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COVID-19 and Aboriginal and Torres Strait Islander populations

02 April 2020

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) acknowledges the increased risk that COVID-19 poses to the Aboriginal and Torres Strait Islander community.

RANZCOG recognises the work of the Aboriginal and Torres Strait Islander Advisory Group on COVID-19 and advises that health care workers follow the recommendations outlined by The Australian Government Department of Health and The Communicable Diseases Network Australia (CDNA)

RANZCOG is committed to improving the health and wellbeing of Aboriginal and Torres Strait Islander people. We acknowledge their enduring culture, their elders, past, present and emerging and pledge to walk alongside them to create a peaceful and reconciled nation.

Key factors:

The risk of transmissions and severity of COVID-19 may be increased in Aboriginal and Torres Strait Islander pregnant women as a result of:
 
  • Increased mobility- frequent travel between, and within, Aboriginal and Torres Strait Islander communities, and the large number of fly-infly-out workers in remote communities may facilitate the spread of disease.
 
  • Remoteness – resulting in reduced access to heath care and other services; delays in transporting specimens and receiving results; and barriers to implementing preventive strategies(e.g.  consistent access to running water/ soap, hand sanitiser).
 
  • Barriers to:
i) accessing health care, leading to delayed presentations
ii)  screening- including barriers of access and acceptability
iii) accessing public health messages (language and cultural barriers)
 
  • Overcrowding-leading to increased risk of disease transmission, and limiting the ability to follow social distancing recommendations
 
  • Burden of disease- The presence of underlying chronic disease (e.g. diabetes, renal or chronic obstructive airways disease) and other co-morbid factors such as a chronic history of smoking and undernutrition may contribute to an increased risk of severe disease from COVID-19 within Aboriginal and Torres Strait Islander populations.

Other factors:
 
  • In times of increased financial and emotional stress, women at risk of intimate partner violence are likely to be most in danger. This risk is also magnified by home isolation. It is important that women-at-risk have support provided, to enable them to get the help they need and the ability to get to a safe place.
 
  • Cultural barriers to ‘social distancing’ – social distancing and self-isolation practices may be difficult for Aboriginal and Torres Strait Islander communities to implement, as large multi-generational families often live under one roof, and large gatherings (e.g. funerals and sorry camps) are an important part of culture. In addition, the historical legacy of colonisation may impact on an individual/community’s willingness to follow government orders and forced restrictions. It is critical that the meaning behind infection control measures is provided in order to maximise adherence to social distancing measures.
 
  • Appropriate communication is key. It is vital that health education messages on COVID-19 (including understanding of the disease, and methods of prevention, screening, and isolation) are delivered in in a culturally appropriate way that incorporates the Aboriginal and Torres Strait Islander concept of health and well-being. Language; method of delivery; and content of the message should all be delivered through the lens of Aboriginal and/or Torres Strait Islander people.
 
  • Prevention and control strategies for COVID-19 in Aboriginal and Torres Strait Islander communities should be developed and designed in partnership with Aboriginal and Torres Strait Islander communities to ensure an equal representation of voices. It is imperative that a wide range of stakeholders from all community service organisations in addition to health services (e.g. schools, local shire authorities) are included in public health responses to ensure prevention strategies flow through to all corners of the community.
 
Additional resources can be found here:
 



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