Grampians — Closing the Gap in Indigenous eye health

Indigenous health faces challenges in translating evidence-based frameworks into improved outcomes for Aboriginal and Torres Strait Islander people.1 The Grampians region of Victoria highlights a successful model of enhancing eye health outcomes.

In 2014, the Victorian Government allocated $100 000 under Koolin Balit: Victorian Government strategic directions for Aboriginal health 2012–2022 to support the improvement of Indigenous eye care services in the Grampians region.2 Moreover, the 2012 Roadmap to close the gap for vision describes an effective whole-of-system regional approach to improve Indigenous eye health outcomes.3

The collective work in the Grampians region resulted in a number of outstanding successes. The Grampians Region Aboriginal Eye Health Advisory Group (GRAEHAG) met regularly to drive planning, implementation, data sharing and evaluation to improve eye health outcomes. Gap analysis identified the need for additional optometry services through the Australian College of Optometry, with visits increasing over five-fold from 2012. Additional equipment and training needs were managed through purchase of slit lamps and a retinal camera by the Grampians Medicare Local and the Department of Health and Human Services (DHHS) for use in local Aboriginal Medical Services (AMS). Health promotion resources, developed with strong local community engagement, contributed to free online material designed for adaptation across Australia. These changes supported an increase of over 55% of patients receiving annual diabetic eye checks from 2013 to 2016.

Barriers to eye services were dealt with, including lengthy waiting times for public cataract surgery. By 2015–16, the Grampians region had significant increases in cataract surgery rates (over 64%) and hospital admissions for eye disease (over 54%), with eight Indigenous patients undergoing surgery via Commonwealth funds administered through the Rural Workforce Agency, Victoria (RWAV; Mary Sullivan, Senior Project Officer, Aboriginal Health and Wellbeing Branch, Department of Health and Human Services, Melbourne, personal communication, October 2016). The uptake of $10 subsidised spectacles increased 50% through dialogue with the community addressing cultural barriers. A regional seminar on improving services to Indigenous patients was held for mainstream providers.

The Grampians project faced challenges that included getting all stakeholders to participate from the outset in the regional advisory group, and identifying funding for additional eye care services, equipment and training.

The GRAEHAG facilitated interaction between participants lacking access to existing channels of communication to collaborate on Indigenous eye health issues. All stakeholders, including the local AMS, had an investment, voice and opportunity to shape the direction of the project, with shared data informing further service improvement and a sustainable approach. A final GRAEHAG project report will be published in February 2017.