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Table 6 Examples of comments on community linkages

From: Describing and analysing primary health care system support for chronic illness care in Indigenous communities in Australia's Northern Territory – use of the Chronic Care Model

Weaknesses/threats (negative) Strengths/opportunities (positive)
Community linkages
The health centre staff spent all of their time within the clinic and there had been no one working in the community for the last 6 months. Having no access to a car was identified as a problem. The community store supports the healthy food choices via labelling of shelves and using shelf talkers, and meets with the health centre staff fairly regularly to plan. To promote diabetes awareness the store manager has prepared a set of diabetes guidelines for community stores called "No Cry Diabetes".
The health centre has a large numbers of AHWs, whose work includes community visits – but the extent and level of activities is not known. It appears as though much of the work done out in the community by the AHWs is not recorded, therefore may go unrecognised and may be undervalued. In collaboration with the community store, the health centre set up a health booth outside the store, providing education and well people's screening for passers by and people going shopping. "Do blood pressure, BSL, cholesterol, and BMI. Target groups are men above 45 years and obese. If people have a problem or are sick then give them information and suggest that they make an appointment".
There are budgetary problems in the health centre to cover costs of external services needed to train staff or provide services. Tiwi for Life program is funded by the Health Board (governing body of the health centre) and has focus of prevention and health promotion in the community. The program implements a range of activities, such as sports days and tobacco prevention week. Communication between the program and the health centre is perceived as good. The health centre has also developed networking with other organisations. For example, a Health Week is held once per year in the clinic in partnership with Tiwi for Life, Department of Health and Community Services, Diabetes Australia, and Council for Aboriginal Alcohol Program Services.
Sometimes there is a lack of communication between the health centre and the external services which come to the community to do prevention activities. The opportunity of linking prevention with clinical services has been missed.