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You are to write a brief explanation of what “Closing the Gap” (CTG) policy is including the history and data that influenced the policy’s creation. You are then to discuss the significance of this policy on Aboriginal & Torres Strait Islander People’s health outcomes using relevant literature and statistics. In this answer include any challenges and/ or barriers which may have affected the changes.


2. Analyse the impact of Judy’s Diabetes and how it is addressed within CTG including the long-term consequences to health and social determinants. 
3. Discuss the benefits of Judy being registered on CTG, and how this may have an impact on her social determinants.
4. Why would the AMS and ALO be referring Judy What services do they provide including an explanation about the relationship between the health systems.

Objectives of Close the Gap Campaign

Health issues are widely influenced by the social determinants and ethnic background. In context of the same, it can be said that Australia harbours a major proportion of the Indigenous population who are commonly known as the aboriginals. A wide gap has been observed to exist between the indigenous and the non-indigenous population set based at Australia in terms educational, economic and medical facilities.

In order to address the gap, it was felt necessary to incorporate developmental schemes in order to serve the minor community and adopt measures so as to bridge the gap between the two communities and facilitate a developmental progress. The essay will talk about one such strategy that was aimed at promoting improved medical facilities to the indigenous community and would correlate the objectives of the scheme with the provided case study.

The social justice report of 2005 reveals the demand put forward by Tom Calma who was the former commissioner of the social justice affairs (Baum et al. 2013). He solely urged the Australian government to reform the laws so as to increase the life expectancy of the aboriginals by 25 years (Kingsley et al. 2013). The appeal drew the attention of the various non-governmental organizations and thus two landmark campaigns were launched in favour in the year 2006 and 2007 respectively (Anderson et al. 2016).

The campaigns are popularly known as the Health Equity Campaign and the Close the Gap campaign. The campaigns generated a successful effect to the limit that it led to the observance of the National Close the Gap day that even attracted cross-government action. The Close the Gap campaign (CAG) successfully led to the designing of six stringent targets aimed at promoting welfare to the indigenous population based at Australia. The overview of the targets can be summarized in the following points (Laba et al. 2015):

  • To substantially reduce the gap in terms of employment within a tenure of ten years so as to provide equal employment opportunities both for the indigenous as well as non-indigenous set of population
  • To reduce the gap between the indigenous and the non-indigenous set of population in terms of academic and numeric conceptual understanding
  • To shut down the gap in terms of life expectancy within the completion of one cycle of generation
  • Within a time span of 10 years, the campaign is expected to substantially reduce the rate of mortality in children 5 years and below
  • To ensure a minimum secondary level education to all the indigenous students by the end of the year 2020
  • To make sure that the primary need of education is accessible to all the aboriginal children staying in remote areas within a time span of approximately ten years

In order to achieve the above said objectives, the campaign was launched in partnership with organisations such as the National Partnership Agreement on Remote Service Delivery, National Partnership on Indigenous Economic Partnership, Closing the Gap in the Northern Territory National Partnership Agreement and other such collaborations (Schutze et al. 2016). On critical evaluation of the efficacy of the campaign it can be stated that the project has yielded positive resulted in terms of substantial reduction of the infant mortality rate (Brown 2013).

Additionally, the initiative has also helped in increasing the access of education to the remote areas of the Australian territory inhabited by the indigenous population. However, the reports have not advocated any positive results in association with the other targets which comprise of bridging the gap in employment opportunities, enhancing the life expectancy through the generation and refining the existing approach of education. On critically evaluating the expenditure report it can be said that an approximate amount of almost $25.4 dollars was invested on the effective implementation of the project, out of the total cost.

Collaborations of Close the Gap Campaign

the direct government cost was roughly around, $ 44,128 for the aboriginal community whereas the total expenditure for the non-aboriginals was accounted to be around, $19,589 (Alford 2014). Annual finance reports have revealed that on an average, annually around $3.5 billion dollars have been spent on the close the gap project have been spent but the results yielded in relation to the grand expenditure is not that impressive (Panaretto et al. 2013). The main limitation that has been explored deals with the absence of infrastructure to implement the policies of improvisation effectively and the absence of any feedback database, so as to improvise the strategies (Mitrou et al. 2014).

            Studies significantly reveal that there is a high incidence of diabetes, cardiovascular disease and kidney problems pertaining to conditions such as development of kidney stones in the indigenous population based at Australia. The impact of Diabetes in Judy can elicit severe hormonal changes and other health related complications such as infection in the urinary tract, vision problems, anxiousness and irritability, increase in hunger and thirst and cognitive impairments. The condition might also pave the way for the development of gynaecological complications, hypertension and increased risk of cardiac arrests.

As is evident from the case study, Judy needs regular dressing of her leg ulcer which makes it evident that it is difficult for her to carry out activities of daily living such as using the washroom or dressing by herself.  The CTG aims to provide care to address the criticalities such as provide assistance in the daily dressing of the leg ulcer, take care of the medication regime by providing funds and also catering to the needs of the patient in case of an acute emergency (Willis et al. 2016).

The idea of the CTG is to make the medical facilities readily accessible to indigenous patients such as Judy and also educate them about the government schemes so that they can avail the benefits associated with it and also develop an essence of a healthy standard of living within them. The CTG has framed the policies with an effective consideration of the background of the indigenous community population and the social determinants that affect the well-being of them in terms of poor availability of nutritional diet, poor concept of hygiene, improper sanitation facilities and lack of education with respect to health development programs (Browne-Yung et al. 2013).

            The benefits that Judy is entitled to avail on being registered as on the CTG scheme mainly comprises of heavy discounts on the pharmaceutical expenditure. Advantage in terms of monetary benefit is assured to the aboriginal patients who have developed a substantial chronic illness and the benefit is based on the zero payment on behalf of the patient for medication prescribed for chronic illness. Post diagnosis, Judy could claim all her pharmaceutical expenditures and thus be saved from the heavy burden of economic expenditure.

Efficacy and Limitations of Close the Gap Campaign

As, Diabetes is classified as a chronic illness, hence, it should be stated that the PBS scheme would save Judy’s medical expenses for a lifetime (Willis et al. 2016). At the same time Judy would be under the supervision of medical assistance throughout the tenure of her illness and it would help in promoting a speedy recovery. In addition to this, Judy would also set an example for her contemporaries to be registered under the CTG scheme so as to avail medical benefits.

            The AMS is an acronym that stands for the Aboriginal medical service that was established in the year 1971 at Redfern with the primary objective of facilitating medical services to the aboriginal community (Anderson et al. 2016). The AMS strives to raise the health standards of the Torres Islander indigenous community people. The offered medical services comprise of a wide range of services such as medical care, alcohol and drug addiction rehabilitation program, dental care and old age care.

The ALO on the other hand are the Australian Liaison officers who ensure that proper medical service is being dispensed to the aboriginal patients in terms of chronic illness facility, immunisation schedules and imparting training and education to the healthcare professionals so as to spread awareness regarding the MBS scheme to the indigenous community people suffering from any chronic disease (Kingsley et al., 2013). While the AMS deals with the wide range of medical health benefits available for the treatment of the indigenous community people the ALO closely monitors the effectiveness of the implementation of the programs.

            Hence, to conclude it should be stated that the Australian government has adopted measures in order to assure health benefits and improving the social determinants that affect the health of the indigenous segment of the Australian population. The government schemes available as well as the non-governmental campaigns are aimed at designing improved programs to ensure an improvement in the overall health standard of the aboriginal community.

The targets of the campaign aim to critically evaluate strategies and bridge the existing gap between the indigenous and the non-indigenous segment of the Australian population within a stipulated time frame of about ten years. Although the efforts have been strenuous but the outcome has not been significantly impressive so far, however efforts are still being harboured to promote successful outcomes.

References

Alford, K., 2014. Economic value of aboriginal community controlled health services. Canberra: National Aboriginal Community Controlled Health Organisation Press Club.

Anderson, I., Robson, B., Connolly, M., Al-Yaman, F., Bjertness, E., King, A., Tynan, M., Madden, R., Bang, A., Coimbra Jr, C.E. and Pesantes, M.A., 2016. Indigenous and tribal peoples' health (The Lancet–Lowitja Institute Global Collaboration): a population study. The Lancet, 388(10040), pp.131-157.

Baum, F.E., Laris, P., Fisher, M., Newman, L. and MacDougall, C., 2013. “Never mind the logic, give me the numbers”: Former Australian health ministers' perspectives on the social determinants of health. Social Science & Medicine, 87, pp.138-146.

Brown, H., 2013. Promoting positive health messages to Aboriginal people. Australian Pharmacist, 32(11), p.52.

Browne-Yung, K., Ziersch, A., Baum, F. and Gallaher, G., 2013. Aboriginal Australians' experience of social capital and its relevance to health and wellbeing in urban settings. Social Science & Medicine, 97, pp.20-28.

Kingsley, J., Townsend, M., Henderson-Wilson, C. and Bolam, B., 2013. Developing an exploratory framework linking Australian Aboriginal peoples’ connection to country and concepts of wellbeing. International journal of environmental research and public health, 10(2), pp.678-698.

Laba, T.L., Usherwood, T., Leeder, S., Yusuf, F., Gillespie, J., Perkovic, V., Wilson, A., Jan, S. and Essue, B., 2015. Co-payments for health care: what is their real cost? Australian Health Review, 39(1), pp.33-36.

Mitrou, F., Cooke, M., Lawrence, D., Povah, D., Mobilia, E., Guimond, E. and Zubrick, S.R., 2014. Gaps in Indigenous disadvantage not closing: a census cohort study of social determinants of health in Australia, Canada, and New Zealand from 1981–2006. BMC Public Health, 14(1), p.201.

Panaretto, K.S., Gardner, K.L., Button, S., Carson, A., Schibasaki, R., Wason, G., Baker, D., Mein, J., Dellit, A., Lewis, D. and Wenitong, M., 2013. Prevention and management of chronic disease in Aboriginal and Islander Community Controlled Health Services in Queensland: a quality improvement study assessing change in selected clinical performance indicators over time in a cohort of services. BMJ open, 3(4), p.e002083.

Schutze, H., Pulver, L.J. and Harris, M., 2016. The uptake of Aboriginal and Torres Strait Islander health assessments fails to improve in some areas. Australian family physician, 45(6), p.415.

Swain, L., 2016. Improving medication management for Aboriginal and Torres Islander people by investigating the use of Home Medicines Review, pp 111-113

Willis, E., Reynolds, L. and Keleher, H. eds., 2016. Understanding the Australian health care system. Elsevier Health Sciences.

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