Issues that impact on Aboriginal Health Workers' and Registered Nurses' provision of diabetes health care in rural and remote health settings

Type 2 diabetes mellitus is an established health problem for Indigenous Australians. One strategy to address this issue is to educate health professionals in diabetes management and education. Objective: The objective of this paper is to identify important issues that compromise the clinical practice of rural and remote Aboriginal health workers (AHWs) and registered nurses (RNs) who undertook an accredited Australian Diabetes Educators Association diabetes course and to suggest strategies to improve practice. Design: The design used a qualitative approach and discussion schedule to elicit responses. Setting: The setting involved two Aboriginal community controlled and seven mainstream health services in the Far Western region of New South Wales. Participants: The participants were experienced diabetes educators (RNs and AHWs), managers and students currently enrolled in the course (n=17). Results: The results indicated issues that compromise diabetes practice and identified strategies to improve practice. Issues were: the confusing funding practices by health providers, the duplication of health services, the lack of recognition of diabetes qualifications and the transient nature of Indigenous people. Strategies included the need for: continuous dedicated diabetes health funding, a role clarification for diabetes educators, strategic diabetes planning and the importance of diabetes educators working in partnership. Conclusion: The conclusion from this study indicates that if the delivery of diabetes health services to Indigenous Australians is to improve it is necessary to address these identified issues.