Melbourne School of Population and Global Health

Emma E Stanford, Fiona D Lange, Carol A Holden, Mitchell D Anjou, Hugh R TaylorIndigenous Eye Health, The University of Melbourne, Melbourne, Australia

Why Does Trachoma Persist as a Public Health Problem in Australia?

Poster prepared for PHAA 44th Annual and 20th Chronic Diseases Network Conference.Alice Springs, September 2016. Emma Stanford: esta@unimelb.edu.au (03) 90358255www.iehu.unimelb.edu.au | www.facebook.com/cleanfacesstrongeyes

Why?

What Works?

1.References:

2.

SAFE Strategy

F for Facial Cleanliness

ConclusionAustralia is on track to eliminate trachoma as a public health problem by 2020

But we need to keep the pressure on with:

Australia is signatory to WHO agreement to eliminate blinding trachoma by 2020

SAFE strategy fully implemented is the agreed approach

Antibiotic treatment brings infection rates down but;

Clean Faces are needed to stop transmission

Access to properly maintained washing facilities is essential

Current E�orts have Reduced the Prevalence of Trachoma in Children

Dirty faces are accepted as the norm in many communities (with eye and nose secretions)

Poor personal and community hygiene and over crowded living conditions

Lack of safe and functional bathrooms with limited access to water, soap, tissues, paper towels and mirrors

Restrictions around who can fix taps and delays in getting them fixed

Cross portfolio silos prevent coordinated approach

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5.

Now 150 communities have 0% prevalence

More cross portfolio collaboration as with NT Departments of Education and Health will result in sustained efforts

Community led initiatives for improved hygiene have made an impact

More than 1300 Trachoma Story Kits distributed

Promoted through:

E for Environmental Improvements

Access to safe and functional bathrooms and washing facilities in homes, schools and childcare

What is Required?

More effort to reinforce clean faces and improve washing facilities

Break down cross portfolio silos of Health, Education, Environmental health, Housing and Prime Minister and Cabinet

Work in partnership with community leaders, key contacts and hygiene programs to strengthen community action

Timely data sharing to focus on “hot-spots”

25%

20%

15%

10%

5%

0%

PREV

ALE

NCE

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

1-9 years5-9 yearsProjected 5-9 years

Ongoing maintenance and supply of water, soap, tissues, paper towels and mirrors to facilitate good hygiene

Environmental improvements to be supported by Health, Education, Housing and Prime Minister and Cabinet for community-wide benefit

McDonald E, Bailie R, Grace J and Brewster D (2009). "A case study of physical and social barriers to hygiene and child growth in remote Australian Aboriginal communities."BMC Public Health 9: 346-359. WHO Alliance for the Global Elimination of Trachoma by 2020. Eliminating Trachoma: Accelerating Towards 2020. http://www.trachomacoalition.org/GET2020/ Communicable Disease Network Australia (CDNA) Trachoma – National Guidelines for Public Health Units. 2014 http://www.health.gov.au/internet/main/publishing.nsf/Content/cdna-song-trachoma.htm National Trachoma Surveillance and Reporting Unit. Australian Trachoma Surveillance Report 2015.

Baunach E, Lange FD, Lines D, Pedwell B, Cooney R, Taylor HR. The development of culturally safe and relevant health promotion resources for effective trachoma elimination in remote Aboriginal communities Aboriginal & Islander Health Worker Journal. 2012;36(2) Why is trachoma blinding Aboriginal children when mainstream Australia eliminated it 100 years ago? The Conversation. September 2016. http://theconversation.com

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Trachoma resources available at www.iehu.unimelb.edu.au

- CSAs on Radio and TV- Community Videos- Yamba and Milpa Roadshows - Melbourne Football Club Clinics

Sustained behaviour change is the key

Community partnership and support for keeping children’s faces clean, blowing noses and washing hands

Entertaining/interactive local approaches to positively influence health related behaviours

- cross portfolio collaboration- strengthened hygiene partnerships and messages- work in partnership with communities

Australia needs to ensure resources and focus continues until trachoma is eliminated

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5Clean Faces, Strong Eyes messages developed with Katherine West Health Board Ngumbin Reference Group, IEH and CDC in NT