Ten years of trachoma elimination in rural Western Australia: lessons from the field

Ten years of trachoma elimination in rural Western Australia: lessons from the field Conference Paper

14th National Rural Health Conference: A World of Rural Health

• Author(s): Huppatz, Clare , Gibson, Robyn, Castledine, Hannah, Cross, Kate, Custodio, Juliana, Davies, Jane, Gilles, Marisa, Jones, Phillippa, Lester, Matthew, Mak, Donna, Mullane, Robert, Symonds, Lyn, Ward, Jeanette, Wood, Marianne, Woollacott, Claire
• Secondary Author(s): Coleman, Leanne
• Published: 2017
• Publisher: National Rural Health Alliance

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Abstract: Introduction: Trachoma is an important eye infection, which affects an estimated 84 million people, and is responsible for 8 million cases of preventable blindness worldwide. The international Alliance for Global Elimination of Trachoma by the year 2020 (GET2020) is a WHO-led initiative which unites countries, including Australia, in a commitment to eliminate trachoma as a public health problem by 2020. Australia has several areas in which endemic trachoma persists, including rural and remote Aboriginal Communities in Western Australia (WA). The WA Trachoma Program formed in 2006, and applied evidence based guidelines, and a coordinated strategic approach to reducing trachoma across WA. We review program data and discuss their implications for trachoma elimination in Australia, identifying key lessons learned. Methods: Reported trachoma screening data from more than 50 Aboriginal Communities across WA were analysed to provide an understanding of program progress. Key challenges and barriers to effective implementation have been documented, as well as reflections from key stakeholders. The impact of identified program milestones and key program decisions are analysed with respect to the changing rates of trachoma prevalence. Results: The trachoma prevalence in WA has dropped from 24% in 2006, to 2.6% in 2015. Program KPIs improved over this time, with the number of ‘at risk’ communities screened increasing from 75% to 100%, and the number of children in the target group screened increasing from 39% to 89%. Program milestones that facilitated these successes included: increased funding; clearly identified KPIs; a coordinated approach to screening; innovative workforce solutions; formation of a Program Reference Group; and excellent relationships with key stakeholders and Aboriginal Communities. Discussion: As Australia nears its target of eliminating trachoma as a public health problem by 2020, significant challenges to this goal remain. New programmatic issues threaten elimination in some areas, including the limitations of the screening tool, the highly mobile Aboriginal population and issues of program fatigue. New strategies are required that address these issues: greater coordination between jurisdictional programs; renewed Community engagement with the use of more generic health promotion messaging; and a sharp focus on key social determinants, particularly environmental health conditions. Conclusion: Trachoma is a worldwide problem and Australia is the only developed country with endemic trachoma. The WA Trachoma Program has demonstrated that a flexible and responsive approach can greatly reduce trachoma prevalence as we near our target of elimination by 2020.

• Urls: http://www.ruralhealth.org.au/14nrhc/sites/default/files/Castledine%2C%20Hannah_C8_1.pdf Available from, http://www.ruralhealth.org.au/14nrhc/program/concurrent-speakers Download site
• Publisher Location: Cairns