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A small rural community leading the march to strengthen its primary care services: The challenges and achievements to date.


Cath Cosgrove ,

Mallacoota Community Health Infrastructure and Resilience Fund (CHIRF), Mallacoota, VIC, AU
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Hazel Dalton

The University of Newcastle - Centre for Rural and Remote Mental Health, Orange, NSW, AU
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The Community Health, Infrastructure and Resilience Fund Inc (CHIRF) is a health promotion charity that was formed in May 2016 by a group of Mallacoota residents when it became clear that the sole medical practice in the town, the Mallacoota Medical Centre (MMC), which at that time was operating with one general practitioner (GP), would collapse without solid community support; leaving the community without the services of GPs. Mallacoota has population of 1,036 residents that swells to 8,000 in peak holiday times. Forty-nine percent of its residents are aged 60-years and over. It is situated at the eastern tip of Victoria and is one of the state’s most geographically isolated communities (ABS-RA4 and MMM6). Mallacoota is the only community in Victoria without a public hospital or bush nursing centre or residential aged care services. The nearest hospital is NSW, with 1 hr. 45-minute travel time each way.

CHIRF's initial focus was to address Mallacoota's GP shortage and in partnership with the MMC it began a ‘Dr Search’ initiative in May 2016. With the successful recruitment in early 2018 of a second GP and the placement of a GP registrar, CHIRF commenced broadening its mission. It is now focussed on addressing the communities’ other significant unmet primary health care (PHC) needs including allied health services, medical equipment, building infrastructure and health workforce. To help secure funding for its expanded mission, CHIRF is partnering with other community groups, has expanded its geographical focus to include the Wilderness Sapphire Coast and has been lobbying elected representatives and funding bodies. CHIRF has secured funding for: building a new medical centre, establishing an after-hours medical service, improving mental health services and providing greater support in community for people living with chronic health conditions. In the longer-term, CHIRF is working to secure extended aged care services including a residential aged care facility and high care nursing services in Mallacoota. All CHIRF’s PHC strategies place the MMC as the service hub for coordination and delivery of services. CHIRF believes for a small, geographically remote town like Mallacoota, a medical practice hub model is the most economically efficient approach for delivering PHC services. CHIRF as a DGR charity has been able to access funding sources and funding streams that are not readily accessible to private medical practices.

CHIRF is also committed building the evidence base to support other geographically remote small rural communities to help strengthen locally PHC services. To support this, a research partnership was formed in early 2019 with the University of Newcastle and University of New England. This community-academic partnership has recently received funding to undertake an evaluation of Teen Clinics operating in medical centres in the region.

This presentation will discuss the challenges and benefits of adopting a community-led model to strengthen PHC services in small rural towns including sustainability and replicability issues. The experience of volunteers taking an active role in strengthening PHC services and the development of and the plans for the university – community partnership will also be covered.

How to Cite: Cosgrove C, Dalton H. A small rural community leading the march to strengthen its primary care services: The challenges and achievements to date.. International Journal of Integrated Care. 2021;20(S1):136. DOI:
Published on 26 Feb 2021.


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