scholarly journals Leading with local solutions to keep Yarrabah safe: A grounded theory study of an Aboriginal community- controlled health organisation’s response to COVID-19

2021 ◽  
Author(s):  
Janya McCalman ◽  
Marlene Longbottom ◽  
Sara Fagan ◽  
Ruth Fagan ◽  
Suzanne Andrews ◽  
...  
Keyword(s):  
Grounded Theory ◽  
Health Service ◽  
Primary Healthcare ◽  
Chief Executive ◽  
Indigenous Communities ◽  
Advisory Group ◽  
High Morbidity ◽  
Governance Reform ◽  
First Case ◽  
Local Solutions

Abstract Introduction Pandemics such as COVID-19 are a serious public health risk for Australian Aboriginal and Torres Strait Islander communities, yet primary healthcare systems are not well resourced to respond to such urgent events. At the start of the COVID-19 pandemic, a federal government advisory group recommended a rapid, tailored Indigenous response to prevent predicted high morbidity and mortality rates. This paper examines the efforts of one ACCHO, which in the absence of dedicated funding, pivoted its operations in response to COVID-19. Gurriny Yealamucka Health Service (Gurriny) is the only primary healthcare service in the discrete Indigenous community of Yarrabah, Far North Queensland. Methods The research was conducted at the request of the Chief Executive Officer of Gurriny. Grounded theory methods were used to sample and analyse transcripts of interviews with thirteen Gurriny staff and five others - Yarrabah and government leaders and community members, and 59 documents. Data were imported into NVIVO-12 and coded, with key concepts compared, organised into higher order constructs, then structured into a theoretical framework. Results Gurriny responded to COVID-19 by leading with local solutions to keep Yarrabah safe. Four key strategies were implemented: managing the health service operations, realigning services, educating and supporting community, and working across agencies. These strategies were enabled or hindered by five conditions: the governance and leadership capcity of Gurriny, relying on the health taskforce, locking the door, “copping it”, and (not) having resources. A year after the first case was experienced in Australia and on the eve of vaccine rollout to Indigenous communities, there have been no COVID-19 cases in Yarrabah. Discussion The success of the locally-led, holistic, comprehensive and culturally safe response of Gurriny suggests that such tailored place-based approaches to pandemics (and other health issues) are appropriate, but require dedicated resourcing. Key challenges related to fragmented and rapidly changing government processes, poorly coordinated communication and resource allocation channels, and bottlenecks in hierarchical funding approval processes.Conclusion The COVID-19 response in Yarrabah demonstrates the need for governance reform towards greater resourcing and support for local decision making.

scholarly journals Leading with local solutions to keep Yarrabah safe: a grounded theory study of an Aboriginal community-controlled health organisation’s response to COVID-19

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Janya McCalman ◽  
Marlene Longbottom ◽  
Sara Fagan ◽  
Ruth Fagan ◽  
Suzanne Andrews ◽  
...  
Keyword(s):  
Grounded Theory ◽  
Health Service ◽  
Primary Healthcare ◽  
Indigenous Communities ◽  
Advisory Group ◽  
High Morbidity ◽  
Governance Reform ◽  
Aboriginal Community ◽  
First Case ◽  
Local Solutions

Abstract Background Pandemics such as COVID-19 are a serious public health risk for Australian Aboriginal and Torres Strait Islander communities, yet primary healthcare systems are not well resourced to respond to such urgent events. At the start of the COVID-19 pandemic, a federal government advisory group recommended a rapid, tailored Indigenous response to prevent predicted high morbidity and mortality rates. This paper examines the efforts of one ACCHO, which in the absence of dedicated funding, pivoted its operations in response to COVID-19. Gurriny Yealamucka Health Service (Gurriny) is the only primary healthcare service in the discrete Indigenous community of Yarrabah, Far North Queensland. Methods The research was conducted at the request of the Chief Executive Officer of Gurriny. Using grounded theory methods, thirteen Gurriny staff and five Yarrabah and government leaders and community members were interviewed, transcripts of these interviews and 59 documents were imported into NVIVO-12 and coded, and key concepts were compared, organised into higher order constructs, then structured into a theoretical framework. Results Gurriny responded to COVID-19 by leading with local solutions to keep Yarrabah safe. Four key strategies were implemented: managing the health service operations, realigning services, educating and supporting community, and working across agencies. These strategies were enabled or hindered by five conditions: the governance and leadership capacity of Gurriny, relying on the health taskforce, locking the door, “copping it”, and (not) having resources. A year after the first case was experienced in Australia and on the eve of vaccine rollout to Indigenous communities, there have been no COVID-19 cases in Yarrabah. Discussion The success of the locally led, holistic, comprehensive and culturally safe response of Gurriny suggests that such tailored place-based approaches to pandemics (and other health issues) are appropriate, but require dedicated resourcing. Key challenges were the fragmented and rapidly changing government processes, poorly coordinated communication and resource allocation channels, and bottlenecks in hierarchical funding approval processes. Conclusions The COVID-19 response in Yarrabah demonstrates the need for governance reform towards greater resourcing and support for local decision making by Aboriginal community-controlled health organisations.

scholarly journals Facilitating Sustainable Disaster Risk Reduction in Indigenous Communities: Reviving Indigenous Worldviews, Knowledge and Practices through Two-Way Partnering

2021 ◽  
Vol 18 (3) ◽  
pp. 855
Author(s):  
Tahir Ali ◽  
Petra Topaz Buergelt ◽  
Douglas Paton ◽  
James Arnold Smith ◽  
Elaine Lawurrpa Maypilama ◽  
...  
Keyword(s):  
Grounded Theory ◽  
Risk Reduction ◽  
Indigenous People ◽  
Natural Hazards ◽  
Disaster Risk Reduction ◽  
Indigenous Communities ◽  
Disaster Risk ◽  
Indigenous Research ◽  
Ecological Knowledge ◽  
Community Members

The Sendai Framework of Action 2015–2030 calls for holistic Indigenous disaster risk reduction (DRR) research. Responding to this call, we synergized a holistic philosophical framework (comprising ecological systems theory, symbolic interactionism, and intersectionality) and social constructionist grounded theory and ethnography within a critical Indigenous research paradigm as a methodology for exploring how diverse individual and contextual factors influence DRR in a remote Indigenous community called Galiwinku, in the Northern Territory of Australia. Working together, Indigenous and non-Indigenous researchers collected stories in local languages using conversations and yarning circles with 20 community members, as well as participant observations. The stories were interpreted and analysed using social constructivist grounded theory analysis techniques. The findings were dialogued with over 50 community members. The findings deeply resonated with the community members, validating the trustworthiness and relevance of the findings. The grounded theory that emerged identified two themes. First, local Indigenous knowledge and practices strengthen Indigenous people and reduce the risks posed by natural hazards. More specifically, deep reciprocal relationships with country and ecological knowledge, strong kinship relations, Elder’s wisdom and authority, women and men sharing power, and faith in a supreme power/God and Indigenous-led community organizations enable DRR. Second, colonizing practices weaken Indigenous people and increase the risks from natural hazards. Therefore, colonization, the imposition of Western culture, the government application of top-down approaches, infiltration in Indigenous governance systems, the use of fly-in/fly-out workers, scarcity of employment, restrictions on technical and higher education opportunities, and overcrowded housing that is culturally and climatically unsuitable undermine the DRR capability. Based on the findings, we propose a Community-Based DRR theory which proposes that facilitating sustainable Indigenous DRR in Australian Indigenous communities requires Indigenous and non-Indigenous partners to genuinely work together in two-directional and complementary ways.

scholarly journals Routes to the top: the developmental journeys of medical, clinical and managerial NHS chief executives

BMJ Leader ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. 64-68 ◽  
Author(s):  
Alex Till ◽  
Gerry McGivern
Keyword(s):  
Leadership Development ◽  
Health Service ◽  
Development Strategy ◽  
Quality Care ◽  
Qualitative Interviews ◽  
Chief Executive ◽  
High Quality ◽  
Cross Sectional ◽  
Chief Executives ◽  
Formal Leadership

IntroductionLeadership, and the role of a Chief Executive in healthcare organisations, has never been more important. This review provides one of the first retrospective cross-sectional analyses of the developmental journeys of chief executives within the National Health Service (NHS).MethodsTwenty-eight semi-structured qualitative interviews were conducted with medical, clinical and non-clinical NHS chief executives from the Health Service Journal’s list of ‘Top Chief Executives’ 2014–2018. Through a thematic analysis of their narratives, lessons for the development of aspiring NHS chief executives emerge.ResultsFew proactively sought leadership opportunities and there was a lack of an active leadership development strategy. Yet the ‘seeds of leadership development’ took root early. Combined with a blended approach of formal leadership development and ‘on-the-job’ informal leadership development, emerging NHS chief executives were exposed to multiple ‘crucible moments’ that helped them develop into and excel at the top of their field.DiscussionTop NHS chief executives possess inherent values and a strong sense of social responsibility that underpin their developmental journeys, guide their behaviour, and strengthen their resilience. Capable, high quality leaders are needed from all professional backgrounds to support high quality care and much more needs to be done, particularly for medical and clinical professionals but for non-clinicians too, to maximise leadership potential within the NHS and develop a pipeline of aspiring NHS chief executives.

scholarly journals Mycetoma in Timor-Leste and first report of nocardiosis

2018 ◽  
Vol 10 (3) ◽  
Author(s):  
Nicola Townell ◽  
Thomas Locke ◽  
Margaret Gibbons ◽  
Dan Murphy ◽  
Joshua Francis ◽  
...  
Keyword(s):  
Causative Organism ◽  
Molecular Testing ◽  
High Morbidity ◽  
Middle Income ◽  
Diagnosis And Management ◽  
Middle Income Countries ◽  
First Case ◽  
Soft Tissue Involvement ◽  
Timor Leste ◽  
Resource Issue

Mycetoma is a neglected tropical disease with an unknown global burden. Although considered endemic to South-east Asia, it has not previously been reported from Timor-Lest. We describe two cases in Timor-Leste, highlighting the challenges surrounding microbiological diagnosis and management shared by many low to middle-income countries. As characteristically described, both patients lived rurally and presented late with marked soft tissue involvement and multiple draining sinuses following a prolonged period of high morbidity. Nocardia brasiliensis, a beadedbranched, modified acid-fast, gram-positive bacilli, was isolated and confirmed by molecular testing in the first case. The causative organism in the second case could not be confirmed due to limited microbiological capabilities. Due to limited local laboratory capabilities, Nocardia spp. infection cannot be routinely confirmed in Timor- Leste. However, the microbiology laboratory is essential for the successful diagnosis and management of Mycetoma. In both cases, medical therapy alone resulted in cure and favorable outcomes, although supply of antibiotic remains an ongoing resource issue.

scholarly journals First case report of infection by Mycobacterium wolinskyi after mammoplasty in Brazil

2013 ◽  
Vol 5 (2) ◽  
pp. 12 ◽  
Author(s):  
Andrea Santos Lima ◽  
Maria Madileuza Carneiro Neves ◽  
Karen Machado Gomes ◽  
Klarissa Miranda Guarines ◽  
Carlos Feitosa Luna ◽  
...  
Keyword(s):  
Case Report ◽  
Health Service ◽  
Mycobacterium Smegmatis ◽  
Case Reports ◽  
Specific Gene ◽  
Biochemical Tests ◽  
Long Period ◽  
First Case ◽  
The World ◽  
Mycobacterium Goodii

<em>Mycobacterium wolinskyi</em> is a rapidly growing mycobacterium, first described in 1999 as a member of the group <em>Mycobacterium smegmatis</em> (<em>Mycobacterium smegmatis</em>, <em>Mycobacterium wolinskyi</em> and <em>Mycobacterium goodii</em>). Only 19 case reports all over the world have been described on literature, none of them in Brazil. On this report, it is described one case of infection after a mammoplasty procedure performed in a private health service in the county of Recife, Pernambuco, Brazil, in 2009. The mycobacteria specie was identified using biochemical tests and sequencing the specific gene <em>rpoB</em>. To treat the infection by <em>Mycobacterium wolinskyi</em> it was necessary to combine antibiotics for a long period of time associated with surgical procedures of the breast abscesses.

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