HST6335 Public Health Strategies

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HST6335 Public Health Strategies

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HST6335 Public Health Strategies

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Course Code: HST6335
University: Edith Cowan University

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Country: Australia

Question:
Describe a facility or organization that provides RSH services and its alignment with national and state policyOutline the services  and programs that are provided for Indigenous peopleOutline the services that are provided for people with disabilitiesOutline the services that are provided for SSAIGD peopleEvaluate the specific services and or programs for each priority populations group (Indigenous people, SSAIG and people with disabilities) in relation to the research evidenceOutline recommendations for improving these services based upon the evidence and the feasibility of this
Answer:

Introduction:
Maintenance of reproductive health and sexual hygiene are considered to be the key components of human life. Previously sexual health had been perceived as a taboo but in association with the modern advancement in the field of science and social perspective, it has emerged out to be a primary concern. In compliance with the current trend, statistical evidences reveal that 25% of the Australian population is affected with some or the other form of sexually transmissible disease (Australian Institute of Health and Welfare 2018). Research studies have further stated that the population set based at the remote and rural areas are affected more severely in comparison to the population set based at the town and cities (Australian Institute of Health and Welfare 2018). The major reason that has been enlisted as the primary cause for the discrepancy in the prevalence of STIs among the rural population has been detected to be the lack of education and awareness regarding sexual health and hygiene.
Studies have also revealed that Chlamydia, Gonorrhea, Syphilis, HIV/AIDS, Hepatitis B, Genital Herpes, HPV and Trichomonas infection are the most reported sexual transmitted infections in Australia (Connell et al. 2013). This report would undertake the case study of an organization offering services for the maintenance of reproductive and sexual health. The organization that has been considered by me is the oldest organization providing sexual health services to people in Australia. This paper would focus on the facilities offered by the Sydney Sexual Health Centre to the aboriginal, disabled as well as the non-aboriginal proportion of the population. Further it would evaluate the quality of the services offered and offer recommendations that could be undertaken in order to improve the service quality dispensed by the organization. 
Description:
Sydney Sexual Health Center is located in the Nightingale Wing, Sydney Eye Hospital at 8 Macquarie street in Sydney, NSW 2000, Australia. It provides reproductive and sexual health services to people (SSHC 2018). The organization was found in the year1993 and is the oldest organization operating in NSW. The organization also forms a part of the Directorate of planning, population health and equity within the south eastern Sydney local health district, which is also known as SESLHD (SSHC 2018). The organization is funded by the NSW ministry of health and commits itself to provide the best quality services within the specific domain.
The organization has received numerous awards for continuous improvement and innovation with respect to the services provided (SSHC 2018). In order to improve sexual and reproductive health of women, the Australian government has introduced effective family planning policies that are at present handled by six organizations. National strategies for the prevention of STIs such as Hepatitis B, Hepatitis C, HIV and BBVs have been endorsed by the Australian Health minister’s committee. In addition to this the Health Ministry offers grants of 12.5 million dollars for effective awareness, 9.8 million dollars for the STI sexual health campaign and more than 33.2 million dollars to treat STIs and BBVs (Newton et al. 2013). The Sydney sexual health centre complies with the National and state policies to render services regarding sexual wellness, prevention from STIs, maternal health and reproductive hygiene.
Facilities offered:
Sydney sexual health center offers a wide range of facilities to meet the health requirement of a diverse target audience. The organization operates through various departments such as General clinic that involves screening, treatment and management of STI and Xpress that makes the screening faster for clients who undergo regular testing. Other departments include the Youth clinic, the Thai and Chinese clinic, the Late Night clinic, a[TEST], Counseling  and the Needle and Syringe Program. These departments offer services to ensure confidential testing, treatment and designing of interventions to help people who are affected with STIs (SSHC 2018).
Services offered to the aboriginal community members include free of cost HIV and STI testing, Hepatitis B vaccination, distribution of contraceptives and condoms and health education and counseling. Services provided at Sydney Sexual Health Centre are free of cost and include facilities such as STI, HIV and Hepatitis screening and treatment (SSHC 2018). The organization provides free sterile injection needles through h a dispenser the NSP service under the NSW NSP program. The organization has a highly updated risk assessment tool that could be used by people in order to evaluate their health status and find out whether or not they are at a risk of developing STIs. In addition to this, support to the younger people involve free distribution of HIV/ STI pregnancy kits, distribution of condoms, advices regarding sexual health, counseling regarding appropriate contraception methods and Hepatitis B and Cervial cancer vaccinations (SSHC 2018). The organization operates within convenient time frame so that it is feasible for the people to seek advice and avail treatment interventions.
Disability Services:
Free of cost HIV and STI screening along with education and awareness with regard to reproductive services for the disabled people are dispensed by the organization. The organization also complies with the NDIS act and engages in organizing counseling sessions for the maintenance of sexual health (SSHC 2018).
Services for SSAIGD:
SSAIGD stands for same sex attracted, intersex and gender diverse. The organization has a program to support the individuals belonging to the LGBTI community. It offers regular HIV, STI and Hepatitis screening for bisexual men, gay men and transgenders (SSHC 2018). The organization conducts confidential testing and offers vaccination programs for Hepatitis A and Hepatitis B. Further, it should be noted that in case of positive screening results, the organization has an efficient treatment procedure. PrEP is a form of antiretroviral drug that is prescribed to HIV negative people in order to prevent HIV infection. PEP is another medication which is prescribed to patients who have been potentially exposed to HIV infection. The organization also extends its services to the sex workers within the community. Research studies have revealed a major prevalence of HIV infection in sex workers and the LGBTI community on account of unprotected sexual intercourse. Free condom distribution and counseling is offered to effected people in order to maintain sexual health and adapt preventive measures to eradicate STIs.  
Service Evaluation:
This section would focus on the service strategies that could be undertaken in order to improve the quality of services offered to the target audience of indigenous people, SSAIG and people with disabilities based on available research evidences.
Indigenous population:
The aboriginal and Torres strait islander form the 3% of the total population base of Australia. This set of the population has remained confined to the remote areas and have insufficient access to health care facilities. On account of the cultural diversity and lack of education there is a wide prevalence of STIs and BBVs among the aboriginal community members. Research papers have revealed advancements in the field of medical science and technology to deal with the scenario. The knowledge about the antiretroviral medication has led to a major breakthrough in controlling sexual transmitted infections (Ward et al. 2013). In addition to this, it should be crucially note that as per the Fourth National Aboriginal and Torres Strait Islander Blood borne Virus and Sexually Transmitted Infected Strategy 2014-2017, it is expected that the use of anti viral vaccination would help in the complete eradication of hepatitis C from the Australian continent (Baum et al. 2013). A strong emphasis has been put on designing awareness strategies so as to educate people about the impact of STIS on health. Further, it should also be mentioned that it has been stated in research papers that a timely screening and intervention procedure must be undertaken so as to detect the prevalence of infection on an early basis and accordingly adapt measure to deal with the issue.
In order to create awareness a strong emphasis has been put on the establishment of a holistic centered approach that could be achieved through community practices. Community programs aimed at promoting awareness against STIS include elements such as spiritual healing, improving participation in education, improving social and environmental health, instilling positive behavior and strengthening community function. In addition to this government schemes such as close the gap (CTG) policy aims to focus on these health issues and effectively improve the life expectancy of the aboriginal community members in a decade (Baum et al. 2013).
SSAIG:
Sexual health covers a wide range of aspects that includes physical, mental and spiritual well being. While dealing with SSAIG community members, care givers must engage in a client centered therapeutic relationship. Awareness programs highlighting the importance of indulging in safer sex practices should be briefed to the people. Importance of using condoms or other barriers such as dental dams and femidoms should be briefed to the members of the SSAIG community. Research studies reveal that the use of barriers methods prevents the entry of body fluids such as semen and vaginal lubricants to enter the body of a normal person and cause infection (Wilson et al. 2013). Studies have further revealed that gay and bisexual men are at an increased risk of transmitting HIV on account of indulging in anal sex. Care givers should educate gay and bisexual men to use a condom and get tested regularly so as to avoid the possibility of developing STI. In addition to this, permanent contraception methods such as vasectomy, IUDs and tubectomy should be advised to the members of the SSAIG community (Connell et al. 2013). Assistance in case of sexual violence should also be provided. Care givers must cater to their needs especially in such cases to make them comfortable and at the same time educate them regarding sexual and reproductive health.
People with disabilities:
The disabled set of population has been the most ignored segment of population and has been perceived by the societal stigma. Common myths associated with disabled people include the belief that they are sterile and do not possess sexual desire (Taggart and Cousins 2014). Denial of sexual and reproductive health right has been a common norm in this regard. There is an increasing need to reform the outlook of the society in the manner they perceive disability. Breakdown of social barriers and improved access to health care facilities can help in improving the standard of sexual and reproductive health in disabled people. Research papers have revealed that health promoting schools could essentially focus on imparting knowledge about sexual health to the disabled people (Newton et al. 2013).
In addition to this, there is a need to create a family centered relationship between the physicians and the care providers so as to help parents overcome societal barriers and assume an active role in imparting sexual education to their children. In order to improve the flow of communication, there is a need to initiate collaboration with different support organizations that can offer medical aid to disabled people (Taggart and Cousins 2014). Caregivers engaging in promoting sexual and reproductive health care to the disabled must be effectively trained so that they are able to help intellectually disabled people with family planning (Connell et al. 2013) . The care providers also must engage in educating the disabled about using protection such as condoms and contraceptives while engaging themselves in sexual intercourse. In addition to this care givers must also highlight the importance of maintaining menstrual hygiene and concentrate on cleanliness of private parts.
Strengths and Weakness of SSH:
In order to proceed with the recommendation section, the strength and weakness of the organization would first be compared and accordingly the recommendations would be suggested for each target population.

Strengths

Weakness

· Has increased access to target population
· Has excellent infrastructure and technological expertise
· Observes health and well-being as core philosophies

· Lack of schemes to administer mass awareness within the target population group
· Credibility issue related to target population
· Lack of innovation and provision off staffing in remote areas

Recommendations:
Recommendations that could be undertaken in order to maintain a safe sexual and reproductive health for the aboriginal community members, LGBTI and disabled individuals would include implementation of the discussed strategies mentioned below. Improving community awareness and access to information would help people to understand the importance of maintaining sexual health. Supporting healthy ageing, improving the system of education, responding to the system of specific population group, Prioritizing prevention and providing quality care at the correct time and place can help in controlling the occurrence of STIs to a great extent. Increased access to healthcare facilities can be promoted through informative posters and brochures. Community programs could highlight all the necessary information related to the maintenance of sexual health.
Compliance with the LGBTI policies in collaboration with the Australian government can help in making the health care facilities easily accessible to the individuals belonging to the LGBTI community. Basic sexual education should be incorporated as a school curriculum so as to promote awareness among young students about the implications of engaging in unprotected sexual intercourse (Holt et al. 2013). At the same time, measures must be undertaken so as to make the information accessible to students who have dropped school. Informative messages about using disposable and sterilized needles and use of contraceptive devices such as condoms to avoid accidental pregnancies and STIs must be briefed to the students.
 In addition to this, community workers must ensure that multidisciplinary services are available to the indigenous population set along with access to preventive strategies on being screened positive. Promoting awareness to reduce the stigmatized approach of the society can help in attaining positive outcomes. Inclusion of innovation in technology such as ‘telehealth’ and electronic helpline portal can help in making the services readily accessible to the disabled as well (de Visser et al. 2014). Stringent compliance and implementation of Aboriginal and Torres Strait Islander Sexually Transmitted Infectious Action Plan 2016-2021 can help in reducing the incidence of STIs (Graham et al. 2013).
Conclusion:
Therefore to conclude, it can be stated that maintenance of reproductive and sexual health is a primary concern and must not be compromised with under any circumstances. On closely analyzing the evidences furnished by the research papers it can be stated that the prevalence of STIs is fairly higher in the indigenous set of population than the non-indigenous population base at Australia. The primary reasons that could be held accountable for the disparity in the prevalence rate could be enlisted as poor accessibility to health care facilities and lack of education in association to the negative health implications of STIs. It has also been recorded that the disabled proportion of the Australian population is lagging behind in terms of opportunities for the maintenance of reproductive and sexual health. The LGBTI community members have also been stated to be the high risk population prone to develop STIs. The Australian government has attempted to provide quality care in order to maintain the reproductive and sexual health of the people through various grants and policies. The health care organizations comply with the NSQ standards and strove to deliver the best quality services and make the access to healthcare much easier.
Awareness campaigns and educating people about the need to maintain sexual hygiene can help in lowering the prevalence rate of STIs and other associated diseases in Australia. Sexual health centers offer free screening of STIs in order to assist people in detecting the disease at the initial phase. In addition to this, organizing community programs that outline the basic knowledge about the maintenance of reproductive hygiene and offering counseling to deal with disease if screened positive can help in providing a healthy environment to the people.
References:
Australian Institute of Health and Welfare 2018. Reports & statistics – Australian Institute of Health and Welfare. [online] Australian Institute of Health and Welfare. Available at: https://www.aihw.gov.au/reports-statistics [Accessed 26 Sep. 2018].
Baum, F., Freeman, T., Jolley, G., Lawless, A., Bentley, M., Värttö, K., Boffa, J., Labonte, R. and Sanders, D., 2013. Health promotion in Australian multi-disciplinary primary health care services: case studies from South Australia and the Northern Territory. Health Promotion International, 29(4), pp.705-719.
Connell, R.W., Crawford, J., Dowsett, G.W. and Kippax, S., 2013. Sustaining safe sex: Gay communities respond to AIDS. Routledge.
de Visser, R.O., Badcock, P.B., Simpson, J.M., Grulich, A.E., Smith, A.M., Richters, J. and Rissel, C., 2014. Attitudes toward sex and relationships: the Second Australian Study of Health and Relationships. Sexual health, 11(5), pp.397-405.
Graham, S., Guy, R.J., Cowie, B., Wand, H.C., Donovan, B., Akre, S.P. and Ward, J.S., 2013. Chronic hepatitis B prevalence among Aboriginal and Torres Strait Islander Australians since universal vaccination: a systematic review and meta-analysis. BMC infectious diseases, 13(1), p.403.
Holt, M., Hull, P., Lea, T., Guy, R., Bourne, C., Prestage, G., Zablotska, I., de Wit, J. and Mao, L., 2013. Comprehensive testing for, and diagnosis of, sexually transmissible infections among Australian gay and bisexual men: findings from repeated, cross-sectional behavioural surveillance, 2003–2012. Sex Transm Infect, pp.sextrans-2013.
Sydney Sexual Health Centre 2018. [online]. Available at: https://www.sshc.org.au/ [Accessed 26 Sep. 2018].
Newton, D., Keogh, L., Temple-Smith, M., Fairley, C.K., Chen, M., Bayly, C., Williams, H., McNamee, K., Henning, D., Hsueh, A. and Fisher, J., 2013. Key informant perceptions of youth-focussed sexual health promotion programs in Australia. Sexual health, 10(1), pp.47-56.
Taggart, L. and Cousins, W., 2014. Health promotion for people with intellectual and developmental disabilities. McGraw-Hill Education (UK).
Ward, J., Bryant, J., Worth, H., Hull, P., Solar, S. and Bailey, S., 2013. Use of health services for sexually transmitted and blood-borne viral infections by young Aboriginal people in New South Wales. Australian journal of primary health, 19(1), pp.81-86.
Wilson, N.J., Parmenter, T.R., Stancliffe, R.J. and Shuttleworth, R.P., 2013. From diminished men to conditionally masculine: sexuality and Australian men and adolescent boys with intellectual disability. Culture, health & sexuality, 15(6), pp.738-751.

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