the client. The plan is implemented by empowering the people and the community regarding increasing their capacity to be engaged in the activity that aims to improve and promote health and wellbeing of the people.
One of the key action areas of this plan include recruiting and developing a highly skilled and competent workforce to educate and improve health outcomes of the population in chronic disease. The plan also aims to include the number of Aboriginal workers working in the health sector. It also ensures that the staff are competent, skilled, supported and trained enough to facilitate the delivery of culturally safe care and a high quality care. It also ensures that Aboriginal safety and security implanted in the service. It incorporates the strategies to increase the number if Aboriginal workers to deliver services for chronic care across all settings (Lange et al., 2017).
In the year 2007, on behalf of the Australian Government Minister and Northern Territory Emergency Response (NTER) for Families, Community Services and Indigenous Affairs, Mal Brough MP, announced and suggested to protect the Aboriginal children in the Northern Territory. The announcement, along with the combination with other actions, included alcohol restrictions, compulsory health checks, compulsory income management, welfare reform, banning of pornography, scrapping of the permit system for common areas, and improving housing and community living arrangements (O’Mara, 2010).
Northern Territory Emergency Response (NTER) was introduced with lack of community consultation being a deep concern, in the response of which Australian Indigenous Doctors’ Association (AIDA) selected to undertake an assessment for a health impact to raise voice to the affected communities and enable discussion with policymakers and the leaders to improve NTER and reduce the negative impact on the health and wellbeing in the community (O’Mara, 2010).
Most of the chronic conditions are managed or prevented or delayed by interventions targeting making effective lifestyle changes. It is important to make informed choices for behavioural change, which is essential in effective management of chronic conditions (Riegel et al., 2017). Since health promotion plays an important role in the reducing the risk factors, the primary focus of the plan is to enable health promotion intervention across a continuum that are more likely to foster a difference if there were more focused on settings and also individuals. Health education is also found he most effective provided with consistent ad effective messages being delivered to population or community and also to the healthcare providers through a program or a broader campaign. Therefore, the awareness campaigns targeted to the public and the community form as an essential part of the health promotion (Health.nt.gov.au, 2019).
Therefore, in order for the plan to be implemented or executed, education on health is necessary in the community. This can be done by producing healthy lifestyle infographics by addressing the risk factors (for example, smoking, drinking, and obesity, excessive consumption of foods rich in fat and physical inactivity) and raising awareness by particularly focusing on the young adolescent or youths, who are more involved in these habits. The plan is implemented by engaging the community and the stakeholders for strengthening the development of the frameworks, policy and programs of the strategy (Health.nt.gov.au, 2019). The plan ensures that the tools for community awareness including social marketing and campaigns must promote consistent messages that are evidence based and also include an evaluation component for informing the applications to the targeted group of the Northern Territory. It is implemented by ensuring the best available and innovative practices for prevention activities that will be implemented in both urban as well as in the rural areas (Health.nt.gov.au, 2019).
References:
Barrett, D. H., Ortmann, L. H., Dawson, A., Saenz, C., Reis, A., & Bolan, G. (Eds.). (2016). Public health ethics: cases spanning the globe (Vol. 3). Springer Open.
Brady, T. J., Anderson, L. A., & Kobau, R. (2015). Chronic disease self-management support: public health perspectives. Frontiers in public health, 2, 234.
Braveman, P. (2014). What are health disparities and health equity? We need to be clear. Public health reports, 129(1_suppl2), 5-8.
Harrison, C., Henderson, J., Miller, G., & Britt, H. (2017). The prevalence of diagnosed chronic conditions and multimorbidity in Australia: A method for estimating population prevalence from general practice patient encounter data. PLoS One, 12(3), e0172935.
Health.nt.gov.au. (2019). Chronic conditions prevention and management – Department of Health. Retrieved 1 November 2019, from https://health.nt.gov.au/professionals/chronic-conditions-health-professionals/chronic-conditions-prevention-and-management
Health.nt.gov.au. (2019). Retrieved 1 November 2019, from https://digitallibrary.health.nt.gov.au/prodjspui/bitstream/10137/2724/3/Chronic%20Conditions%20Strategy%20Implementation%20Plan%202017-2020.pdf.pdf
Jaul, E., Barron, J., Rosenzweig, J. P., & Menczel, J. (2018). An overview of co-morbidities and the development of pressure ulcers among older adults. BMC geriatrics, 18(1), 305.
Lange, F. D., Jones, K., Ritte, R., Brown, H. E., & Taylor, H. R. (2017). The impact of health promotion on trachoma knowledge, attitudes and practice (KAP) of staff in three work settings in remote Indigenous communities in the Northern Territory. PLoS neglected tropical diseases, 11(5), e0005503.
O’Mara, P. (2010). Health impacts of the Northern Territory intervention. Medical Journal of Australia, 192(10), 546-548.
Riegel, B., Moser, D. K., Buck, H. G., Dickson, V. V., Dunbar, S. B., Lee, C. S., … & Webber, D. E. (2017). Self?care for the prevention and management of cardiovascular disease and stroke: A scientific statement for healthcare professionals from the American Heart Association. Journal of the American Heart Association, 6(9), e006997.
Willett, W. C., Koplan, J. P., Nugent, R., Dusenbury, C., Puska, P., & Gaziano, T. A. (2006). Prevention of chronic disease by means of diet and lifestyle changes. In Disease Control Priorities in Developing Countries. 2nd edition. The International Bank for Reconstruction and Development/The World Bank.
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