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All Ireland Traveller Health Study. Presentation for NTHN 23 rd October 2007. The AITHS.
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All Ireland Traveller Health Study Presentation for NTHN 23rd October 2007 Pavee Point Travellers’ Centre
The AITHS The first study of Travellers’ health status and health needs that involves all Travellers living on the island, North and South. The study will access health needs, as identified by Travellers and service providers and measure the health status of Travellers. Pavee Point Travellers’ Centre
Minister Mary Harney, July 2007, Launch AITHS • Traveller health is a priority area and considerable work has been undertaken, in consultation with the interest groups, in commissioning this Study. The purpose of the study is to examine the health status of Travellers, to assess the impact of the health services currently being provided and to identify the factors which influence health status. It will provide a framework for policy development and practice in relation to Traveller health.” Pavee Point Travellers’ Centre
Context to AITHS • Differential in Traveller health status • Data we have is from 1986 and 1987 • Gap not Closing (Census 2006) • No Traveller organisation participation • No qualitative data • Only in Republic of Ireland • Study never completed Pavee Point Travellers’ Centre
HRB Study • Infant mortality rate 18.1 per 1000 live births (National figure is 7.4) • At birth Traveller men can expect to live 9.9 years less than settled men • Women 11.9 years less than settled women • SIDS rate (cot death) among Traveller families is more than 3.7 times higher than national figures • Traveller life expectancy is now that of the general population in 1940s Source: Health Board Research 1987 Pavee Point Travellers’ Centre
Pyramids of the Traveller and settled population from the Census 2006 Pavee Point Travellers’ Centre
Background to AITHS • NTHS Recommendation • NAPS Target “reducing differential in life expectancy between Travellers and settled people by 10% by 2007” • NHS –to implement NAPS Target • NTHAC and Lobbying • IPH Consultation • Completed in December 2003 Pavee Point Travellers’ Centre
NTHS Recommendation • to ‘carry out a Traveller Needs Assessment and Health Status Study to update and extend the indicators used in the last survey of Travellers’ Health Status and to inform appropriate actions required in the area of Travellers’ Health’ (2002) Pavee Point Travellers’ Centre
Northern Ireland Links • Utilise existing infrastructure of the Department of Health, Social Services and Public Safety, Travellers and Traveller organisations and a range of experienced health providers and researchers • Establish a Northern Ireland Regional Traveller Health Network including representatives from these areas to act as a feedback link • UCD Employment of a part-time field co-ordinator in Northern Ireland who has knowledge and expertise in relation to Travellers health • Membership on TRG Pavee Point Travellers’ Centre
Study principles from national consultation & tender document • Equality, human rights, social inclusion, anti-racist, anti-sexist, anti-discriminatory, and anti-poverty values. • Respect for Travellers values, beliefs, culture and perceptions. • Training and resourcing to ensure that Travellers and Traveller organisations build their capacity to participate fully in all stages of the study. • Stakeholder input throughout Pavee Point Travellers’ Centre
Study Aims The aim of the Study is to examine the health status of Travellers, to assess the impact of the health services currently being provided and to identify the factors which influence mortality and health status. It will provide a framework for policy development and practice in relation to Travellers. Pavee Point Travellers’ Centre
Management of AITHS • DoHC contracts UCD • Technical Steering Group to oversee AITHS • Reports to NTHAC • HSE Reference Group • Traveller Reference Group Pavee Point Travellers’ Centre
TSG Steering Group • Dr Philip Crowley, Deputy Chief Medical Officer, DoHC (Chair); • Seamus CamplissonDoHSSPS; • Dr Evelyn Mahon, Trinity College Dublin; • Ms Olive McGovern, Social Inclusion Unit, DoHC; • Ms Leonie O’Neill, National Service Planner, Social Inclusion HSE; • Ms Ronnie Fay, Pavee Point • Ms RosaleenMcDonagh, Irish Traveller Movement. The TSG will meet with the UCD Project Team on a quarterly basis and will report to the DoHC. Pavee Point Travellers’ Centre
Traveller Study Reference Group CDP/FRC Trv. Pre- schools SW LA ELO’s VTTP LDP Other Key Informants Traveller Ref. Group Pavee Point Travellers’ Centre NTHN CDP Network NATC Regional THN NITN PHCPs Trv.Org Trv. CDP’s TTC’s Traveller Peer Researchers
AITHS Approach • There are four sub studies involved in undertaking the AITHS: • Census of Travellers • Vital Statistics • Health Utilisation • Review of Services Pavee Point Travellers’ Centre
Sub-study 1 : Census of Traveller Population • A count of every Traveller on the island of Ireland • Age, Sex, Region and Accommodation • Based on Voluntary Self Identification • Including ‘hard to reach Travellers’-homeless, prisoners, mental health institutions etc. • Carried out Spring 2008 Pavee Point Travellers’ Centre
Sub-study 2: Vital Statistics • Mortality Study • Measure Health Status, Mortality Rates and Life Expectancy • Reporting by PHNs and Travellers (during Census Visit) of all Traveller Deaths in the Previous Year Pavee Point Travellers’ Centre
Sub-study 2 :Vital Statistics Contd. • Birth Cohort Study; Handheld Record-voluntary group to follow up for a year • Information on birth and child health outcomes • One year prospective study reporting by Travellers and PHNs (Hand held record) • Compared with Longitudinal study on Children Pavee Point Travellers’ Centre
Sub Study 3: Health Utilisation & Factors affecting It (Quantitative: Travellers & Providers) (i) Factors influencing health status of Travellers and their access to health services (Surveys and questionnaire, collected at time of Census. Representative sample; e.g. Blue/yellow form) (ii) Perceptions and attitudes of service providers towards Travellers and their health (Surveys and questionnaire) Pavee Point Travellers’ Centre
Sub Study 4: Review of Services(Qualitative: Travellers & Providers) (i) Review of services – Qualitative Study (Mapping and Case Study) (ii) Exploration of health issues as perceived by Travellers – Focus Group and other Qualitative tools (iii) Exploration of health issues as perceived by service providers – Qualitative Study Pavee Point Travellers’ Centre
Comparative Analysis Data will be compared with other National and International Studies as appropriate e.g. • SLÁN • Lifeways • Longitudinal study of Children • National Consumer Study • National Vital Statistics • Original HRB Study • International studies on MEGs Pavee Point Travellers’ Centre
AITHS Timeline Pavee Point Travellers’ Centre
Milestones • Census Spring 2008 • Traveller Fieldwork completed Winter 2008 • AITHS Completed Summer 2010 • Interim Progress Reports throughout the AITHS Pavee Point Travellers’ Centre
What Travellers will Gain from AITHS • Participation in identifying their health needs, perceptions and barriers to access to services • Up to date evidence to inform the next NTHS. • an accurate Population count, including Travellers in institutions. • gaps and barriers in service provision identified • mortality and morbidity rates and estimate current life expectancy for Travellers will be documented and compared with the settled population Pavee Point Travellers’ Centre
Travellers gain ….Contd. • The links between the broader social determinants and the health status of Travellers will be explored • Travellers can recommend how the issues affecting their health status should be addressed through the qualitative discussions • Recommendations and models of good practice on how to address Traveller health issues will be documented drawing on study info and international literature • Information to lobby regionally and nationally and inform wider public policy debates Pavee Point Travellers’ Centre
Traveller Organisations’ Role • Active support and prioritisation by all Traveller Groups • Preparatory work with Travellers in each area/region to ensure they understand the study and participate – ‘buy-in’ • Completion of the mapping and enumeration exercise to ensure all Travellers have the opportunity to participate in the study • Identification of ‘key-informants/contact people’ in areas where no/poor Traveller infrastructure • Attendance at training to ensure that a cadre of Traveller ‘peer-researchers’ and coordinators are available to undertake the research in your area. Pavee Point Travellers’ Centre
Traveller Organisations’ Role …..Contd. • Lobby for THU resources to support the implementation of the AITHS with meaningful Traveller participation • Identify needs to support you to participate effectively in this study • Lobby to increase the size of sample in each region/area to guarantee access to local data. Pavee Point Travellers’ Centre
AITHS Update • UCD Awarded Contract June 2007 • Launched July 2007 • TSG Meetings • Traveller Reference Group Established • Information and Training Provided Pavee Point Travellers’ Centre
Thank you for your participation www.paveepoint.ie Pavee Point Travellers’ Centre