'Aboriginal health is not just the physical wellbeing of an individual but is the social, emotional and cultural well-being of the whole community in which each individual is able to achieve their full potential thereby bringing about the total well-being of their community. It is a whole-of-life view and includes the cyclical concept of life-death-life.' (NAHS,1989).
Health disparities between Aboriginal and Torres Strait Islander (Aboriginal) people and other Australians continue to be a priority for Australian governments. Aboriginal Australians are significantly more affected by; low birth weight, chronic diseases and trauma resulting in early deaths and poor social and emotional health
Historically immunisation has been and remains, a simple, timely, effective and affordable way to improve Aboriginal health, delivering positive outcomes for Aboriginal and non-Aboriginal people of all ages.
It is a particular interest of NCIRS to inform practice and policy for immunisation and vaccine preventable diseases relating to Aboriginal Australians. NCIRS can see the potential that can be achieved through expanding the appropriate use of new and existing vaccines and improving vaccination coverage and timeliness, and these are messages we wish to promote.
Communication to service providers of the successes and barriers to immunisation service delivery for Aboriginal Australians is achieved through a range of publications and conference presentations.
Our research and surveillance activities contribute to policy through reports to government and participation on national and state based immunisation committees.
Aboriginal immunisation work at NCIRS is conducted in three areas;-
- Analysis of large national datasets
- Evaluation and grant-funded research
- National coordination
Deputy Director – Surveillance – Dr Robert Menzies BAppSc (Applied Bio), MPH, PHD
National Indigenous Immunisation Coordinator - Ms Telphia Joseph BHlthSc (CD/AbHlthSc)
Assistant National Indigenous Immunisation Coordinator - Mr Brendon Kelaher BHlthSc (Hons)
Analysis of large national datasets
NCIRS have been leaders in the use of VPD surveillance data to evaluate and track trends in morbidity in Aboriginal people. The reports on Vaccine Preventable Diseases and Vaccination Coverage in Aboriginal and Torres Strait Islander People have required development and/or application of new methods to determine the quality and completeness of Aboriginal data. Establishing minimum criteria of data quality has identified improvements in some jurisdictions which have allowed wider use of data and subsequent publication through these reports. While the AIHW has developed methods for assessing data quality for hospitalisations in Aboriginal people, NCIRS is the only organisation to systematically apply similar standards to VPD hospitalisations and vaccination coverage.
Reports that focus on vaccine preventable diseases and vaccination coverage in Aboriginal and Torres Strait Islander people are published regularly. They are modelled on the national surveillance reports (link to VPD report in surveillance section) and provide a comparison of VPDs and vaccination coverage in Aboriginal and non-Aboriginal Australians. The quality of Aboriginal health data is also a focus of these reports. The latest (second) report, which covered the period 2003–2006, was published as a supplement issue of Communicable Diseases Intelligence in June 2008.
These reports bring together relevant routinely collected data on, notifications, hospitalisations, deaths and childhood and adult vaccination coverage: Vaccination Coverage Reports
These reports have also been modified for use by Aboriginal Health Workers and other staff without clinical experience working in Aboriginal health: Vaccination for our Mob
Evaluation and grant-funded research
The National Centre for Immunisation Research (NCIRS) conducts a variety of research regarding Aboriginal and Torres Strait Islander people and vaccine preventable diseases, across surveillance, evaluation and vaccine relevance.
Projects can be generated due to Federal programs/policies, State and Territory initiatives or from consultation with health professionals working within the National Aboriginal Community Controlled Health Service and their affiliates.
Collaboration also occurs with other centres such as the SAX Institute, Menzies School of Health Research, Women's Hospital Melbourne and State and Territory Departments of Health.
Examples of In-House Projects
- Evaluation of the hepatitis A vaccination program added to the NIP in 2005 for Aboriginal children in Northern Territory, Queensland, South Australia and Western Australia. (conducted for the Department of Health and Aging, 2012-2013.
Examples of Collaborating Projects
- NHMRC Centre for Research Excellence in Population Health - Immunisation in under Studied and Special Risk Populations. NCIRS is a partner organisation in this CRE site, which includes a focus on Aboriginal people.
A cluster of vulvar cancer and vulvar intraepithelial neoplasia in young Australian Aboriginal women
(Royal Women’s Hospital, Melbourne)
- The Study of Environment on Aboriginal Resilience and Child Health (SEARCH)
(SAX Institute, Sydney)
- Women, Human papillomavirus, Aboriginal, Non-Aboriginal, Urban, Rural Study (WHINURs)
(Royal Women’s Hospital, Melbourne)
- Improving vaccination timeliness of Aboriginal children through a personalised immunisation calendar (Aboriginal Medical Service Western Sydney)
Since 2006 NCIRS has played a major role in national coordination through setting up the National Aboriginal and Torres Strait Islander Immunisation Network. to and those involved in providing immunisation services to Aboriginal and Torres Strait Islander people nationally. The focus of this network is to promote communication and coordination between the National Immunisation Committee the Aboriginal Community Controlled sector, other service providers and immunisation program managers, to ensure effective vaccination policy development and program delivery. The network is administered by the \National Indigenous Immunisation Coordinator, a position hosted at NCIRS.
Example outcomes from this activity include:
- Negotiation and liaison to get approval for the release of the Indigenous status of overdue children during ACIR reporting, and
- The development of Guidelines helped facilitate collaboration between service providers to ensure culturally safe follow-up, of overdue Aboriginal children.
Shift focus to the government and private sectors
The NIC now propose that the focus of NATSIIN shift to the government and private sectors. This will provide the opportunity to maintain the NATSIIN process, while broadening the participation of organisations outside the community controlled sector.
Functions of NATSIIN
- Provide advice to the National Immunisation Committee on issues related to the immunisation of Aboriginal people
- Conduct quarterly teleconferences
- Produce a quarterly NATSIIN Message stick, to enhance communication with the Aboriginal Health sector on immunisation issues
- State and Territory S&T Immunisation Departments of Health, who each nominate up to 2 suitably experienced people
- Australian General Practice Network
- National Rural Health Alliance
- Indigenous Doctors Association