Addressing Otitis Media in Toddlers of Aboriginal Community
Otitis media (OM) is recognised as the middle ear infection, and it is one of the most common childhood diseases that causes pain and deafness. Venekamp et al. (2013) assert that by three years of age, many children experience OM, which makes the illnesses one of the most prevalence diseases among young toddlers. Otitis media is classified into two category that is acute otitis media (AOM) and chronic otitis media (COM). Typically, AOM is usually common in children under two years, and its signs include fever, runny nose, irritability where a child is getting systematically unwell, and children developing a sign of an earache (Qureishi et al., 2014). On the other hand, (COM) handled inappropriately, can affect children’s quality of life (Tsilis et al., 2013). Some of the effect of COM to children includes inflammation to the mucosa of the middle ear, eroding ossicular chain, as well as the children’s hearing process (Tsilis et al., 2013).
For decades, OM has become a major concern for young children, especially the toddlers in the age of 1-3 years (Australian Hearing, 2016). However, in countries such as Australia, the Aboriginal children are likely to experience this problem due to the aspect of the living conditions, housing, nutrition, and any other environmental-related issue (Australian Hearing, 2016). Reports show that the condition begins within weeks of births and it can persist into adolescence (Australian Institute of Health and Welfare, 2014). The Australian Bureau of Statistics (2017) writes that for many Aboriginal children, hearing loss is known to cause social interactions problems and difficulty experiences for the affected children in the schools. According to Hills (2012), OM affects about 80% of the children in Australia, mostly kids aged three years. As a result, this has made the disease one of the most common disorders affecting the children in the country. Similarly, Hills (2012) says that the number of the Aboriginal children diagnosed with otitis media in Australia has increased, with the 2012 research showing that 73% of toddlers between 1-12 months had otitis media.
Between 2012 and 2013, around 3% of the Aboriginal children were reported to have otitis media (Australian Bureau of Statistics, 2017). Moreover, as the high prevalence of otitis media among Aboriginal children is associated with secondary complications, the condition has affected more up to 67% of the young-aged Australian Aboriginal children (Hills 2012). Australian Institute of Health and Welfare (2017) quotes that since 2014; otitis media was expected to exceed the 4% threshold, which would make the infection a major public health concern affecting young Aboriginal toddlers in Australia. In agreement with this argument, Hills (2012) uses the report by the World Health Organization (WHO) to find out that the prevalence of otitis media in Indigenous kids is greater or equal to 4%, which has made the disease to become a standard issue in the region. To help future generation become better pupils and to have a happier childhood, I will start this project.
Project Description
The proposed project Aboriginal Otitis Media Children Project (AOMCP) aim is to reduce the 5-10% of casualty due to infection and prevent its recurrence amongst Aboriginal toddlers in remote areas. One of the programs that the project intends to implement is immunisation, as through this program the Australian healthcare system can protect the Aboriginal toddlers from OM and ear cholesteatoma (abnormal skin growth behind the eardrum) (Carlos O’Connor Reina, 2015).
Immunisation against the bacteria such as streptococcus pneumoniae that cause otitis media has proved to be an effective way of reducing the disease, especially for young toddlers (Li et al., 2015). Pneumococcal infection can cause other problems including pneumonia, deafness, and brain damage. (Center for Disease Control and Prevention 2014).
Strengths
- This project will reduce the risk related to other diseases.
- (AOMCP) has numerous benefits, as it will build on the Healthy Ears and accelerate the Happy Kids’ project that commenced in Australia. For instance, in a report that was prepared by Australian Indigenous HealthInforNet (2015), it is outlined that it is relevant for the healthcare system to run Ear programs in schools, where it will be much easier to offer young children medical services that will make them live a happy life. The Goldfield South East Health Region Ear program was beneficial for Aboriginal children in the kindergarten to year three, as the program would slow down the spreading of OM and any other diseases relating to OM, thus enhancing the happiness of the kids in the school and community (Indigenous HealthInforNe, 2015).
- The (AOMCP) will be the pilot project started with metropolitan clinics that intend to expanding to remote if the program is successful. The pilot project will operate through the advancement of a local health services focus shared by a partner degree nursing program. It will also incorporate an evaluation procedure to determine if this arrangement is cost effective.
- Pneumococcal vaccination is known for its benefit of reducing the rates of otitis media and tympanostomy tube insertion (Groth, Thomsen, & Ovesen, 2015).
Weaknesses
- Immunisation exposes the body to the risks of harmful and toxic chemicals, which may bring unnecessary complications of young children even after they grow up (Center for Disease Control and Prevention, 2011). Although pneumococcal vaccination is not dangerous, they can be irritating, and it can take time (months or years) for the children to shake off the annoyance that is caused by vaccination (Vaccine Knowledge Project, 2015).
- Immunisation can cause a high temperature, possibly leading to convulsions (NHS Choice Information, 2017).
- Allergic itchy skin rash (NHS Choice Information, 2017).
The Plan to Implement Immunisation/Vaccination
A comprehensive and sustainable approach must be addressed to families, Aboriginal community, research institutes, and community health services. This will be achieved through communication, Health promotion, monitoring at a local, regional and State level.
Objectives of the Project
- Vaccination program for children with recurrent ear disease.
- Limit acute symptom and complication caused by AOM.
- Maximise language development and minimise long-term damage to the middle ear.
Strategies
- Prevention-increase awareness and understanding through health assessments of 0-5-year-old children by primary health care staff.
- Surveillance-improved early identification of ear disease including routine, regular follow-up through child health program.
- Consistent treatment-referral pathways, high-quality care to provide.
- Workforce development support for relevant staff including Aboriginal health workers.
- Coordination-develop relevant stakeholders to increase collaboration and share of resources. The important part of the preventative approach is peoples’ understanding of the risk factors and responding quickly. The program needs to support, educate careers and families about the importance of adherence.
- Use National Ear Health records in the form of audios and videos to achieve the objective of this project. Typically, any national ear health campaign materials such as DVDs and initiatives that include media campaigns will be localised if they found to be effective.
- Use of patient centred model of care, as a coordinated approach to reduce chances of children having OM, enhancing OM treatment are done in the right time and by the use of accurate techniques to prevent the spreading of OM.
Patient centred model of care will be executed by doing the following:
- First it through emphasising on the significant of washing hands and toys frequently to reduce the possibilities of infection.
- Outlining the need for making sure that children are not exposed to cigarette smoke.
- Setting up programs for seasonal flu shots and pneumococcal vaccines.
- Distributing leaflets, audios on radio, social websites for awareness, support, guidance, and early screening to manage the potential complication
- The introduction of campaigns that will encourage parents to consider early vaccination programs in order to prevent children from being affected by the infection. The campaign will be done by targeting parents visiting the local clinics with information packages of children who have been affected by OM. To facilitate the campaign, I will issue parents with a 10 pages postcard
Some of the information that I will outline in the campaign card include
- The negative impact of OM infection
- Risk factors to get the disease
- How to prevent OM
- Why children needs vaccination against OM
- The postcards will also have a pamphlet guide section, where the parent will read and understand things they to do so that they can control the spreading of OM. For example, in the card, parents will learn the simple ways to slow down the prevailing of OM, which includes, avoiding smoking, frequent hand washing, and breastfeed infants instead of bottle-feeding.
Budget Estimates
This project is expected to cost $300, and the amount will include all the standard and average cost incurred for sustainability of the project.
Table 1: Budget breakdown as per the need of each activity incorporated in this project
| Workforce and Materials | Cost ($) |
| Employees salary | 180 |
| Training fee | 70 |
| Emergency cases | 25 |
| Miscellaneous expenses | 25 |
Timeline Estimate (90 days)
Table 2: Project timeline and activities
| Time (days) | Activity |
| 7 days | Train the team of nurses on the use of the selected program. |
| 15 days | Carry out screening tests to determine the prevalence of the otitis media. |
| 15 days | Collect and record screening findings |
| 7 days | Interpret the findings to understand the extent of immunisation on minimising OM. |
| 21 days | Use the suggested plan to execute an early immunisation to control the prevalence of otitis media. |
| 25 days | Comparing the current status of the children involved in the treatment with the previous period with no treatment practices. |
Evaluation
Since otitis media is a multifactorial infection, the use of pneumococcal vaccination to control the spreading of the illness will be an effective strategy. Schilder et al. (2016) stress that in the cases where the vaccine was used to reduce the burden of OM children aged 2, 4, and 6 months were given a universal vaccination, while children aged 12-15 months were immunised with a booster dose. Consequently, Schilder et al., (2016) write that the pneumococcal vaccination was effective as it leads to a 29% reduction of OM and 6 to 7% decrease of the prevalent of AOM. Correspondingly, Granath (2017) reports that when immunisation of children during their first year of life (1-12 months), the prevalence of OM can reduce with up to 7%. Thus, for this project vaccination is taken as the most effective strategy that will help the Aboriginal community to lessen the pervasiveness of OM in children.
Work with Partnership
In essence, to facilitate this project, the planner will consult with the local administrators and the representative of the Aboriginal people. As the project organiser, I plan to create a partnership with the WA Department of Health because the organisation is widely recognised for its role in promoting the health of the Aboriginal community. Conversely, building a partnership with the WA Department of Health will be substantial for this project because the organisation provides consultation and advice to the people interested in implementing strategic plans set to promote the quality of the healthcare system in the areas where Aboriginal people resides (Government of Western Australia Department of Health, 2017). Besides, I intend to partners with WA Department of Indigenous Affairs, as the organisation that issues funds for people who wants to initiate projects that will improve and mend the health of the Indigenous children (Government of Western Australia Department of Aboriginal Affairs, 2017). Lastly, I will arrange to collaborate with the WA Regional Development Council in which the organisation will offer training to the project team and fund the project, as one of the key responsibilities that the council carry to promote the health of the Aboriginal community (Government of Western Australia Department of Regional Development, 2017).
Sustainability
For sustainability, I will conduct an assessment in order to create a multidisciplinary approach aimed at ensuring that no individuals misuse the tools, resources, and funds that were used to make the project a success. This means that the project team will come up with ethical concepts that will regulate the application of the properties that were employed in the project to ensure that if the project needs to be implemented again, the resources used in the initial project would be utilised for the second time. As such, I will use the rules to ensure that the resources used to make the project a success are not wasted and through the aspect of sustainability, the project has the characteristic of continuity. Consequently, such protocol will support the project and ensure that it is sustained for the future purposes.
References
Australian Bureau of Statistics, (2017). 4727.0.55.001 – Australian Aboriginal and Torres Strait Islander Health Survey: First Results, Australia, 2012-13. Retrieved from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/0BBD25C6FF8BDB06CA257C2F001458BF?opendocument.
Australian Hearing, (2016). What you need to know about middle ear infections. Retrieved from: https://www.hearing.com.au/otitis-media/
Australian Indigenous HealthInforNet, (2015). Review of ear health and hearing among Indigenous Australians. Retrieved from: http://www.healthinfonet.ecu.edu.au/other-health-conditions/ear/reviews/our-review
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