Innovations in Hepatitis B care and service provision in the NT – A culturally informed model of care

This session was presented within the workshop Equity and Access: unlocking the keys to viral hepatitis elimination. Kelly, Linda and Sarah presented data and innovations from the Hep B PAST project which has been working to determine the Hepatitis B Serostatus of all Aboriginal people within the NT and to improve the care available to those with Hepatitis B. This project had been developed in response to the high rate of Hepatitis B in the Aboriginal population of the NT, which has a prevalence of 15% in the pre-vaccination cohort in some remote communities.

The most impressive part of this project has been the work that has been done in partnership with Aboriginal people and communities to develop appropriate educational resources for patients (in their first language) and culturally appropriate training for Aboriginal staff working in healthcare.

The involvement of Aboriginal people at the core of the project has ensured that the project has evolved and developed to be culturally appropriate and acceptable to residents in remote communities. This model could no doubt inform those working with CALD communities Australia wide in how to develop and deliver acceptable resources and education in conjunction with diverse communities.

One of the most remarkable outcomes of this project has been the development of the ‘Hep B Story’ app which I have personally used in clinical practice in Yolnu Matha speaking communities. This app is being translated into additional languages as part of the project and the accessibility and usability of this means of resource delivery has proven popular with both clinicians and consumers.

Another part of the project aims to make Hepatitis care more accessible in the NT by developing core groups of both clinicians and community workers with the aim of making care available in a more acceptable model for remote Aboriginal people. This has involved training more S100 prescribers with particular focus on those working in remote communities and also ensuring that chronic disease nurses and Aboriginal Health Practitioners (AHP’s) receive appropriate training and support to deliver appropriate care within the nurse and AHP led model of care in remote communities.

Although the remote NT is a very different context to many healthcare settings within Australia the model of moving the delivery of appropriate Hepatitis care into the primary and community health domain is a challenge being addressed Australia wide. This model of healthcare could be utilised outside of the remote setting with core groups of trained community members working in partnership with clinicians to achieve equity of access for disadvantaged or difficult to access populations.

This model of care has already led to a rate of 18% of Aboriginal people with Hepatitis B within Top End Health Service clinics being prescribed antiviral treatment, and the project isn’t finished yet.

 

Author Bio: Catherine is a GP with a special interest in Population and ATSI health. She has worked in remote primary healthcare in the NT since 2012