Alan Crouch

Immunization And The Millennium Development Goals: Progress And Challenges In Latin America And The Caribbean

The child mortality rate has been greatly reduced in Latin America and the Caribbean (LAC). More than half of the gains in reducing child mortality are attributable to immunization. The Revolving Fund of the Pan American Health Organization contributed to this achievement by catalyzing policy innovations that sustained national immunization programs, such as vaccine legislation and budgetary decrees to ensure delivery of services. In addition to measuring the impact of immunization on the child mortality reduction target of the Millennium Development Goals in the LAC region, this paper provides a policy framework to ensure that the rest of the target is reached.

The Young Person Check: screening for sexually transmitted infections and chronic disease risk in remote Aboriginal and Torres Strait Islander youth.

Objective : This paper describes the implementation and selected outcomes of the Young Person Check (YPC), a high‐coverage screening program in far north Queensland targeting remote youth aged 15–24 years for sexually transmissible infections (STI) and chronic disease risk. The YPC was conducted 19 times in eight discrete remote communities and one community cluster between 2009 and 2012.

Hip Hopping the Gap – Performing Arts Approaches to Sexual Health Disadvantage In Young People in Remote Settings

Objective: Closing the gap in Indigenous health and wellbeing in remote settings in the Torres Strait and Northern Peninsula Area of Far North Queensland (FNQ) includes addressing a well-documented sexual health disadvantage among young people. Community mobilization around the underlying risk factors influencing sexual health is required. Method: Performing-arts-based workshops were conducted in schools and after-school venues in four remote Aboriginal and Torres Strait islander locations in FNQ in early 2010, to initiate consciousness-raising around the real dimensions of youth sexual health risk. Specific objectives included strengthening operational partnerships at school-level and developing ongoing consultative processes in each location for sexual health reference group development. Results: Results include a significantly strengthened productive partnership with primary and high schools in each location and sixteen production-ready hip hop songs exploring a range of physical, emotional and sexual health themes authored by the students and recorded on site. Additional outcomes included the willingness of community councils and civil society organizations to support local sexual health reference group activity. Conclusions: This initiative, the Indigenous Hip Hop Project, although accompanied by opportunity costs including alternative, more core business uses of staff time and program budget, has demonstrated the power of tapping the creative energy of young people at risk and the potential for mobilizing communities to activism around sexual health disadvantage.

Should we change the focus of health promotion in sexual health clinics

In a response to the recent article by Rudiger Pitroff and Elizabeth Goodburn on changing the focus of health promotion in sexual health clinics, Crouch and Fagan draw attention to the confusion among practitioners between brief interventions in clinics (health education) and the actual nature and scope of sexual health promotion. The response refocuses attention on the Ottawa Charter for Health Promotion and on the social determinants of sexual health inequity as appropriate design drivers of a pilot initiative proposed by Pitroff and Goodburn to re-orient sexual health service provision around the real needs of its clients.

Communities and condoms – how difficult can it be?

Sexually transmitted infections are common in remote settings in Queensland Australia yet sexually active young people living remotely do not have reliable commercial or free access to condoms. Without the ready availability of condoms young people are denied the chance to choose to be safe. This editorial reflects on the history since 2006 of the public health effort to develop sustainable condom infrastructure for Aboriginal and Torres Strait Islander residents in remote North Queensland Communities. It provides a brief discussion of some of the policy issues and health service issues including failed attempts to garner Health District management support for condom supplies in clinics and innovative programs to make condoms accessible in hotels clubs and bars. Case studies have been carried out in six communities and provide condom uptake reporting. The lack of published research into all-hours condom availability and distribution reporting in remote Aboriginal and Torres Strait Islander settings in Australia is a powerful signifier of the low priority accorded to condom access by communities health service providers and policy makers alike.

Successes in sexual health communications development, programmatic implementation and evaluation in the Torres Strait region 2006 to 2012.

Objective: To evaluate the Indigenous sexual health promotion program in the Torres Strait 2006–2012 that culminated in an education‐entertainment radio drama, Kasa Por Yarn (KPY).