Population health in South Metropolitan Health Service

Population Health provides a range of community services including rehabilitation, health promotion, and public health services to people living in the South Metropolitan Health Service (SMHS) area.

Health promotion

Health Promotion includes a range of social and political interventions to strengthen the skills and capabilities of individuals, and to improve adverse social, environmental and economic conditions which impact on health.

The three health promotion teams, including Fremantle, Peel, Rockingham and Kwinana (PARK) Health Districts, work with various stakeholders to reduce the incidence of lifestyle-related chronic disease and injury by creating healthy environments and modifying lifestyle risk factors.

The teams’ priority areas include:

  • increasing physical activity and healthy eating
  • reducing smoking and harmful alcohol use
  • improving sexual health.

The teams have established strong community links in their areas, and collaborate with community groups, workplaces, schools and local government authorities to develop and support a range of health promotion programs.

Working closely with local government, the teams have access to health and wellbeing demographic data that enables them to work with vulnerable populations at risk of particular health issues.

Metropolitan Communicable Disease Control

The Metropolitan Communicable Disease Control (MCDC) team works to protect the health of the population by monitoring notifiable communicable diseases and sexually transmitted infections. As well as following up contacts to reduce the spread of infections in the community, the team offers expert advice to primary care providers to help them manage communicable diseases.

This metropolitan-wide service provides expert advice and support to general practice, residential aged care facilities, hospitals, education facilities, childcare centres and other settings to ensure notifiable diseases and other communicable diseases of public health significance (including outbreak management) are managed appropriately.

The team works collaboratively with immunisation service providers and other relevant stakeholders to deliver WA immunisation programs and implement strategies to improve immunisation rates.

It delivers education and expert advice on the implementation of WA immunisation programs to service providers and collaborates with stakeholders on projects and strategies to improve immunisation rates in the region.

Aboriginal Health

Our Aboriginal Health team works to improve the health of Aboriginal people living in the South Metropolitan Health Service through the delivery of quality healthy lifestyle programs with a focus on chronic disease prevention and management and an approach to healthcare that is both holistic and focussed on the client and family.

The team provides services to Aboriginal people living across the Perth metropolitan area and includes people living in the North, East and South Metropolitan Health Services.

To achieve our goals, we work closely with the Aboriginal community, Aboriginal Health Strategy and the wider health services to ensure services are culturally appropriate, easily accessible and support the patient journey throughout the health system.

Aboriginal healthy lifestyle programs

Moorditj Djena

Moorditj Djena is a podiatry and nutrition outreach program targeting Aboriginal people over the age of 18 years with one or more of the following conditions:

  • a diagnosis of diabetes mellitus with poor control or understanding of management
  • recent foot ulcer or non-traumatic amputation
  • diagnosis of peripheral arterial disease or peripheral neuropathy.


The (LIFE) Program is a holistic, generic model of care for the management of chronic conditions adapted for Aboriginal communities. It was developed under license from Stanford University, California, by the Pika Wiya Health Service and Spencer Gulf Rural Health School in South Australia (SA) as part of the Sharing Health Care SA Project in 2001.

Journey of Living with Diabetes (JLWD)

The Journey of Living with Diabetes (JLWD) program delivers culturally appropriate diabetes prevention, education and self-management skills for Aboriginal people. The aim is to increase JLWD participants’ health literacy to empower them to take control of their own health in partnership with a range of health service providers. 

Community Rehabilitation

Community Rehabilitation is a multidisciplinary service that provides coordinated intervention to patients with complex rehabilitation needs within a community setting.

The Community Rehabilitation service provides the following care options:

  • rehabilitation closer to home
  • access to an extensive multidisciplinary team through a single point of referral, making it a ‘one stop shop’ for patients who have complex needs
  • patient centred care, with patient, carer and family involvement in goal setting
  • coordinated care to ensure a smooth transition between inpatient and outpatient settings
  • high quality, evidence based assessment and intervention
  • pathways to linked services, including the Aged Care Assessment Team (ACAT) and Complex Needs Coordination Team (CoNeCT).
The service covers a wide range of rehabilitation specialties, including:
  • amputee rehabilitation
  • cardiac rehabilitation
  • falls and mobility
  • general deconditioning
  • geriatric rehabilitation
  • memory and cognition
  • neurological rehabilitation (including Parkinson’s condition services)
  • orthopaedic rehabilitation
  • pulmonary rehabilitation
  • spinal rehabilitation.
Community Rehabilitation services are located at the following hospital sites:
  • Fremantle Hospital and Health Service Rehabilitation Centre 
    • Telephone: 9431 3650 
    • Fax: 9431 3666 
  • Rockingham General Hospital Community Rehabilitation 
    • Telephone: 9599 4877 
    • Fax: 9599 4700 

GPs should refer patients requiring medical assessment via the Central Referral Service.

Allied Health referrals can be faxed directly to the hospital sites using the Community Rehabilitation referral form (PDF 297KB).

Contact details

Metropolitan Communicable Disease Control (MCDC)

Anita Clayton Centre
Suite 1/311 Wellington St
Perth, Western Australia, 6000
Ph: +61 8 9222 8588
Fx: +61 8 9222 8599
1300 MCDCWA (1300 62 32 92)
Email: contactMCDC@health.wa.gov.au

PARK team - Kwinana office

(Health promotion, Aboriginal health)
1 Peel Court, Kwinana WA 6111
PO Box 187, Kwinana WA 6966
Ph: +61 8 9419 2266
Fx: +61 8 9439 1088

PARK team - Mandurah office

(Health promotion, Aboriginal health)
112 Lakes Road, Mandurah, WA 6210
Ph: +61 8 9586 4500
Fx: +61 8 9586 4595