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The Australian CDC funded an independent review of BBV and STI programs that found these programs are improving health outcomes for Aboriginal and Torres Strait Islander communities. The programs are also helping people in rural and remote areas access culturally safe health care.
IPS Management Consultants carried out the review and looked at 3 BBV and STI programs delivered through Aboriginal Community Controlled Health Organisations (ACCHOs). It found that the following elements are key to improving sexual health and better access to health care:
- strong community leadership
- culturally safe care
- sustainable workforce capacity.
Community-controlled organisations driving better health outcomes
The evaluation found that ACCHOs have provided culturally safe BBV and sexual health services that meet the needs and priorities of their communities. ACCHOs delivering sexual health programs reported higher testing rates for chlamydia and gonorrhoea than ACCHOs without these programs. The biggest improvements were seen in remote and very remote communities.
Key strengths found were local decision-making, First Nations leadership and strong community engagement. These strengths helped build trust and encourage more people to access prevention, testing, treatment and follow- up services. This includes rural, remote and very remote communities where access to healthcare can be more difficult.
The evaluation found that these programs are strong because of delivery partners who are connected to the communities. They are the National Aboriginal Community Controlled Health Organisation, the Kirby Institute University of New South Wales, and the Flinders University International Centre for Point of Care Testing.
Workforce and innovation are improving access to care
The evaluation found that Aboriginal Health Workers, Aboriginal Health Practitioners, nurses and other frontline staff play a vital role in the success of these programs. They build trusted relationships, reduce stigma and help people access care, making it easier for communities to engage with prevention, testing and treatment services.
The evaluation also found that point-of-care testing helped more people get tested, diagnosed and treated sooner by bringing rapid STI testing closer to where they live. Using point-of-care testing makes care more convenient and patient focused, as people can receive test results and treatment on the same day. Faster results help people get the care they need sooner and reduce the risk of infections spreading.
While the evaluation showed strong results, it also found ongoing challenges that could affect the long-term success and growth of the programs. These include:
- workforce shortages
- high staff turnover
- uncertainty about future funding.
Potential for long-term benefits
Modelling carried out for the evaluation suggests that if these programs continue over the next 10 years and have a gradual increase in testing, they could prevent more than 124,000 STI infections among Aboriginal and Torres Strait Islander clients of regional and remote ACCHOs. Under these same assumptions, the modelling also estimated that STI rates among Aboriginal and Torres Strait Islander people aged 15 to 34 years in regional and remote areas could fall by almost 50%.
The modelling also suggests fewer people would experience serious health problems caused by untreated STIs. This includes infertility, pregnancy complications and congenital syphilis. These findings show the long-term value of investing in community-led and culturally safe health care.
The evaluation found that strong Aboriginal and Torres Strait Islander BBV and STI responses depend on:
- well-supported health services
- a skilled workforce
- community-controlled leadership
- responding to local needs.
The evaluation provides critical insights into what is working well, what is affecting delivery, and what could strengthen future delivery of these important programs.