Remote health service vulnerabilities and responses to the COVID‐19 pandemic

Abstract

The rapid response to the COVID-19 pandemic in Australia has highlighted the vulnerabilities of remote Aboriginal and Torres Strait Islander communities in terms of the high prevalence of complex chronic disease and socioeconomic factors such as limited housing availability and overcrowding. The response has also illustrated the capability of Aboriginal and Torres Strait Islander leaders and the Aboriginal Community Controlled Health Services Sector, working with the government, to rapidly and effectively mitigate the threat of transmission into these vulnerable remote communities. The pandemic has exposed persistent workforce challenges faced by primary health care services in remote Australia. Specifically, remote health services have a heavy reliance on short-term or fly-in, fly-out/drive-in, drive-out staff, particularly remote area nurses. The easing of travel restrictions across the country brings the increased risk of transmission into remote areas and underscores the need to adequately plan and fund remote primary health care services and ensure the availability of an adequate, appropriately trained local workforce in all remote communities.

Telenursing home care and COVID-19: a qualitative study

“…Telenursing provides access to health services, which can affect the condition of remote patients. 18 Nursing services performed in telenursing include patient triage, symptom management, education and control of using care tools such as oxygen capsules and masks through telephone and at home. 19–22 Counselling, education, diagnosis and record of patients' information are also possible through telenursing.…”

Social work and public health – Logical collaborators

“…As a result, the usual gap between First Nations health and the general population has been reversed precisely because the response started with listening to communities and handing over control of the response (Silva, 2020). The challenge now for public health and policy is to build on this early success and address the longstanding structural vulnerabilities for these communities (Fitts et al, 2020).…”

Plan A, Plan B, and Plan C-OVID-19: adaptations for fly-in and fly-out mental health providers during COVID-19

“…Similar to Canada, Australia has a vast expanse of land making it difficult to recruit health professionals in remote areas [ 7 ]. Researchers in Australia have found that individuals living in remote areas, including Indigenous communities, are made vulnerable to COVID-19 due to geographical and historical factors; as a result, they face higher rates of chronic disease and other socio-economic factors such as overcrowding, making compliance with social distancing guidelines difficult [ 8 ]. Residents of Indigenous communities in northern Canada experience similar vulnerabilities [ 9 ] as Indigenous peoples in Australia.…”

“…Commonly reported barriers to offering services via telehealth or online include concerns regarding privacy and safety, impact on rapport building between provider and clients, reduced non-verbal communication (gestures), and insufficient technological support [ 5 , 28 ]. In an Australian study in which researchers examined the impacts of COVID-19 on Aboriginal peoples and Torres Strait Islanders, these populations were found to experience a higher prevalence of chronic diseases and tobacco use but were also affected by socio-economic factors such as overcrowding, rendering Indigenous populations particularly vulnerable to COVID-19 [ 8 ]. In addition to the existing challenges that residents of remote communities face in accessing and receiving care in Australia, additional workforce challenges have also been noted during the pandemic such as changes in national demand for short-term work force and increased risk of losing permanent staff due to burnout [ 8 ].…”

“…In an Australian study in which researchers examined the impacts of COVID-19 on Aboriginal peoples and Torres Strait Islanders, these populations were found to experience a higher prevalence of chronic diseases and tobacco use but were also affected by socio-economic factors such as overcrowding, rendering Indigenous populations particularly vulnerable to COVID-19 [ 8 ]. In addition to the existing challenges that residents of remote communities face in accessing and receiving care in Australia, additional workforce challenges have also been noted during the pandemic such as changes in national demand for short-term work force and increased risk of losing permanent staff due to burnout [ 8 ]. Although it is a different country and cultural context, there are some overlapping concerns that relate to Inuit communities in Canada [ 9 ].…”