Trachoma elimination in remote Indigenous Northern Territory communities: baseline health-promotion study

Abstract

Abstract. Identify trachoma knowledge, attitudes and practice of staff in clinics, schools and community workplace settings to optimise trachoma-elimination health-promotion programs in the Katherine West Health Board region of the Northern Territory. Prior to the introduction of a suite of health promotion resources the Indigenous Eye Health Unit and Katherine West Health Board conducted a baseline survey of open, multi-choice and closed questions regarding knowledge, attitudes and practices in relation to trachoma with 72 staff members over a 6-month period in 2010À11. Data were analysed for differences between settings. Two significant barriers and one enabling factor were identified. One in five staff members in clinics and 29% of staff members in schools were unaware they lived and worked in a trachoma-endemic area. One-third of school staff and 38% of clinic staff considered it normal for children to have dirty faces. However, the majority of participants felt comfortable talking about hygiene issues with others. The presence of dirty faces in young Indigenous children underpins the continuing prevalence of trachoma. Increasing the awareness of the health effects of children's nasal and ocular secretions and changing community acceptance of dirty faces as the norm will reduce the risk of trachoma and other childhood infections. Staff in clinics, schools and community work settings can play a role in trachoma elimination by actively encouraging clean faces whenever they are dirty and by including face washing in holistic hygiene and health education. Staff in schools may need additional support. Trachoma-elimination health promotion should increase awareness of trachoma prevalence and encourage all who work and live in remote Indigenous communities to take action to promote facial cleanliness and good hygiene practices.

Does Hukou origin affect establishment of health records in migrant inflow communities? A nation-wide empirical study in China

“…Interestingly, higher household income is found to be negatively associated with establishment of health records among the migrants, which is inconsistent with previous studies [19]. Those migrants who have higher income might have more stressful work, and thus have less time to make use of public health services [25]. …”

The impact of health promotion on trachoma knowledge, attitudes and practice (KAP) of staff in three work settings in remote Indigenous communities in the Northern Territory

“…A key barrier to eliminating trachoma and addressing other hygiene-related health issues, is normalisation of dirty faces in young children in some remote Indigenous communities [42,43]. Indigenous and non-Indigenous staff and community members do not always notice children’s dirty faces or help to clean eye or nose secretions from the faces of small children [10]. Non-Indigenous staff may be hesitant to assist or discuss clean faces for fear of shaming, being rude or intrusive, or they may simply not know how best to help.…”

“…Data items relating to ‘clean face’ acceptability and knowledge around preventive actions used the WHO ‘clean face’ definition and the commensurate community nomenclature for referencing ‘dirty’ faces was used. This terminology was supported through pilot testing of the questions with the Ngumbin Reference Group (NRG) [10]. …”

“…Yet it persists in remote Aboriginal communities where limited and overcrowded housing, lack of working bathrooms and poor hygiene, are still common [7,8,9]. Additionally, children with persistent eye and nose secretions sometimes go unnoticed and is not always commonplace to wash a child’s face whenever it is dirty [10,11]. …”

Evaluation of a Short Term Education Program in Rural Southern Ethiopia

“…This complication, without repair, leads to corneal abrasions, scarring and eventual blindness. To compound the problem, a study done by Lange, Baunach, McKenzie, (2014) found that leaders of rural communities in endemic areas, such as teachers and traditional healers, are not only unaware that their community is burdened by trachoma but also find it normal for children to have dirty faces that are likely harboring the bacterium. This lack of awareness by community leaders and large disease burden has been personally observed by faculty and students from the University of Texas Health Science Center at San Antonio who have been traveling to rural Ethiopia for the past eight years.…”