Eye health programs within remote Aboriginal communities in Australia: a review of the literature (original) (raw)

Eye health services for Aboriginal people in the western region of NSW, 2010

New South Wales Public Health Bulletin, 2012

Aim: To assess the availability, accessibility and uptake of eye health services for Aboriginal people in western NSW in 2010. Methods: The use of document review, observational visits, key stakeholder consultation and service data reviews, including number of cataract operations performed, to determine regional service availability and use. Results: Aboriginal people in western NSW have a lower uptake of tertiary eye health services, with cataract surgery rates of 1750 per million for Aboriginal people and 9702 per million for non-Aboriginal people. Public ophthalmology clinics increase access to tertiary services for Aboriginal people. Conclusion: Eye health services are not equally available and accessible for Aboriginal people in western NSW. Increasing the availability of culturally competent public ophthalmology clinics may increase access to tertiary ophthalmology services for Aboriginal people. The report of the review was published online, and outlines a list of recommendations.

We can see the gap: regional eye health coordination for indigenous Australians

Aboriginal And Islander Health Worker Journal

The eye care needs of Indigenous Australians require local and regional coordination to successfully bring together individuals and communities with eye care providers and service delivery facilities. A new model of coordination is required to embrace community, primary care, secondary eye care, hospital, regional, jurisdictional and national organisation requirements. The eye health coordination workforce should be integrated within existing health service programs but will require additional commitment to close the gap for vision.

Lessons learned from a subsidised spectacles scheme aiming to improve eye health in Aboriginal people in Victoria, Australia

2020

The Victorian Aboriginal Spectacles Subsidy Scheme (VASSS) aimed to improve access to visual aids and eye care for Aboriginal and Torres Strait Islander Victorians. The VASSS started in July 2010 and has operated continually since. In 2016, we explored the collaborations, planning, adaptations and performance of the VASSS over the first 6 years by reviewing and analysing service data, as well as data from semistructured interviews, focus groups and surveys. An estimated 10853 VASSS cofunded visual aids were delivered over 6 years, and the mean annual number of comprehensive eye examinations provided within services using VASSS grew 4.6-fold faster compared with the 4 years preceding the VASSS. We estimate that 16% and 19% of recipients presented with distance and near vision impairments respectively, all of which were corrected with visual aids. VASSS achievements were attained through collaborations, flexibility, trust and communication between organisations, all facilitated by fun...

Strengthening Indigenous eye care in Australia and New Zealand through a Leaders in Indigenous Optometry Education Network

Australian and New Zealand Journal of Public Health, 2021

Australian and New Zealand Journal of Public Health 89 © 2021 The Authors This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. The leaders of optometry schools in Australia and New Zealand/ Aotearoa aim to establish a Leaders in Indigenous Optometry Education Network (LIOEN) dedicated to strengthening Indigenous eye care through better educating optometry students and increasing the number of Indigenous optometrists.

Re-examining the gap: A critical realist analysis of eye health inequity among Aboriginal and Torres Strait Islander Australians

Social Science and Medicine, 2021

The prevalence of diabetes among Aboriginal and Torres Strait Islander (hereafter 'Aboriginal') Australians is three times greater than non-Aboriginal Australians, contributing to a greater risk of blindness from treatable and preventable ocular conditions, most prominently cataract and diabetic retinopathy. In rural and remote Aboriginal communities, blindness prevalence is higher, and ocular treatment coverage and uptake are lower. In collaboration with Aboriginal Community Based Researchers (CBRs), this study explored complex contingent factors that shape access to eye health services among rural and remote Aboriginal Australians living with diabetes. Interviews (n = 126) and focus groups (n = 12) were conducted with patients, primary care clinicians, and CBRs, in four rural communities in the Northern Territory and New South Wales. Factors internal and external to health systems were examined, drawing on Bourdieu's concepts of habitus, and doxa to understand agency and decision-making among patients and clinicians. The study used the ontology of critical realism, categorising contingent factors as underlying structures (generative mechanisms), and applying a decolonising approach that centred causal relationships and tensions between dominant (Western biomedical neoliberalism) and non-dominant (Aboriginal) value systems. Three forms of marginalisation; linguistic, economic, and cultural, were identified as the generative mechanisms that inhibit equitable eye health outcomes. Marginality is linked to structural factors that position Aboriginal culture as a barrier, and is reinforced through biomedical health systems, and the agents who operate in and influence them. In order to address eye health inequity, a shift in how Aboriginal cultural sovereignty is understood within health systems is needed, to position it as a strength that can facilitate eye care accessibility, and to support enhanced cultural responsivity among clinicians and service providers.

Sustaining remote-area programs: retinal camera use by Aboriginal health workers and nurses in a Kimberley partnership

The Medical journal of Australia, 2005

To describe how a novel program of diabetic retinopathy screening was conceived, refined and sustained in a remote region over 10 years, and to evaluate its activities and outcomes. Program description; analysis of regional screening database; audit of electronic client registers of Aboriginal community controlled health services (ACCHSs). 1318 Aboriginal and 271 non-Aboriginal individuals who underwent retinal screening in the 5 years to September 2004 in the Kimberley region of north-west Australia; 11 758 regular local Aboriginal clients of Kimberley ACCHSs as at January 2005. Characteristics of clients and camera operators, prevalence of retinopathy, photograph quality, screening intervals and coverage. Among Aboriginal clients, 21% had diabetic retinopathy: 19% with non-proliferative retinopathy, 1.2% with proliferative retinopathy, and 2.8% with maculopathy. Corresponding figures for non-Aboriginal clients were 11%, 11%, 0 and 0.4%, respectively. Photograph quality was general...

Visual impairment among Aboriginal and Torres Strait Islander patients attending an Australian Indigenous primary health service: a cross-sectional study

Australian Journal of Primary Health, 2020

This cross-sectional study aimed to identify the period prevalence of visual impairment (VI) and blindness among Aboriginal and Torres Strait Islander people attending an Indigenous urban primary healthcare service, eye care practitioner referrals for those with VI and any opportunities to improve care delivery. Visual acuity (VA) examinations, using a Snellen chart, are performed as part of routine annual health assessments offered to children and adults. This study included patients aged ≥5 years (n=1442) who had a health assessment conducted between 1 January 2015 and 31 December 2016 and provided consent for the use of their health assessment information for research. Of patients with available data, 2.4% (33/1374) experienced VI, defined as presenting VA worse than 6/12 to 6/60 in the better-seeing eye. VI was more common in those aged ≥60 years (14/136; 10.3%) and was significantly associated with increasing age (P<0.001). No patients experienced blindness, defined as prese...