Culturally safe health care practice for Indigenous Peoples in Australia: A systematic meta-ethnographic review

2021 ◽  
pp. 135581962110418
Author(s):  
Stephanie De Zilva ◽  
Troy Walker ◽  
Claire Palermo ◽  
Julie Brimblecombe
Keyword(s):  
Health Care ◽  
Indigenous Peoples ◽  
Health Care Services ◽  
Torres Strait Islander ◽  
Indigenous Health ◽  
Cultural Knowledge ◽  
Cultural Safety ◽  
Care Practice ◽  
Health Care Practice ◽  
Torres Strait

Objectives Culturally safe health care services contribute to improved health outcomes for Aboriginal and Torres Strait Islander Peoples in Australia. Yet there has been no comprehensive systematic review of the literature on what constitutes culturally safe health care practice. This gap in knowledge contributes to ongoing challenges providing culturally safe health services and policy. This review explores culturally safe health care practice from the perspective of Indigenous Peoples as recipients of health care in Western high-income countries, with a specific focus on Australian Aboriginal and Torres Strait Islander Peoples. Methods A systematic meta-ethnographic review of peer-reviewed literature was undertaken across five databases: Ovid MEDLINE, Scopus, PsychINFO, CINAHL Plus and Informit. Eligible studies included Aboriginal and Torres Strait Islander Peoples receiving health care in Australia, had a focus on exploring health care experiences, and a qualitative component to study design. Two authors independently determined study eligibility (5554 articles screened). Study characteristics and results were extracted and quality appraisal was conducted. Data synthesis was conducted using meta-ethnography methodology, contextualised by health care setting. Results Thirty-four eligible studies were identified. Elements of culturally safe health care identified were inter-related and included personable two-way communication, a well-resourced Indigenous health workforce, trusting relationships and supportive health care systems that are responsive to Indigenous Peoples’ cultural knowledge, beliefs and values. Conclusions These elements can form the basis of interventions and strategies to promote culturally safe health care practice and systems in Australia. Future cultural safety interventions need to be rigorously evaluated to explore their impact on Indigenous Peoples’ satisfaction with health care and improvements in health care outcomes.

scholarly journals Colonial Legacies and Collaborative Action: Improving Indigenous Peoples’ Health Care in Canada

2020 ◽  
Vol 10 (5) ◽  
Author(s):  
Lloy Wylie ◽  
Stephanie McConkey ◽  
Ann Marie Corrado
Keyword(s):  
Health Care ◽  
Health Services ◽  
Indigenous People ◽  
Health Care System ◽  
Health Care Services ◽  
Indigenous Health ◽  
Care Practice ◽  
Attitudes And Practices ◽  
Care Services ◽  
Care System

Indigenous people experience significant health disparities compared to non-Indigenous people, which are exacerbated by less accessible and poorer quality health care services. This research aimed to understand the specific barriers to health care that Indigenous patients and their families face, as well as to explore promising practices and strategies for improving the responsiveness of health services to the needs of Indigenous people. Through qualitative interviews with Indigenous and non-Indigenous health care and social services providers, we identified a range of challenges and successful approaches, and developed recommendations for improving policy and practice to address the gaps in culturally safe health care services. Our study shows that many of the barriers Indigenous people face when accessing health care are rooted in the broader social determinants of health, such as poverty, racism, housing, and education. These are complex problems that are outside of the traditional scope of health care practice. However, this study has also demonstrated that many barriers to equitable care actually stem from within the health care system itself. We found that health care gaps were often attributable to poorly funded on-reserve health care services and culturally unsafe off-reserve services.  Attitudes and practices among those working in health care and gaps in coordination between mainstream and Indigenous services are challenges related to the way the health care system operates. Solutions are needed that address these issues. Given the multifaceted nature of access barriers, strategies to improve health services for Indigenous people and communities require a comprehensive and systemic approach.  

Improving the Service to Aboriginal and Torres Strait Islanders through Innovative Practices Between Aboriginal Hospital Liaison Officers and Social Workers in Hospitals in Victoria, Australia†

2020 ◽  
Author(s):  
Helen Bnads ◽  
Elizabeth Orr ◽  
C John Clements
Keyword(s):  
First Nations ◽  
Social Workers ◽  
Torres Strait Islander ◽  
Indigenous Health ◽  
Public Hospitals ◽  
Cultural Safety ◽  
Colonial Legacy ◽  
Torres Strait ◽  
First Nations People

Abstract Aboriginal and Torres Strait Islanders have suffered violence and extreme prejudice in every walk of life as a result of the European colonisation of Australia. We acknowledge the ongoing colonial legacy to this suffering and discuss how cultural safety is a solution to overcoming some elements of the disadvantages that still beset Aboriginal and Torres Strait Islander people in terms of accessing health care. Accessible and culturally safe health services are critical in reducing health inequalities for First Nations’ people because of the burden of ill-health they experience. ‘Cultural safety’ in this context refers to approaches that strengthen and respectfully engage with Aboriginal and Torres Strait Islander cultures in mainstream services. Alongside holistic Indigenous health and primary prevention approaches, a broad range of medical, socio-cultural and allied health support is needed to alleviate these inequalities. In this article, we describe how the working relationship between Aboriginal Hospital Liaison Officers and Social Workers in public hospitals in Victoria, Australia, contributes to cultural safety, and thereby improves the quality of care and a reduction in discharges against medical advice by Aboriginal patients. We conclude that elements of this model may be applicable to improving care for First Nation peoples in other countries.

scholarly journals Building Indigenous health workforce capacity and capability through leadership – the Miwatj health leadership model

2021 ◽  
Vol 22 ◽  
Author(s):  
Stephen Harfield ◽  
Carol Davy ◽  
Anna Dawson ◽  
Eddie Mulholland ◽  
Annette Braunack-Mayer ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Indigenous Health ◽  
Cultural Safety ◽  
Structured Interviews ◽  
Indigenous Leadership ◽  
Health Care Organisation ◽  
Leadership Model ◽  
Care Services ◽  
Formal Leadership

Abstract Aim: In the crowded field of leadership research, Indigenous leadership remains under-researched. This article explores the Leadership Model of an Aboriginal Community Controlled Primary Health Care Organisation providing services to the Yolngu people of remote northern Australia: the Miwatj Health Aboriginal Corporation (Miwatj). Background: The limited research which does exist on Indigenous leadership points to unique challenges for Indigenous leaders. These challenges relate to fostering self-determination in their communities, managing significant community expectations, and navigating a path between culturally divergent approaches to management and leadership. Methods: Guided by Indigenous methodology and using a mixed methods approach, semi-structured interviews, self-reported health service data, organisational and publicly available documents, and literature were analysed using a framework method of thematic analysis to identify key themes of the Miwatj Leadership Model. Findings: The Miwatj Leadership Model is underpinned by three distinctive elements: it offers Yolngu people employment opportunities; it supports staff who want to move into leadership positions and provides capacity building through certificates and diplomas; and it provides for the physical, emotional, and cultural wellbeing of all Yolngu staff. Furthermore, the model respects traditional Yolngu forms of authority and empowers the community to develop, manage and sustain their own health. The Miwatj Leadership Model has been successful in providing formal pathways to support Indigenous staff to take on leadership roles, and has improved the accessibility and acceptability of health care services as a result of Yolngu employment and improved cultural safety. Conclusions: Translating the Miwatj Leadership Model into other health services will require considerable thought and commitment. The Miwatj Leadership Model can be adapted to meet the needs of other health care services in consideration of the unique context within which they operate. This study has demonstrated the importance of having a formal leadership model that promotes recruitment, retention, and career progression for Indigenous staff.

Antenatal emotional wellbeing screening in Aboriginal and Torres Strait Islander primary health care services in Australia

2013 ◽  
Vol 46 (1) ◽  
pp. 73-82 ◽  
Author(s):  
Kaniz Gausia ◽  
Sandra Thompson ◽  
Tricia Nagel ◽  
Alice Rumbold ◽  
Christine Connors ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Services ◽  
Torres Strait Islander ◽  
Emotional Wellbeing ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
Torres Strait

scholarly journals Indigenous access barriers to health care services in London, Ontario

2017 ◽  
Vol 86 (2) ◽  
pp. 6-9 ◽  
Author(s):  
Stephanie McConkey
Keyword(s):  
Health Care ◽  
Health Services ◽  
Indigenous Peoples ◽  
Health Care Services ◽  
Service Providers ◽  
Cultural Safety ◽  
Cultural Barriers ◽  
Access Barriers ◽  
Care Services ◽  
Pain Medications

Introduction: Indigenous peoples in Canada suffer higher rates of health inequalities and encounter a number of health services access barriers when compared to their non-Indigenous counterparts. Indigenous peoples experience social and economic challenges, cultural barriers, and discrimination when accessing mainstream health services. Methods: In London, Ontario, 21 interviews and 2 focus groups (n = 25) with service providers were completed, each session spanning approximately 1 to 1.5 hours. Interviews were voice recorded and transcribed verbatim. Themes were identified using NVIVO 10 software. Findings: Approximately 2 to 5% of clients are Indigenous in hospital-based services. There are a number of social factors that influence whether Indigenous peoples access health services. Indigenous peoples do not have access to adequate pain medications because physicians are reluctant to provide Indigenous patients with pain medications due to common perceptions of addiction. Indigenous peoples also have barriers accessing a family physician because physicians are reluctant to take on new patients with complex health needs. Conclusion: Systemic discrimination is still alive in the health care system; therefore, there is a need for cultural safety training among physicians to increase awareness of access barriersand challenges that many Indigenous patients face when seeking health care.

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