Wurli- Wurlinjang Health Service Strategic Plan July 2013 June 2016 Wurli-Wurlinjang is a community controlled Aboriginal health service providing comprehensive primary health care services to the people of Katherine, Northern Territory.
Introduction Wurli-Wurlinjang Health Service had its origins in the Kalano Health Service, which itself was part of an Australia-wide surge in the development of Aboriginal community-controlled health services in the early 1980s. At that time Aboriginal people were not accessing the mainstream health system, for a variety of reasons. Lack of access meant the health system at that time effectively discriminated against Aboriginal people. There was a need for a health service where Aboriginal clients felt welcome and comfortable. A new health centre building was opened at Kalano in 1983, and staff began work among the Aboriginal population in the town of Katherine and in the camps and living areas. In 1993 Wurli-Wurlinjang Health Service was separately incorporated, taking its name and logo from the mosquito dreaming which was a symbol of the Jawoyn land where it was originally situated. In 1995 Wurli-Wurlinjang moved to its current premises in Third Street Katherine, thereby improving its access to all Aboriginal people in the town. Over the years Wurli has moved to a greater focus on the underlying determinants of health, establishing specialised programs for men s health, mental health and family wellbeing, alcohol and other drugs, tobacco control and others. These programs have required their own facilities and now Wurli delivers services from a number of locations across Katherine. And while we continue to deliver general and acute care at our main clinic in Third Street, one of our busiest locations now is Gudbinji, in Kintore Street, where clients with chronic conditions receive a model of care appropriate to their needs. Population growth, increased availability of health funding through the Commonwealth Government, the need for more specific targeting of illness, and Wurli s desire to provide better services to its clients, have now led our organisation to consider further growth of our facilities. Planning is underway to redevelop the main Wurli campus in Third Street, and this project will dominate our infrastructure development for years to come. Governance As an Aboriginal community-controlled organisation, Wurli is governed by a Board of Directors elected by members of the Corporation living in Katherine and surrounding community living areas. Elections are held every three years. The Board has representatives from: Jodetluk (two positions) Geyulkgan Ngurro (two positions) Mialli Brumby (four positions) Rockhole (four positions) Katherine town (four positions) Board members take their governance responsibilities seriously. They understand their communities and the issues which are of concern to residents, and undertake training provided by the Office of the Registrar of Indigenous Corporations. Our vision The Board of Wurli-Wurlinjang has a strong vision: To move forward as one, to heal our people and improve our health. Our values Our values lie underneath all our work. They are the rock on which we build Wurli-Wurlinjang, and help us turn our vision into reality. Our values are: to build respect for our elders and our culture to empower people to take responsibility for their health to ensure good governance and take responsibility for our organisation to recognise the diversity among Aboriginal people in Katherine, and the importance of a variety of approaches to be honest about what alcohol and other drugs (including tobacco) are doing to our people to understand that health and healing is not only a job for health professionals but for everyone to foster respect between Aboriginal and non-aboriginal people. 2 Wurli-Wurlinjang Health Service Strategic Plan July 2013 June 2016 3
Our goals Wurli aims to provide comprehensive primary healthcare services. Our overall goals are to provide services and support for Aboriginal people encompassing primary medical care as well as addressing the underlying conditions which bring about poor health. We take a holistic approach which recognises the personal, cultural and political circumstances which impact on the health of Aboriginal people, and our charter includes not only service delivery but such diverse functions as advocacy, family support, wellbeing and others. A framework for primary healthcare core service delivery has been endorsed by the community-controlled sector and Commonwealth and Northern Territory Governments. Wurli endorses this framework, and considers all the functions set out below as falling within our potential role. It is handy to divide these functions up into five sections or domains. In developing this Strategic Plan, Wurli has considered the background, or context, of our community and the best way to deliver health services. (A) Health background Looking at the various types of illness that impact on our people helps us make decisions about the types of services we deliver. The most meaningful way of describing the impact of illness is to talk about the years of healthy life lost, both time lost due to premature death and time spent disabled by disease. This pie graph shows the proportions of years of healthy life lost due to various illnesses in the NT. Proportions of disability adjusted life years by disease category, Northern Territory, 1999 2003 Core Functions of Primary Health Care for the NT Domain 1: Clinical services Services delivered to individual clients and/or families, in both clinic and home/community settings, including treatment, prevention and early detection, rehabilitation and recovery, and clinical support systems. Domain 2: Health promotion Non-clinical measures aimed to improve the health of the community as a whole. Health promotion includes a range of activities from building healthy public policy to providing appropriate health information and education, and encourages community development approaches that emphasise community agency and ownership. Domain 3: Corporate services and infrastructure Functions to support the provision of health services, including the availability and support of well-trained staff, financial management, infrastructure, information technology, administration, management and leadership, and systems for quality improvement across the organisation. Domain 4: Advocacy, knowledge and research, policy and planning Includes health advocacy on behalf of individual clients, on local or regional issues, or for system-wide change; the use of research to inform health service delivery as well as participation in research projects; and participation in policy and planning processes (at the local/regional/northern Territory and national levels). Domain 5: Community engagement, control and cultural safety Processes to ensure cultural safety throughout the organisation; engagement of individual clients and families with their own health and care; participation of communities in priority setting, program design and delivery; and structures of community control and governance. Others 8% Skin 2% Infectious 2% Musculoskeletal 2% Digestive 3% Neonatal 4% Genitourinary 5% Intentional injuries 5% Unintentional injuries 6% Chronic respiratory 7% Mental 17% Cardio-Vascular 12% Diabetes 10% Cancer 9% Neurological 8% Source: Zhao Y, You J and Guthridge S 2008. Burden of Disease and Injury in the Northern Territory, 1999 2003 Unpublished 11 4 Wurli-Wurlinjang Health Service Strategic Plan July 2013 June 2016 5
Goals for 2013 16 National data on risk factors contributing to the health gap between Aboriginal and Torres Strait Islander and non-indigenous people. 20 15 10 5 0 Tobacco Obesity Physical inactivity High blood cholesterol Alcohol High blood pressure The proportion of our resources (people and money) devoted to the core primary health care functions at any one time varies according to the priorities set by Wurli. Wurli has prioritised the following goals for the period covered by this Strategic Plan: Low fruit & vegetable intake Source: Commonwealth Department of Health and Ageing, National Aboriginal and Torres Strait Islander Health Plan 2013 2025, Canberra 2013 p27 (B) Service delivery model As a model for delivering our services, Wurli adopts a life course approach. This is set out in the table below. Wurli aims to provide all the services indicated on this chart, in addition to providing a walk-in acute care service for short-term ailments. Providing all these core services adequately for the whole population requires an enormous amount of resources, particularly given the levels of illness in our community. Wurli-Wurlinjang believes we do the best we can with the resources provided to us. We continue to discuss our resource needs with governments and others. Life course approach to chronic illness prevention and management Age 0 4 years 5 14 years 15 54 years 55+ years Immunisation Prevention Health education, promotion and advocacy Antenatal / postnatal care 0 4 Early detection 5 14 15 54 55+ Men s and women s health Social and emotional wellbeing Management Treatment, ongoing management including self-care Effective health information system Communicare 6 Wurli-Wurlinjang Health Service Strategic Plan July 2013 June 2016 7
GOAL 1 Expand our physical infrastructure, to better meet the need for increased health service delivery. Our strategy to achieve this goal is to implement the master plan developed for the Wurli-Wurlinjang health campus. Creche / Playground Mothers & babies Ear / Eye Clinics Administration GOAL 2 Develop an appropriate balance between the attention we pay to acute care needs, on the one hand, and longer-term planned care needs, on the other. emphasise the importance of early intervention in preventing and managing chronic conditions undertake well person s checks, in addition to caring for sick people, particularly for young people, and maintain a focus on health promotion and community engagement. GOAL 3 Continue to build the human resource capacity of Wurli-Wurlinjang. act on the recognition that our workers are our most important asset continue to employ qualified professional staff continue to provide support and training for all employees continue to emphasise the importance of building career pathways for local Aboriginal people, as Aboriginal Health Practitioners, and extend training and career options for local Aboriginal people across a range of skill areas in the organisation. Proposed Masterplan Wurli-Wurlinjang Health Service Third St, Katherine Renal Reverse Osmosis Dental / chronic disease Cafe Existing Clinic Well Being 8 Wurli-Wurlinjang Health Service Strategic Plan July 2013 June 2016 9
GOAL 4 Develop a focus on services relating to family and individual wellbeing and mental health, utilising the strengths inherent in Aboriginal culture. recognise the damage done to individuals and families through colonial history act on the understanding that the strengthening of Aboriginal culture is a way to mitigate that damage, and provide dedicated services which address individual and family wellbeing, mental health, and alcohol and other drug services. GOAL 5 Recognise that a key component in improving Aboriginal health is to address the social determinants of health, including environmental health, and that advocacy on these social determinants is a core function of Wurli-Wurlinjang. appreciate that many of the factors which underlie the health problems of Aboriginal people are beyond the capacity of a health service to address recognise that we have a duty to bring these factors to the attention of governments and other organisations in a responsible but forceful manner, and use all relevant means of communication to do this, including mass media. GOAL 6 Develop and strengthen partnerships with other service providers, understanding that collaboration at the local, regional, Territory and national level underpins efforts to close the gap in Aboriginal health. recognise that Aboriginal people in this region, the Northern Territory, and around the country have more in common than separates them, and develop strategic alliances, both formal and informal, which bring Aboriginal organisations together for common health-related purposes. 10 Wurli-Wurlinjang Health Service Strategic Plan July 2013 June 2016 11
Published by: Wurli-Wurlinjang Health Service 25 Third St, Katherine, Northern Territory PO Box 896, Katherine, NT 0851 Ph: (08) 8972 9123 wurli@wurli.org.au www.wurli.org.au October 2013 Wurli-Wurlinjang All rights reserved. The content, including artwork, of this publication should not be reproduced without prior authorisation of Wurli-Wurlinjang. Design: Black Wattle Consulting