Nganampa Health Council, South Australia

Nganampa Health Council, South Australia¹²⁹
Nganampa Health Council is an Aboriginal community controlled comprehensive primary health care service that has been operating on the Anangu Pitjantjatjara Yankunytjatjara Lands in the far north and west of South Australia since the mid-1980s. They operate health clinics in nine communities, and run a range of primary health care programs including aged care, sexual health, environmental health, health worker training, dental, women’s health, male health, children’s health and substance abuse prevention.¹³⁰

Nganampa is operated on strong principles of community-control, with an elected Board of Management, all local clinics managed by Anangu, and employment of many community residents. However, the organisation also has a strong record of valuing technical, evidence-based approaches to primary health care delivery, and an approach that encourages continual evaluation.¹³¹

Despite the often extreme poverty and lack of access to education and employment, Nganampa has built up a strong record over twenty years of improving health outcomes for the Aboriginal community, particularly in the areas of child and maternal health (despite local social and economic problems, the health service has achieved birth weight outcomes better than the national Aboriginal average and comparable with the broad Australian population outcomes) and the control of sexually transmitted disease.

Measures

• maternal health

- sustained increase in mean birth weight since the establishment of the health service
- decrease of low birth weight babies from 14.2% of births to 9.9% of births
- 80% reduction in perinatal mortality in the first ten years of the service (from 45.2 deaths per 1000 births to 8.65 deaths per 1000 births)
- a greater than three-fold increase in attendance for antenatal care in the first trimester

• child health

- reductions in the proportion of children with moderate or severe growth failure
- marked decline in the incidence of acute respiratory illness and diarrheal disease in children
- sustained child immunisation coverage at or close to 100%

• STD/HIV Control

- reduction in syphilis on the APY lands from around 20% in 1984 to around 0.5% over the last six years
- rates of gonorrhoea and chlamydia reduced to about one third of their previous level.

Contributing factors

• community management and control:

- regional model with dispersed health service delivery sites

• evidence-based approach:

- best practice clinical and population health services

• employment and training:

- Aboriginal training and employment
- multidisciplinary teams
- long-term retention of key staff

• improved access to secondary and tertiary care:

- provision of transport, accommodation and social support for clients travelling for hospital / specialist care

• collaboration with other organisations on public and environmental health issues
• advocacy role:

- on social determinants of health (housing, alcohol supply, food supply)
- for equitable, needs-based resourcing of health services

• quality management processes:

- health management information systems

129 Our thanks to Associate Professor Paul Torzillo, Medical Director of Nganampa Health Council, for participating in our key practitioner panel and contributing much of the unpublished data on which this section is based.130 See Nganampa Health Council web site at www.nganampahealth.com.au.
131 Nganampa Health Council. (nd). "Strategic Plan 2007-2010." from http://www.nganampahealth.com.au/downloads/Nganampa%20SP%202010.pdf.