The impact of Aboriginal community controlled health service advocacy on Aboriginal health policy

2005 ◽  
Vol 11 (2) ◽  
pp. 53 ◽  
Author(s):  
Ben Bartlett ◽  
John Boffa
Keyword(s):  
Health Policy ◽  
Health Service ◽  
Health Services ◽  
Torres Strait Islander ◽  
Aboriginal Health ◽  
Aboriginal Community ◽  
Implementation Phase ◽  
Torres Strait ◽  
Strategic Relationships ◽  
The Impact

This paper reviews the advocacy role of Aboriginal community controlled health services (ACCHSs) in the development of Aboriginal health policy over the past 30 years, with a specific focus on the recent changes in Commonwealth funding and administrative responsibility - the transfer of Aboriginal health service funding from the Aboriginal and Torres Strait Islander Commission (ATSIC) to the Office of Aboriginal and Torres Strait Islander Health Services (OATSIHS) within the Commonwealth Department of Health and Ageing (DoHA), and the development of policies aimed at Aboriginal health services accessing mainstream (Medical Benefits Scheme [MBS]) funds. The outcomes of this policy change include a significant increase in funding to Aboriginal primary health care (PHC), the inclusion of ACCHSs in collaborative strategic relationships, and the development of new arrangements involving regional planning and access to per capita funds based on MBS equivalents. However, the community sector remains significantly disadvantaged in participating in this collaborative effort, and imposed bureaucratic processes have resulted in serious delays in releasing funds for actual services in communities. Government agencies need to take greater heed of community advocacy, and provide appropriate resourcing to enable community organisations to better direct government effort, especially at the implementation phase. These remain major concerns and should be considered by non-health sectors in the development of new funding and program development mechanisms in the wake of the abolition of ATSIC.

scholarly journals Factors supporting retention of health and wellbeing staff in Aboriginal health services: a strength-based case study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Sara Deroy ◽  
Heike Schütze
Keyword(s):  
Health Service ◽  
Health Services ◽  
Aboriginal Health ◽  
Social Accountability ◽  
Cultural Safety ◽  
Staff Retention ◽  
Professional Advancement ◽  
Aboriginal Community ◽  
Health And Wellbeing

Abstract Background Aboriginal Community Controlled Health Services are fundamental to improving the health and welfare of Aboriginal peoples. A key element that contributes to the effectiveness of these services are Aboriginal health and wellbeing staff. However, Aboriginal health and wellbeing staff often suffer high rates of stress and burnout. Current literature focuses on proposed strategies to increase staff retention in Aboriginal Health Services, yet, there is limited information available showcasing what has actually worked. Method This was an intrinsic strengths-based case study of one regional Aboriginal Community Controlled Health Service. Semi-structured research yarning interviews were conducted with past and present staff employed in health and wellbeing roles to highlight the factors that staff felt contributed to their retention. Results Ten interviews were conducted between February and April 2018. Six key themes emerged: social accountability, teamwork and collaboration, cultural safety, supervision, professional advancement, and recognition. We add to the literature by identifying the importance of bi-directional communication, and showing that social accountability, teamwork and collaboration, cultural safety, supervision, professional advancement, and recognition continue to be important factors that contribute to health and wellbeing staff retention in Aboriginal Health Services. Conclusion This exemplar Aboriginal Health Service may provide insights into future strategies to improve staff retention in other health services.

Child Health Services in England and Wales: An Overview

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 1032-1036
Author(s):  
Shirley Goodwin
Keyword(s):  
Health Policy ◽  
General Practitioner ◽  
National Health Service ◽  
Child Health ◽  
Health Service ◽  
Health Services ◽  
Social Security ◽  
Child Health Services ◽  
England And Wales ◽  
The Impact

Child health services in England and Wales are rendered largely through the National Health Service and Social Security. The activities of local authorities are also important to child health. The structure and scope of services offered children by each of these is presented and discussed, with special attention to changes anticipated during the next 2 years. The care of children is integrated into the system serving all ages, so that services are difficult to evaluate and resources are shared with other groups. Health policy for children is fragmentary, although encouraging trends are visible in the evolution of existing policy. The impact of impending changes in hospital, community, and general practitioner services on the care of children is unclear at this time.

Gonorrhoea testing and positivity in non-remote Aboriginal Community Controlled Health Services

Sexual Health ◽  
2017 ◽  
Vol 14 (4) ◽  
pp. 320 ◽  
Author(s):  
Mary Ellen Harrod ◽  
Sophia Couzos ◽  
James Ward ◽  
Mark Saunders ◽  
Basil Donovan ◽  
...  
Keyword(s):  
Health Services ◽  
Torres Strait Islander ◽  
Clinical Encounter ◽  
Current Approach ◽  
Research Network ◽  
Torres Strait Islander People ◽  
Remote Communities ◽  
Aboriginal Community ◽  
Torres Strait ◽  
Concurrent Testing

Background Gonorrhoea occurs at high levels in young Aboriginal and Torres Strait Islander people living in remote communities, but there are limited data on urban and regional settings. An analysis was undertaken of gonorrhoea testing and positivity at four non-remote Aboriginal Community Controlled Health Services participating in a collaborative research network. Methods: This was a retrospective analysis of clinical encounter data derived from electronic medical records at participating services. Data were extracted using the GRHANITE program for all patients aged 15–54 years from 2009 to 2013. Demographic characteristics and testing and positivity for gonorrhoea were calculated for each year. Results: A total of 2971 patients (2571 Aboriginal and/or Torres Strait Islander) were tested for gonorrhoea during the study period. Among Aboriginal and/or Torres Strait Islander patients, 40 (1.6%) tested positive. Gonorrhoea positivity was associated with clinic location (higher in the regional clinic) and having had a positive chlamydia test. By year, the proportion of patients aged 15–29 years tested for gonorrhoea increased in both men (7.4% in 2009 to 15.9% in 2013) and women (14.8% in 2009 to 25.3% in 2013). Concurrent testing for chlamydia was performed on 86.3% of testing occasions, increasing from 75% in 2009 to 92% in 2013. Factors related to concurrent testing were sex and year of test. Conclusions: The prevalence of gonorrhoea among young Aboriginal and/or Torres Strait Islander people in non-remote settings suggests that the current approach of duplex testing for chlamydia and gonorrhoea simultaneously is justified, particularly for women.

The Centre of Clinical Research Excellence in Aboriginal and Torres Strait Islander Health: An Operational Rationale and Some Reflections on Progress so far

2006 ◽  
Vol 12 (2) ◽  
pp. 97 ◽  
Author(s):  
Glenn Giles ◽  
Merridy Malin ◽  
Peter Harvey
Keyword(s):  
Health Services ◽  
Clinical Research ◽  
Indigenous People ◽  
Torres Strait Islander ◽  
Aboriginal People ◽  
Aboriginal Health ◽  
Health Council ◽  
Torres Strait ◽  
Research Excellence ◽  
Torres Strait Islander Health

The Centre of Clinical Research Excellence (CCRE) in Aboriginal and Torres Strait Islander Health was established in late 2003 through a major National Health and Medical Research Council (NHMRC) grant involving collaboration between the Aboriginal Health Council of South Australia (AHCSA), Flinders University, and Aboriginal Health Services. Our foundation research communities are the Aboriginal communities served by these Aboriginal Health Services in the Spencer Gulf / Eyre Peninsula region. In recent years a number of collaborative research programs involving chronic illness management, self-management and coordinated care have been implemented in these communities and this work is the basis of the initial CCRE activities. Key objectives of the CCRE are to improve the health status of Indigenous people through conducting relevant and meaningful Aboriginal controlled health research, providing formal training for Indigenous health researchers and developing innovative approaches to health care that can be readily translated and applied to support communities. The inclusion, empowerment and engagement of Indigenous people in the process of managing community health represent tangible strategies for achieving more equitable health outcomes for Aboriginal people. This paper outlines the CCRE operational rationale and presents early activities and outcomes across the three strategic areas of CCRE operations: research, education and training, and translation. Some critical reflections are offered on the progress and experience of the CCRE thus far. A common obstacle this CCRE has encountered is that the limited (especially staff) resources available to the Aboriginal Health Services with which we are collaborating make it difficult for them to engage with and progress the projects we are pursuing.

Cardiovascular disease risk assessment in an Aboriginal community-controlled health service: comparing algorithms

2020 ◽  
Vol 26 (4) ◽  
pp. 281 ◽  
Author(s):  
Xavier Fitzgerald ◽  
Ana Herceg ◽  
Kirsty Douglas ◽  
Nadeem Siddiqui
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
High Risk ◽  
Health Service ◽  
Torres Strait Islander ◽  
Lipid Lowering ◽  
Risk Scores ◽  
Cvd Risk ◽  
Aboriginal Community ◽  
Torres Strait

Aboriginal and Torres Strait Islander people have high rates of cardiovascular disease (CVD). The National Vascular Disease Prevention Alliance (NVDPA) CVD risk assessment algorithm is used for all Australians. The Central Australian Rural Practitioners Association (CARPA) algorithm used in the Northern Territory adds five percentage points to all NVDPA risk scores for Indigenous Australians. Information was extracted from an Aboriginal Community-Controlled Health Service for all Aboriginal and Torres Strait Islander regular clients aged 35–74 years without known CVD (n=1057). CVD risk scores were calculated using both algorithms. Prescription of lipid-lowering medications was assessed. Clients with high-risk scores were reviewed and recalled if required. CVD risk scores were calculated for 362 (34.4%) clients. Clients with high CVD risk comprised 17.7% (NVDPA) or 23.8% (CARPA), with most determined clinically. Clients with low CVD risk comprised 73.7% (NVDPA) or 47.2% (CARPA). More than 30% of those with high risk were not on lipid-lowering medications. Significant health and social issues affected treatment uptake. It is unclear which algorithm is most applicable; however, this service has decided to continue to use the NVDPA algorithm. Use of CVD risk assessment and management of high-risk clients could be increased in primary care.

Engaging with Aboriginal Shire Councils in remote Cape York communities to address smoke-free environments

2019 ◽  
Vol 25 (5) ◽  
pp. 419
Author(s):  
Kiarah E. Cuthbert ◽  
Clare Brown ◽  
Melinda Hammond ◽  
Tiffany A. Williams ◽  
Desmond Tayley ◽  
...  
Keyword(s):  
Health Services ◽  
Tobacco Smoking ◽  
Torres Strait Islander ◽  
Service Providers ◽  
Critical Role ◽  
Torres Strait Islander People ◽  
Aboriginal Community ◽  
Health Council ◽  
Cape York ◽  
Torres Strait

The high prevalence and health effect of tobacco smoking and secondhand smoke exposure among Aboriginal and Torres Strait Islander people is well known. Due to its significance, the responsibility of tackling smoking among Aboriginal and Torres Strait Islander people should not remain solely with health service providers. The creation of supportive environments and collaboration beyond the health sector are critical elements of comprehensive primary health care practised by Aboriginal Community Controlled Health Services. This paper discusses how Apunipima Cape York Health Council worked with three Aboriginal Shire Councils to create more smoke-free places, using local working groups, information sessions and community-based health promotion. The flexibility and the time allocated to the engagement process with councils, community leaders, organisations and community members were important. All three communities acknowledged the benefits of role modelling and working together to improve health, with addressing tobacco smoking seen as ‘everyone’s business’ and ‘not just service providers’. Aboriginal Shire Councils can play a critical role, in partnership with Aboriginal Community Controlled Health Services, in creating healthy places that enable healthy choices.

A Health Service and Aboriginal & Torres Strait Islander Partnership to Develop and Plan Mental Health Services

1998 ◽  
Vol 4 (4) ◽  
pp. 18 ◽  
Author(s):  
Christine Salisbury
Keyword(s):  
Mental Health ◽  
Action Research ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Torres Strait Islander ◽  
Service Planning ◽  
Medical Setting ◽  
Service Utilisation ◽  
Torres Strait

The aim of this study was to examine the effects of an action research partnership between the Tweed Valley Health Service (TVHS) and the Aboriginal & Torres Strait Islander community for the development and delivery of Aboriginal & Torres Strait Islander Mental Health Services. This partnership was based upon Labonte's (1989) view of empowerment where it is suggested that to be empowered means to have increased capacity to define, analyse and act upon one's problems. It was proposed that the establishment of a 'partnership' based upon these principles would assist in operationalising Indigenous community participation in TVHS planning. To achieve this type of 'partnership', the health service had to be willing to enter the partnership and to give the authority to the Aboriginal & Torres Strait Islander Health Outcome Council to seek and trial solutions on Aboriginal & Torres Strait Islander Mental Health matters. Key outcomes were defined as the extent to which the re-organised services proved to be acceptable and utilised by the local Aboriginal & Torres Strait Islander population. Outcomes were operationalised through measures of service utilisation and consumer satisfaction with accessibility, process and outcomes. The study trialed participatory action research as a method for Indigenous participation in Mental Health Service planning and development and concludes that it is a valid model for cross cultural research and health service development in a complex medical setting.

Walan Girri: developing a culturally mediated case management model for problematic alcohol use among urban Indigenous people

2014 ◽  
Vol 38 (4) ◽  
pp. 440 ◽  
Author(s):  
Ray Lovett ◽  
Phyll Dance ◽  
Jill Guthrie ◽  
Roxie Brown ◽  
Julie Tongs
Keyword(s):  
Health Service ◽  
Case Management ◽  
Brief Intervention ◽  
Torres Strait Islander ◽  
Aboriginal Health ◽  
Social Health ◽  
Management Model ◽  
Care Planning ◽  
Health Team ◽  
Torres Strait

Objective To describe the design and implementation of a culturally mediated case management model at Winnunga Nimmityjah Aboriginal Health Service (Winnunga) for Indigenous clients who consume alcohol at problematic levels. Methods Our research took place from March 2008 to March 2010 in the Australian Capital Territory and built on previous research partnerships between Winnunga and The Australian National University’s National Centre for Epidemiology and Population Health. We conducted a review of existing models to determine elements for consideration in the community controlled setting, and conducted staff surveys to assess current levels of skill and confidence around alcohol screening, brief intervention and care planning. Using the information from the review and staff surveys, we then undertook staff capacity building to build confidence and skills in conducting alcohol screening, brief intervention and care planning. This process was driven by Winnunga’s social health team. To meet Medicare benefits schedule requirements, and frame the study within the Aboriginal and Torres Strait Islander Chronic Disease Package framework, we included team care arrangements, care planning and health checks. Results Elements of case management were suggested by staff and incorporated into the final model. Forty staff in the health service participated in identifying training needs for the development of the case management model and undertook a range of training before the model was implemented. Staff working within the social health team decided that the focus of the case management was to build a stronger future for their clients, hence the name of the case management model ‘Walan Girri’ (Wiradjuri language for strong future). The model included a package of screening instruments and brief intervention, related polices and discussion of ‘mob’ and ‘country.’ Changes in Winnunga management and staff, the composition of the research team and the way Walan Girri evolved led to protracted development and implementation. Conclusions This project highlights considerations for implementing a case management model in a dynamic health service environment. Capacity building for Winnunga staff and for an Indigenous PhD scholar were part of the process and were integral in maintaining momentum in the project. What is known about the topic? Case management for chronic disease and other health conditions is currently recommended in assisting to resolve those issues. Case management aims to involve a range of healthcare practitioners (general practitioners, nurses and Aboriginal health workers) and providers in conjunction with the client to improve their health status. Currently, there is limited description of how case management models are used within the Aboriginal community controlled context. What does this paper add? This paper adds to the knowledge base in this field by describing the results of a method of case management driven by the community controlled health sector. It also introduces a simple approach that may be useful in a range of contexts in the health setting in building trust and rapport with clients, while engaging the healthcare practitioner in the Aboriginal and Torres Strait Islander cultural contexts of relationships to country and family (mob). What are the implications for practitioners? The implication may be that healthcare practitioners working in Aboriginal and/or Torres Strait Islander Health Services adopt Aboriginal and Torres Strait Islander cultural protocols, such as talking with clients about ‘mob’ and ‘country’, to build trust and rapport.

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