Type 2 diabetes mellitus and its complications affect up to 25% of Aboriginal adults. However, access to primary health care is often poor, with primary care providers serving Aboriginal populations often being overwhelmed by acute care needs. Implementing and sustaining culturally safe programs to screen for chronic disease and provide effective continuing care is therefore a significant challenge. This study demonstrated that a devolved program of screening for retinal complications of diabetes in a remote Aboriginal population can be successfully performed by Aboriginal health workers and nurses using non-mydriatic fundus cameras and sustained over time with regional program support. Data sharing across services, client recall lists and point-of-care prompts generated by patient information systems, together with policies that make primary health care providers responsible for care coordination, helped support timely screening while avoiding over-screening.
Murray RB, Metcalf SM, Lewis PM, Mein JK, and McAllister IL. Sustaining remote-area programs: retinal camera use by Aboriginal health workers and nurses in a Kimberley partnership. Med J Aust 2005;182:520-523