Does Australia have the appropriate health reform agenda to close the gap in Indigenous health?

Donato, Ronald; Segal, Leonie

doi:10.1071/ah12186

Cited by 25 publications

(28 citation statements)

References 21 publications

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“…Australian Aboriginal communities continue to bear a disproportionate burden of oral ill-health relative to other Australians. 3 In spite of this, Aboriginal Australians have been found to access primary-care services including oral-health services at a lower rate than other Australians despite their elevated risk. 1 At the extreme end, the rates of transport to a major hospital for general anaesthesia treatment of significant decay outstrip non-Aboriginal Australians.…”

Section: Introductionmentioning

confidence: 99%

Client perspectives on an Aboriginal community led oral health service in rural Australia

Irving

Gwynne

Angell

et al. 2016

Aust. J. Rural Health

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The implementation of a new community led oral health service to Northern NSW Aboriginal communities was shown here to be well-utilised, respected and in an area of high need. The collaborative approach could be continued to be utilised to implement targeted, community led health promotion programs to facilitate and encourage better oral health practices for the Aboriginal children in these communities.

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Section: Introductionmentioning

confidence: 99%

Client perspectives on an Aboriginal community led oral health service in rural Australia

Irving

Gwynne

Angell

et al. 2016

Aust. J. Rural Health

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“…The health of Australian Indigenous people has been slow to improve despite committed funding [3] and Indigenous Australians remain the most marginalised of any identifiable group, featuring consistently at the lowest point on any marker of disadvantage [4]. As a result of the failure of mainstream services with their Western and biomedical focus to meet Indigenous peoples’ needs, Aboriginal Medical Services were set up in the early 1970s to offer a more culturally safe environment.…”

mentioning

confidence: 99%

Examining the potential contribution of social theory to developing and supporting Australian Indigenous-mainstream health service partnerships

Haynes

Taylor

Durey

et al. 2014

Int J Equity Health

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IntroductionThe substantial gap in life expectancy between Indigenous and non-Indigenous Australians has been slow to improve, despite increased dedicated funding. Partnerships between Australian Indigenous and mainstream Western biomedical organisations are recognised as crucial to improved Indigenous health outcomes. However, these partnerships often experience challenges, particularly in the context of Australia’s race and political relations.MethodsWe examined the relevant literature in order to identify the potential role for social theory and theoretical models in developing and maintaining intercultural partnerships. Having identified relevant theoretical models, terms and possible key words, a range of databases were searched and relevant articles selected for inclusion. An integrative approach brought together theoretical models and practical considerations about working in partnership, to inform our analysis of the literature.FindingsConsidering partnerships between Australian Indigenous and mainstream health organisations as ‘bi-cultural’ is simplistic: rather they are culturally diverse across social and professional levels. As such, partnerships between Australian Indigenous and mainstream health organisations may be better conceptualised as ‘intercultural’, operating across diverse and shifting cultural frames of reference. Theories identified by this review as useful to guide partnerships include power relations, reflexivity and dialogue, borders and strangeness and the intercultural or third space. This paper examines how these theoretical approaches can develop understanding and improve intercultural engagement between mainstream and Australian Indigenous partners in healthcare.ConclusionsRather than viewing partnerships merely as arrangements between disembodied entities, sometimes contractual in nature, they are better seen as activities between people and organisations and essentially dependent on relationships, occurring in an intercultural space that is complex, dynamic and subject to changes in power relations. Theoretical models aiming to understand and improve partnerships indicate the complexity of building and maintaining such partnerships and stress the importance of understanding factors that can strengthen or derail their effectiveness. While the theories presented here are by no means exhaustive, they nonetheless provide a series of entry points through which to engage with the issue and expand the discourse. This approach allows the transformative nature of Australian Indigenous-mainstream ‘culture’ to be explored and understood in its lived expression; rather than relegated to prescriptive categories.

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“…Many of the causative factors of health and ill health lie outside the health system and, to address these, a range of measures that extend beyond the health sector is required. To this end, comprehensive primary healthcare (PHC) is recognised as central to providing a multidisciplinary framework that can interface with other sectors and tackle Indigenous disadvantage (Marmot 2011;Donato and Segal 2013), with health promotion as a core function (Tilton and Thomas 2011). Within this complex context for health care delivery, evaluation of health promotion activities is imperative.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Aboriginal and Torres Strait Islander health promotion activities using audit and feedback

O'Donoghue

Percival

Laycock

et al. 2014

Aust. J. Prim. Health

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Abstract. Indigenous primary health care (PHC) services have been identified as exemplary models of comprehensive PHC; however, many practitioners in these services struggle to deliver effective health promotion. In particular, practitioners have limited capacity and resources to evaluate health promotion activities. Best practice health promotion is important to help address the lifestyle and wider factors that impact on the health of people and communities. In this paper, we report on the acceptability and feasibility of an innovative approach for evaluating the design of health promotion activities in four Indigenous PHC services in the Northern Territory. The approach draws on a popular continuous quality improvement technique known as audit and feedback (A&F), in which information related to best practice is gathered through the use of a standardised audit tool and fed back to practitioners. The A&F approach has been used successfully to improve clinical service delivery in Indigenous PHC; however, the technique has had limited use in health promotion. The present study found that facilitated participatory processes were important for the collection of locally relevant information and for contributing to improving PHC practitioners' knowledge and understanding of best practice health promotion.

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Does Australia have the appropriate health reform agenda to close the gap in Indigenous health?

Cited by 25 publications

References 21 publications

Client perspectives on an Aboriginal community led oral health service in rural Australia

Client perspectives on an Aboriginal community led oral health service in rural Australia

Examining the potential contribution of social theory to developing and supporting Australian Indigenous-mainstream health service partnerships

Evaluating Aboriginal and Torres Strait Islander health promotion activities using audit and feedback

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