scholarly journals Acknowledging and Promoting Indigenous Knowledges, Paradigms, and Practices Within Health Literacy-Related Policy and Practice Documents Across Australia, Canada, and New Zealand

2019 ◽  
Vol 10 (3) ◽  
Author(s):  
Gordon Robert Boot ◽  
Anne Lowell
Keyword(s):  
New Zealand ◽  
Health Literacy ◽  
Health Services ◽  
Indigenous Health ◽  
Indigenous Communities ◽  
Policy And Practice ◽  
Indigenous Knowledges ◽  
Qualitative Research Design ◽  
Health Studies ◽  
Quality In Healthcare

Enhancing health literacy can empower individuals and communities to take control over their health as well as improve safety and quality in healthcare. However, Indigenous health studies have repeatedly suggested that conceptualisations of health literacy are confined to Western knowledge, paradigms, and practices. The exploratory qualitative research design selected for this study used an inductive content analysis approach and systematic iterative analysis. Publicly available health literacy-related policy and practice documents originating from Australia, Canada, and New Zealand were analysed to explore the extent to which and the ways in which Indigenous knowledges are recognised, acknowledged, and promoted. Findings suggest that active promotion of Indigenous-specific health knowledges and approaches is limited and guidance to support recognition of such knowledges in practice is rare. Given that health services play a pivotal role in enhancing health literacy, policies and guidelines need to ensure that health services appropriately address and increase awareness of the diverse strengths and needs of Indigenous Peoples. The provision of constructive support, resources, and training opportunities is essential for Indigenous knowledges to be recognised and promoted within health services. Ensuring that Indigenous communities have the opportunity to autonomously conceptualise health literacy policy and practice is critical to decolonising health care.

Transforming a global order in New Zealand to reduce health inequities in service provision

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Rawson
Keyword(s):  
Public Health ◽  
New Zealand ◽  
Indigenous Knowledge ◽  
Best Practice ◽  
Indigenous Health ◽  
Indigenous Communities ◽  
Health Inequities ◽  
Medical Emergency ◽  
Major Work ◽  
Health Initiatives

Abstract St John has been providing service in New Zealand for nearly 140 years since its arrival. It has now close to 4000 staff and nearly 20000 Members and over 8500 volunteers. In New Zealand the major work of St John is its Ambulance service providing front line first responders to crash, medical emergency and other life-threatening situations. St John New Zealand also provides a number of 'Community Health' initiatives focused on strengthening communities and prevention. In recent years St John has recognised that they have not engaged well with Indigenous communities and that their organisation in New Zealand must become skilled and relevant in addressing the needs of the Indigenous people of New Zealand, as they suffer the greater burden of disease and illness than any other population in the country. St John NZ Community and Health Services are embarking on a process of transformation through re-orienting its culture and practice by adopting Public Health approaches and an equity lens over all its programmes. They also have committed to understanding and using Indigenous knowledge to support this re-orientation to most effectively engage and implement programmes that will reduce Indigenous health inequities. This presentation will describe the process by which they will be implementing their strategy for change and highlight best practice for working with Indigenous communities. Key messages Indigenous Knowledge is key to addressing Indigenous Health inequities. Mainstream Public Health can learn from Indigenous Public Health approaches.

‘Best Intentions’ Lives on: Untoward Health Outcomes of Some Contemporary Initiatives in Indigenous Affairs

2002 ◽  
Vol 36 (5) ◽  
pp. 575-584 ◽  
Author(s):  
Ernest Hunter
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Outcomes ◽  
Social Issues ◽  
Indigenous Health ◽  
Indigenous Communities ◽  
Indigenous Populations ◽  
Royal Commission ◽  
Indigenous Mental Health

Objective: A shortened version of a presentation to the Australian Institute of Aboriginal and Torres Strait Islander Studies, this paper raises questions regarding policy and program directions in Indigenous affairs with consequences for Indigenous health. Method: The author notes the inadequate Indigenous mental health database, and describes contemporary conflicts in the arena of Indigenous mental health, drawing on personal experience in clinical service delivery, policy and programme development. Results: Medicalized responses to the Stolen Generations report and constructions of suicide that accompanied the Royal Commission into Aboriginal Deaths in Custody are presented to demonstrate unforeseen health outcomes. Examples are also given of wellintentioned social interventions that, in the context of contemporary Indigenous society appear to be contributing to, rather than alleviating, harm. Problems of setting priorities that confront mental health service planners are considered in the light of past and continuing social disadvantage that informs the burden of mental disorder in Indigenous communities. Conclusions: The importance of acknowledging untoward outcomes of initiatives, even when motivated by concerns for social justice, is emphasized. The tension within mental health services of responding to the underpinning social issues versus providing equity in access to proven mental health services for Indigenous populations is considered.

Addressing Strengths and Disparities in Indigenous Health

2020 ◽  
Vol 15 (1) ◽  
pp. 4
Author(s):  
Suzanne Stewart
Keyword(s):  
Indigenous Health ◽  
Academic Research ◽  
Indigenous Communities ◽  
Self Determination ◽  
Strong Impact ◽  
Model Of Care ◽  
Personal View ◽  
Indigenous Knowledges ◽  
Making A Difference ◽  
Clinical Environments

As an Indigenous person, I came into the world of Indigenous health scholarship in the 1990s with a personal view that focused on the strength and solutions of our peoples and our cultures. Over the next two decades in research and clinical environments, I observed how biomedicine remained firmly entrenched as the dominant model of care for Indigenous individuals and communities, with traditional knowledges and medicines as an aside or non- existent entirely. I have built my life’s work as a researcher and clinician in centering Indigenous knowledges and healing in both research and health care. Yet today in 2020, biomedicine and Western academic research still dismiss Indigenous knowledges and remain mostly in command of Indigenous health. There are wonderful pockets of Indigenous researchers and practitioners, supported by Indigenous communities that continue to have very little real autonomy or self- determination from colonialism, who are making a difference in Indigenous health by reducing health disparities, using our strengths such as culture, spirituality, medicines, the land, Elders, youth, and more. This issue highlights some of the work by researchers that are making a strong impact on Indigenous health, uplifting our communities.

Listening to indigenous health workers

2011 ◽  
Vol 70 (4) ◽  
pp. 400-406 ◽  
Author(s):  
David Walker ◽  
Marc Tennant ◽  
Stephanie D Short
Keyword(s):  
Oral Health ◽  
Health Workers ◽  
Indigenous Health ◽  
National Policy ◽  
Indigenous Communities ◽  
Policy Support ◽  
Role Development ◽  
Structured Interviews ◽  
Policy And Practice

Objective: This research was undertaken to explore factors operating at the level of the clinic and the community which influence the development of the oral health role of Indigenous Health Workers. The research is a significant aspect of a wider study of the disconnect between the strong national policy support for the development of the oral health role of Indigenous Health Workers and the limited development of the role. Design: Semi-structured interviews were conducted with Indigenous Health Workers to explore their perceptions of the priority of the development of an oral health role and to identify facilitators and barriers to sustainable role development. Setting: The study was conducted in three remote Indigenous communities and two regional centres of the Cape York region in far north Australia. Method: Interviews were conducted with 21 Indigenous Health Workers through five group interviews and eight individual interviews. Results: The findings highlight the high priority given by Indigenous Health Workers to the development of their oral health role while also identifying significant barriers to the sustainable development of this role. Conclusion: The identification of barriers to role development operating at the level of the clinic and the community helps to explain the disconnect between policy and practice in the development of the oral health role of these community health personnel.

scholarly journals An Analysis of Journey Mapping to Create a Palliative Care Pathway in a Canadian First Nations Community: Implications for Service Integration and Policy Development

2017 ◽  
Vol 10 ◽  
pp. 117822421771944 ◽  
Author(s):  
Jessica Koski ◽  
Mary Lou Kelley ◽  
Shevaun Nadin ◽  
Maxine Crow ◽  
Holly Prince ◽  
...  
Keyword(s):  
Palliative Care ◽  
Health Services ◽  
First Nations ◽  
Policy Development ◽  
Care Pathway ◽  
Indigenous Health ◽  
Service Integration ◽  
Indigenous Communities ◽  
Future Research ◽  
Nations Community

Providing palliative care in Indigenous communities is of growing international interest. This study describes and analyzes a unique journey mapping process undertaken in a First Nations community in rural Canada. The goal of this participatory action research was to improve quality and access to palliative care at home by better integrating First Nations’ health services and urban non-Indigenous health services. Four journey mapping workshops were conducted to create a care pathway which was implemented with 6 clients. Workshop data were analyzed for learnings and promising practices. A follow-up focus group, workshop, and health care provider surveys identified the perceived benefits as improved service integration, improved palliative care, relationship building, communication, and partnerships. It is concluded that journey mapping improves service integration and is a promising practice for other First Nations communities. The implications for creating new policy to support developing culturally appropriate palliative care programs and cross-jurisdictional integration between the federal and provincial health services are discussed. Future research is required using an Indigenous paradigm.

scholarly journals Strategies to support culturally safe health and wellbeing evaluations in Indigenous settings in Australia and New Zealand: a concept mapping study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Margaret Cargo ◽  
Gill Potaka-Osborne ◽  
Lynley Cvitanovic ◽  
Lisa Warner ◽  
Sharon Clarke ◽  
...  
Keyword(s):  
New Zealand ◽  
Concept Mapping ◽  
Concept Maps ◽  
Indigenous Health ◽  
Hierarchical Cluster ◽  
Indigenous Communities ◽  
Mapping Study ◽  
Financial Investment ◽  
Evaluation Practice ◽  
Cultural Integrity

Abstract Background In recent decades, financial investment has been made in health-related programs and services to overcome inequities and improve Indigenous people’s wellbeing in Australia and New Zealand. Despite policies aiming to ‘close the gap’, limited evaluation evidence has informed evidence-based policy and practice. Indigenous leaders have called for evaluation stakeholders to align their practices with Indigenous approaches. Methods This study aimed to strengthen culturally safe evaluation practice in Indigenous settings by engaging evaluation stakeholders, in both countries, in a participatory concept mapping study. Concept maps for each country were generated from multi-dimensional scaling and hierarchical cluster analysis. Results The 12-cluster Australia map identifies four cluster regions: An Evaluation Approach that Honours Community; Respect and Reciprocity; Core Heart of the Evaluation; and Cultural Integrity of the Evaluation. The 11-cluster New Zealand map identifies four cluster regions: Authentic Evaluation Practice; Building Māori Evaluation Expertise; Integrity in Māori Evaluation; and Putting Community First. Both maps highlight the importance of cultural integrity in evaluation. Differences include the distinctiveness of the ‘Respecting Language Protocols’ concept in the Australia map in contrast to language being embedded within the cluster of ‘Knowing Yourself as an Evaluator in a Māori Evaluation Context’ in the New Zealand map. Participant ratings highlight the importance of all clusters with some relatively more difficult to achieve, in practice. Notably, the ‘Funding Responsive to Community Needs and Priorities’ and ‘Translating Evaluation Findings to Benefit Community’ clusters were rated the least achievable, in Australia. The ‘Conduct of the Evaluation’ and the ‘Prioritising Māori Interests’ clusters were rated as least achievable in New Zealand. In both countries, clusters of strategies related to commissioning were deemed least achievable. Conclusions The results suggest that the commissioning of evaluation is crucial as it sets the stage for whether evaluations: reflect Indigenous interests, are planned in ways that align with Indigenous ways of working and are translated to benefit Indigenous communities Identified strategies align with health promotion principles and relational accountability values of Indigenous approaches to research. These findings may be relevant to the commissioning and conduct of Indigenous health program evaluations in developed nations.

Is Pacific language ability protective of prevalence of mental disorders among Pacific peoples in New Zealand?

2018 ◽  
Vol 21 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Eirenei Taua'i ◽  
Rose Richards ◽  
Jesse Kokaua
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Common Mental Disorders ◽  
Mental Health Disorder ◽  
Positive Role ◽  
Pacific People ◽  
Language Promotion

Aims: To explore associations between experiences of mental illness, migration status and languages spoken among Pacific adults living in NZ. Methods: SURVEY FREQ and SURVEY LOGISTIC procedures in SAS were applied to data from Te Rau Hinengaro: The New Zealand (NZ) Mental Health Survey, a survey of 12,992 New Zealand adults aged 16 and over in 2003/2004. Pacific people were over sampled and this paper focuses on the 2374 Pacific participants but includes, for comparison, 8160 non-Maori-non-Pacific (NMNP) participants. Results: Pacific migrant respondents had the lowest prevalence of mental disorders compared to other Pacific peoples. However, Pacific immigrants were also less likely to use mental health services, suggesting an increased likelihood of experiencing barriers to available mental health care. Those who were born in NZ and who were proficient in a Pacific language had the lowest levels of common mental disorders, suggesting a protective effect for the NZ-born population. Additionally, access to mental health services was similar between NZ-born people who spoke a Pacific language and those who did not. Conclusions: We conclude that, given the association between Pacific language and reduced mental disorder, there may be a positive role for Pacific language promotion in efforts to reduce the prevalence of mental health disorder among Pacific communities in NZ.

Reproductive Healthcare Beliefs and Behaviours Among Displaced Tribal Communities in Odisha and Chhattisgarh: An Analysis Using Health Belief Model

2021 ◽  
pp. 2277436X2110059
Author(s):  
Madhulika Sahoo ◽  
Jalandhar Pradhan
Keyword(s):  
Health Belief Model ◽  
Cultural Distance ◽  
Indigenous Health ◽  
Belief Systems ◽  
Health Belief ◽  
Indigenous Communities ◽  
Tribal Communities ◽  
Traditional Health ◽  
Belief Model ◽  
Reproductive Healthcare

The modern healthcare system often experiences difficulties in understanding and providing care to indigenous communities. This is mainly because of the cultural distance between mainstream healing methods and indigenous health belief systems. The Lancet series (2006) on indigenous health discussed the integration of Western and traditional health practices and identified the importance of this integration for betterment of the human world. To understand what health and health care signify to tribal communities in India, it is necessary to examine the whole social system and the beliefs and behaviours related to their culture that provides meaning to people. This study examines the traditional medicinal practices and socio-cultural healthcare beliefs and behaviours of diplaced tribal communities in Odisha and Chattisgarh. The current study has used the health belief model (HBM) to examine the perceived susceptibility and severity of diseases among tribal communities, pertaining to their reproductive healthcare beliefs and practices.

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