Contribution of Aboriginal Community-Controlled Health Services to improving Aboriginal health: an evidence review

Abstract

Objective Aboriginal Community-Controlled Health Services (ACCHSs) deliver comprehensive, culturally appropriate primary health care to Aboriginal people and communities. The published literature acknowledging and supporting the roles of ACCHSs in improving Aboriginal health is limited. This paper seeks to collate and analyse the published evidence supporting the contribution of ACCHSs to improving the health of Aboriginal people. Methods A conceptual framework for exploring the contribution of ACCHSs was developed, drawing on the literature on the core functions of ACCHSs and the components of quality primary health care. This framework was used to structure the search strategy, inclusion criteria and analysis of the review. Results ACCHSs contribute to improving the health and well being of Aboriginal peoples through several pathways, including community controlled governance, providing employment and training, strengthening the broader health system and providing accessible, comprehensive primary health care. Conclusions ACCHSs make a range of important contributions to improving the health of Aboriginal peoples that are under-acknowledged. Consideration of the different ways ACCHSs contribute to improving Aboriginal health is of value in the design and evaluation of programs and policies that aim to improve the health of Aboriginal peoples. What is known about the topic? Aboriginal communities have long argued the vital role of ACCHSs in improving Aboriginal health. What does this paper add? This paper provides a comprehensive collation and analysis of the evidence supporting the contributions ACCHSs are making to improving Aboriginal health. What are the implications for practitioners? The conceptual framework and findings outlined in this paper illustrate that ACCHSs are making important contributions to improving Aboriginal health through several pathways. This information can be used to ensure actions to improve Aboriginal health are appropriate and effective. There are important gaps in the literature that researchers need to address.

Primary Health Networks’ impact on Aboriginal Community Controlled Health Services

“…The ACCHS sector, often referred to as the Aboriginal Medical Services or AMSs, delivers high‐quality, comprehensive, and culturally‐informed healthcare, and is run for and by Aboriginal and Torres Strait Islander communities (Campbell, Hunt, Scrimgeour, Davey, & Jones, ). These Indigenous organisations deliver a range of clinical and allied health services and are also involved in community development and health promotion.…”

Are general practitioners getting the information they need from hospitals and specialists to provide quality cancer care for Indigenous Australians?

“…[28][29][30] As a higher proportion of Indigenous Australians live in rural areas, 20 together with other Australians they have worse cancer outcomes than those living in major cities. [35][36][37] ACCHO offer welcoming social spaces, culturally safe care that is responsive to holistic needs, 38 and many Indigenous Australians value their accessibility. However, GP involvement in cancer care is varied, with GP based in rural areas having a greater role in cancer care than their major city counterparts.…”

“…The quality of care delivered by ACCHO is generally at least on par with mainstream services. [35][36][37] ACCHO offer welcoming social spaces, culturally safe care that is responsive to holistic needs, 38 and many Indigenous Australians value their accessibility. 36 From an international perspective, the services provided to Indigenous Australians with cancer form a useful case study.…”

What are the resourcing requirements for an Aboriginal and Torres Strait Islander primary health care research project?

“…2 Diversity across Indigenous communities and Indigenous-focused PHC services, (including size, funding, infrastructure and workforce) means each service may have unique resource requirements. 3 Flexible and sufficient resources are needed for research to be relevant, effective and culturally respectful. 1 Sufficient resourcing may also facilitate compliance with Values and ethics: guidelines for ethical conduct in Aboriginal and Torres Strait Islander health research 4 (hereafter Values and ethics guideline) by funding travel that may foster ethical relationships between external researchers and communities.…”