The issue: Increasing health gap among the mainlanders and the indigenous Australians associated with immunization and vaccination.
There is an impending gap associated with the healthcare status of the mainlanders and the aboriginal population (Percival et al. ,2018). This gap is associated with the prevalence of stigma in the society, prejudice, and stereotyping. The access and feasibility of the healthcare and immunisation among the mainlanders and the indigenous population are also high (Cashman et al., 2016). The major cause of this gap can be identified as the past experiences of the indigenous people where they have been discriminated leading to the development of reclusion and stigma in their society. Incidences like stolen generation and experiences of racism have also left a strong impact on the community (Torres et al., 2017).
There is a staggering gap in the immunisation between the aboriginal population and the mainlanders (Carman, 2019). The gap in immunisation prevails due to a restrictive and reclusive attitude of the indigenous population towards the main landers and also due to the prevalence of stereotypical behaviour and experiences in the medical setting, limiting the access to immunisation and vaccination policies and medical structures (Carman, 2019). The stigma prevails that the population has developed a notion that vaccination can cause sterilisation. This stigma is rooted in the incidences like the stolen generation that has resulted in the development of mistrust in the community. Vaccination and immunisation are necessary to prevent incidences of preventable diseases, improve the quality of life, and promote health in the community (Torres et al., 2017).
It is an essential duty of the healthcare professionals to promote the health and well-being of the community by active participation and by encouraging community education (Government of Australia, 2018). Various national policies have been developed that assert increasing immunisation and vaccination in the aboriginal community. The “Hunter New England Local Health District (HNELHD)” in northern New South Wales (NSW), Australia has implemented the “Close the Gap” approach by the Government of Australia to minimise the prevailing gap between Aboriginal and non-Aboriginal children’s immunisation rates (Cashman et al., 2016). Further, multiple schemes have also been developed by the Government for the Aboriginal and Torres Strait Islander people, the community is able to get extra vaccines for free through the National Immunisation Program (NIP) (Government of Australia, 2018).
This advocacy plan aims to target the healthcare professionals working in the community care and remote locations
Rationale: The healthcare professionals, nurses and midwives are abided to promote health and beneficence in the community by ensuring the welfare of the community. They can increase the rate of immunisation in the aboriginal community by promoting health through patient education and the development of community nursing programs (Lovie-Toon et al., 2016). The nursing and the Midwifery Board of Australia guide the healthcare professionals to promote health in the community as essential conduct of practice established in the principle of the code of conduct (Thomas et al., 2019).
The healthcare professionals are the source of essential information regarding healthcare and wellbeing and therefore act as advocates of the wellbeing of the community health (Lovie-Toon et al., 2016). The healthcare professionals can help in the immunisation by understanding the social and cultural paradigms of the indigenous population and cater to their needs effectively by promoting wellness, education, and by practising cultural competence (Borg et al., 2018).
Community programs: The community programs must be designed and developed by healthcare professionals to educate the community about the need and significance of immunisation (Percival et al. ,2018). The community welfare programs will engage a larger population for the means of information transmission and assist in reaching a larger section. The community programs will also be able to reach the remote locations for providing healthcare facilities like vaccination and immunisation. The healthcare professionals must be engaged in these community programs to reach out and assist the aboriginal community to participate in immunisation and vaccination (Torresi et al., 2019).
Workshops and training: Use of media and organisation of workshops and training is highly important when conducting programs about awareness (Carman, 2019). The workshops and the trainings based on the cultural and social needs of the indigenous population can help the healthcare professionals develop competence and perform analysis.
Face to face interactions: The healthcare professionals must participate in face to face interactions with the people belonging to the aboriginal community. This will be of help in enhancing communication, development of strong interpersonal relationships, development of competency and empathy, and understanding of the needs of the community (Torresi et al., 2019).
Strengthening of community action: The community action is important as it helps in driving an overall change in the community. A change in the mindset of people towards immunisation and vaccination is essential This requires participatory efforts and a driven community action for health promotion and beneficence (Borg et al., 2018).
Policy making: The healthcare professionals must work in accordance to draft policies and promote the beneficence of the community. Policy making is essential as it helps in establishing guidelines for the programs and will assist the healthcare professionals to take suitable steps to promote immunisation and vaccination among the indigenous population (Torres et al., 2017)
Education: The healthcare professionals and the indigenous community must be educated to establish the immediate needs of immunisation and vaccination. This will ensure that the people in the community participate, collaborate, and comply with the vaccination and immunisation policies. Educating the healthcare professionals about the cultural and social needs can help in the development of competence, understanding the ends of the community, and therefore provide suitable care (Lovie-Toon et al., 2016).
Social impact assessment: The impact and efficacy of the immunisation programs should be regularly assessed by statistical analysis of the immunisation and disease incidence (Hendry et al., 2018).
Monitoring and evaluation: The immunisation programs must be monitored and evaluated with critical consideration of the social and cultural guidelines to ensure maximum beneficence of the aboriginals (Lovie-Toon et al., 2016).
Development of personal skills: The personal skills of the healthcare professionals like communication, competence, and empathy must be developed so that the immunisation and vaccination programs can be succeeded with the participatory efforts (Thomas et al., 2018)
Improvement in immunisation: With the successful completion of this program, it is expected that the immunisation state of the aboriginals is improved (Borg et al., 2018).
Limiting the gap or health inequity: The existing gap in the indigenous population and the mainlanders. This there will also be reduction I health inequity in regard with immunisation as the healthcare professionals will be aware of the immunisation programs and will be able to get vaccinated to prevent illness (Thomas et al., 2019)
Improved health care support for the Aboriginal Torres Strait Islander community: The healthcare support to the Aboriginal Torres Strait Islander community with improved access to healthcare, by community reach and vaccination programs (Torresi et al., 2019).
The decrease in disease occurrence rates: With active immunisation, the preventable illnesses will be limited in the community and therefore prevent the disease occurrence (Percival et al. ,2018)
Cashman, P. M., Allan, N. A., Clark, K. K., Butler, M. T., Massey, P. D., & Durrheim, D. N. (2016). Closing the gap in Australian Aboriginal infant immunisation rates--the development and review of a pre-call strategy. BMC Public Health, 16(1), 514.
Government of Australia (2018). Immunisation for aboriginal and Torres strait islander people. Retrieved from: https://www.health.gov.au/health-topics/immunisation/immunisation-throughout-life/immunisation-for-aboriginal-and-torres-strait-islander-people
Hendry, A. J., Beard, F. H., Dey, A., Meijer, D., Campbell‐Lloyd, S., Clark, K. K., ... & Sheppeard, V. (2018). Closing the vaccination coverage gap in New South Wales: the Aboriginal Immunisation Healthcare Worker Program. Medical Journal of Australia, 209(1), 24-28.
Lovie-Toon, Y. G., Hall, K. K., Chang, A. B., Anderson, J., & O’Grady, K. A. F. (2016). Immunisation timeliness in a cohort of urban Aboriginal and Torres Strait Islander children. BMC Public Health, 16(1), 1159.
Thomas, S., Cashman, P., Islam, F., Baker, L., Clark, K., Leask, J., ... & Durrheim, D. N. (2018). Tailoring immunisation service delivery in a disadvantaged community in Australia; views of health providers and parents. Vaccine, 36(19), 2596-2603.
Borg, K., Sutton, K., Beasley, M., Tull, F., Faulkner, N., Halliday, J., ... & Bragge, P. (2018). Communication-based interventions for increasing influenza vaccination rates among Aboriginal children: A randomised controlled trial. Vaccine, 36(45), 6790-6795.
Carman, R. A. (2019). Vaccination coverage rates in Aboriginal and Torres Strait Islander children. A Mixed Methods Study. The impact of immunisation service delivery in general practice on Aboriginal children living in the Perth Metropolitan Area: An opportunity to reduce the Gap?. BMC Public Health, 16(1), 1159
Thomas, S., Higgins, H., Leask, J., Menning, L., Habersaat, K., Massey, P., ... & Durrheim, D. N. (2019). Improving child immunisation rates in a disadvantaged community in New South Wales, Australia: a process evaluation for research translation. Australian Journal of Primary Health, 25(4), 310-316.
Torresi, J., McGuinness, S., Leder, K., O’Brien, D., Ruff, T., Starr, M., & Gibney, K. (2019). Immunisation. In Manual of Travel Medicine (pp. 19-169). Springer, Singapore.
Torres, S., Richard, L., Guichard, A., Chiocchio, F., Litvak, E., & Beaudet, N. (2017). Professional development programs in health promotion: tools and processes to favor new practices. Health Promotion International, 32(3), 587-598.
Percival, N. A., McCalman, J., Armit, C., O’Donoghue, L., Bainbridge, R., Rowley, K., ... & Tsey, K. (2018). Implementing health promotion tools in Australian Indigenous primary health care. Health Promotion International, 33(1), 92-106.
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