HIGHLIGHTS
- Aboriginal and Torres Strait Island populations have high rates of rheumatic fever and rheumatic heart diseases.
- The Australian Department of Health selected seven locations for prevention pilot programs.
- Abt evaluated the pilots and provided recommendations for improvement.
PROJECT
Rheumatic Fever Strategy and KPI Development: Primordial and Primary Prevention Pilot Program Evaluation
The Challenge
Acute rheumatic fever (ARF) and Rheumatic heart disease (RHD), resulting from infection with Group A Streptococcus (GAS), occur at much higher rates in Australia’s Aboriginal and Torres Strait Islander populations and cause serious morbidity and premature mortality.
In response, the Australian Government Department of Health selected seven locations with high prevalence of rheumatic heart disease (and already funded for secondary prevention) for delivering pilot programs focused on primordial and primary prevention of ARF and RHD. These programs required evaluations for impact and outcomes.
The Approach
Between July 2019 and June 2021, the evaluation assessed the appropriateness, effectiveness, value for money, and sustainability of service models implemented at seven sites. The evaluation methodology was developed during a two-day co-design workshop with all the service providers involved in the pilot projects and the Department of Health and Rheumatic Heart Disease Australia. The evaluation involved continuous data collection, including qualitative interviews and service reports, to gauge program success and viability for future applications and for facilitating a community of practice. It also included development of an agreed set of key performance indicators that all providers would report against.
The Results
The evaluation of the Rheumatic Fever Strategy pilot program highlighted diverse approaches among service providers to prevent ARF and RHD in Aboriginal and Torres Strait Islander communities. While flexibility allowed for tailored models, challenges in implementation, such as staff turnover and resource limitations were noted. Successful models integrated both primordial and primary prevention activities, supported by community engagement and collaboration with technical experts. The Department of Health and Aged Care is working with the National Aboriginal Community Controlled Health Organisation and rheumatic fever experts to implement Abt’s recommendations.