National Framework for Action to Promote Eye Health and Prevent Avoidable Blindness and Vision Loss

Key Area for Action 3: Improving access to eye health care services

Action Area: Workforce Supply

There have been major enhancements to the delivery of eye health services through stronger integration and coordination of ophthalmology providers (government, private, not for profit and the NGO sector). These collaborations have resulted in the securing of joint funding of a Top End based Ophthalmology Fellow, Eye Care Coordinator and Indigenous Eye Care Liaison Officer.
During the reporting period, seven full-time equivalent dedicated trachoma nurses have been employed in the NT, five with the NT Department of Health and two with Aboriginal Medical Services, to assist communities with clinical trachoma control measures, and to provide training and support for remote clinicians.

Challenges encountered during the reporting period:

• 
  Retention of skilled trachoma staff.
  

Action Area: Rural and Remote Communities

During the reporting period, NT Department of Health provided a range of targeted eye care services that addressed the needs of remote and very remote communities. These services extended across primary health care eye health services from community health care centre services, visiting optometrists, ophthalmologists and vision care coordinators through to specialist diabetes care providers, care planning and allied health. Referrals to town-based providers and hospital services were also provided.
Trachoma Program activities were conducted almost exclusively in the 79 ‘at risk’ remote Aboriginal and Torres Strait Islander communities. Through a tailored, localised approach, community members did not have to travel for screening or treatment of active trachoma. Clients identified with trichiasis were referred to the regional hospital for corrective eye surgery.
In January-December 2014, 44 remote communities were identified as requiring trachoma screening as per the Communicable Disease Network Australia Guidelines. Of these, all 44 communities were screened, with an overall screening coverage rate of 92%.

Action Area: Access to Cataract Surgery

Service delivery reforms and innovations commenced in early 2014 by the NT DoH to improve access to services has resulted in an increased capacity to address demand for cataract surgery.
Access to cataract surgery has also been significantly enhanced through aligning interstate providers, and implementing joint NT-interstate intensive eye-surgery initiatives. This joint initiative has improved access to cataract surgery and provided a stronger follow-up and referrals process, with improved outcomes for clients.

Action Area: Affordability

The NT Trachoma Program is funded by the Commonwealth of Australia, with no cost to clients, and services provided in home communities wherever possible.

Action Area: Cultural Accessibility

All educational and health promotion resources produced in the NT, including under the Trachoma Program, are developed according to culturally appropriate guidelines, with input from relevant, expert and Aboriginal and Torres Strait Islander health service stakeholders.

Action Area: Public Awareness

Remote NT community members have participated in many promotional campaigns to raise public awareness of trachoma and eye health. The NT Trachoma Programme’s health promotion programme was delivered in partnership with the following agencies:

• 
  the Indigenous Eye Health Unit, based at University of Melbourne;
  
• 
  the Fred Hollows Foundation, Northern Territory; and
  
• 
  the Central Australian Aboriginal Congress, Alice Springs.
  

Example of a successful initiative – Northern Territory
Trachoma campaign to raise awareness through media and sport
A high profile ‘Clean Faces, Strong Eyes’ message campaign was delivered over 2011-2014 targeting high risk communities through TV advertising; radio segments and advertising with female Indigenous leaders and role models, AFL players and Melbourne Football Club at community football clinics; and community-based health promotion workers. Community-based trachoma health promotion activities, ‘Clean Faces, Strong Eyes’, were delivered at Indigenous All Stars AFL games in Alice Springs with messages of good health were shared through AFL clinics and activity sessions with hundreds of school children. Community members were encouraged to get health checks at the Congress Clinic with free tickets to the All Stars game as an incentive: Health Promotion at Indigenous All Stars AFL | Central Australian Aboriginal Congress Aboriginal Corporation²³
A trachoma education television campaign commenced airing on Imparja TV, Alice Springs, on the 1 January 2012 and was screened in total 40 times per week until the 1st of August 2012. The advertisement ran for 30 seconds and reached most of remote Australia. This television community service announcement featured Milpa the Trachoma Goanna with Yamba the Honey Ant supporting the elimination of trachoma in remote Indigenous communities in the Northern Territory by promoting the message Clean face, strong eyes: Milpa the trachoma goanna and Yamba the honey ant [online video] « Health promotion resources « Key resources « Australian Indigenous HealthInfoNet²⁴
Guidelines for Milpa the trachoma goanna education campaign link: Guidelines for Milpa the trachoma goanna education campaign