The Dr Dorothea Sandars and Irene Lee Churchill Fellowship to explore models of integrated primary health care to improve Indigenous eye health

Health and Medicine
The Dr Dorothea Sandars and Irene Lee Churchill Fellowship to explore models of integrated primary health care to improve Indigenous eye health featured image
Visiting eye specialist services are common in primary health care clinics providing health services to Indigenous Australians, however few are fulltime. Effective eye health screening (particularly for diabetic retinopathy) within primary health care and referral pathways to eye health professionals (visiting or external) are integral to a high quality eye health service model for Indigenous Australians. This project explored several models of eye health screening undertaken by primary health care staff, to supplement the services of the visiting eye health professionals, and to prioritise available appointments when eye services do visit. Models utilising referral pathways to visiting, and external eye health providers were studied. The use of EHealth in eye health screening was an important focus of this fellowship, and visiting sites using innovative models utilising well-developed EHealth protocols were a highlight of the project. This is a very exciting and quickly developing area of health care, and the visits provide learnings that could be used in the Australian context. Importantly, models of primary health care, where eye health was integrated into a holistic, multidisciplinary approach to chronic disease management, rather than being considered a “body part” speciality, were explored. This involved visiting PHC clinics, eye health professionals, centralised EHealth facilities, and hospitals, in a broad variety of settings, for key learnings, with the aim to assist in “closing the gap in vision” fully by 2020 for Indigenous Australians. To improve Indigenous eye health, we must improve Indigenous health, and this fellowship focussed on the holistic concept of health, and integration of services. My journey took me to Canada and the USA, examples of first world health systems sharing similar colonial histories to Australia, including the dislocation of First Nations People from land, forced removal of children from families, and the ongoing intergenerational health issues that this history impacts. It was surprising to me that during this project, I was often “joining the dots” between many of the programs I visited. There was little knowledge of the details of other First Nations eye health programs. However, there was great enthusiasm for knowledge exchange from everyone I encountered


Lisa Penrose-Herbert

Lisa Penrose-Herbert


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