There is a variety of health centres in the NT. There are differences in their age, design, and the kinds of materials used to build them. No matter what conditions you find yourself working in, you can still make the health centre a safe, functional and interesting place where people feel comfortable and welcome.
The possibilities and challenges will be different in each health centre, and will depend on:
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how the centre has been built, decorated and maintained | |
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how accessible it is to all groups within the community | |
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what systems are in place, for example to support confidentiality of information | |
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to what extent policies are applied, for example occupational health and safety policies and a cultural safety policy |
Note: 'Cultural safety' is "the need to be recognised within the health care system and to be assured the system reflects something of you - of your culture, your language, your customs, attitudes, beliefs and preferred ways of doing things." (Eckermann et al 1992:168)
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Talk about the sample checklist. Can you think about other things that you can do to improve the building and grounds? |
Making the health centre more accessible means exploring different ways of making sure that all people have access to appropriate services.
| ... Access, consumer rights and liaison Principle Each health centre will make its health programs available to all members of the community in its catchment area. Health team members will liaise with all other health services and sectors in the region to keep the service current with the latest health program developments and to address the health needs of the members of its community. In all interactions with members of the community their rights to privacy, confidentiality and resolution of service dissatisfaction should be respected. Freeman and Rotem 1999:72 |
There is no overall organisational policy on health centre opening hours. Hours still vary slightly across the NT according to:
There are regional differences in health centre opening hours. Compare the following situations.
| Central Australia There are no standard opening hours in Central Australia. Opening hours are negotiated at a community level between the health centre team and the council or health council (if there is one). Some centres are closed for the afternoon, or part of it, so that staff can be out and about in the community. Opening hours may vary during the seasons. For example, in winter the centre may open late in the morning. In summer, health centres may open earlier as people are up early and don't move about in the heat of the afternoon. Summer is ceremonial time so community populations may drop considerably or may increase if the ceremony is in that community. Information provided by Melanie van Haaren, DON, |
| The Top End In the Top End the opening hours of the health service vary depending on community need and community based health programs. There may be a period when the health centre may be closed (excluding emergencies) during the day to run community based programs or health promotion activities. The hours and health programs are determined in consultation with the health board (if applicable), community council or elder group. In some places in the Top End, the end of June to mid July is 'bush holidays' time when people return to their traditional lands. There are fewer people in the community. Sometimes there will be mobile health centres set up to visit the traditional lands. In other places AHWs go on holidays too, and bring back people who are sick for treatment. Information provided by Noelene Swanson, |
One of the issues often raised is that men do not access the health centre very much. Different solutions have been tried to increase men's access, such as:
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alternative programs for men | |
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a separate 'clinic' time for men | |
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a separate entrance and waiting area in or near the health centre | |
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construction of the health centre in 'two halves', with one side for men and the other for women | |
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the recruitment and training of male as well as female AHWs | |
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access to both male and female RANs and doctors |
| Gapuwiyak Men's Health Centre Gapuwiyak is an Aboriginal community in North East Arnhem Land. The people of Gapuwiyak have a very strong culture. In the past, the men have been embarrassed and shamed to go to the health centre. Men will not go to see women about health problems unless they are very sick, sometimes not at all. In 1996 we started to talk about setting up a men's health centre. We had help from Virginia from Miwatj Health to apply to OATSIS for money. The Community Council gave us an old donga and a rusty old car to visit outstations, do filming and visit old men in our area. The Gapuwiyak Men's Health Centre was opened in May 1997. We had two barbeques so all the men could see that they now had their own health centre. More and more men started to come to the health centre, we are really busy now. The centre is staffed by men: a Senior Aboriginal Health Worker, two Trainee Aboriginal Health Workers and an STD/AIDS Educator (half-time). When men and women shared the health centre very few men came, maybe 30 or 40 per month. Now more than 200 are coming each month for different treatments. The men are very happy to have their own health centre. We always do well men's check-ups when men come to the health centre and also on our home visits. These include diabetes checks, blood pressure, heart checks, skin checks, and blood tests for different problems. We always offer health education. Some of the other things we're doing are:
Sometimes we take young ones to a quiet place out bush to sit down and talk about things without anyone bothering us. We are doing STD screening and we've set up a register. We've also installed two condom dispensing machines in the community. If anyone would like to know more about our project you can contact us by phoning 8987 9135. Information provided by Terrence Guyula and Tim Duggan, |
The health centre is a setting in which health information can be shared with community residents as part of regular work practice. The use of videos and displays to share information can make the health centre an interesting place to learn about health. The following activities can be part of a broader education for health strategy.
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Have appropriate posters or pamphlets around the health centre and change them often | |
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Play health related videos in the waiting area | |
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Organise displays around particular themes. Encourage student AHWs to turn their health assignments into displays for local people to view and discuss. Involve school children in drawing pictures to illustrate the theme | |
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Set up demonstrations and experiments. Staff from other programs such as Environmental Health, Food and Nutrition, Alcohol and Other Drugs can provide assistance | |
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Include details of education for health activities in your business plans | |
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See the chapter 'Education for Health', which includes advice on the actions you can take to include education for health processes in work practice | |
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See the chapter 'Sharing Health Information'. The chapter outlines the why, what, who, where, when and how of sharing health information in an effective way | |
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See the section 'Using Media' in the chapter 'Strategies for Health Promotion' | |
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See the section 'Brief Interventions" in the chapter 'Strategies for Health Promotion', for advice on effective ways of sharing health information during one-to-one interactions in the health centre | |
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Find out about the short training course in 'Sharing Health Information' specifically designed and trialed with community health teams | |
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See 'Hands On: The Public Health Education and Training Database'. | |
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Contact Staff Development Branch or your local Health Promotion Unit for information | |