scholarly journals The deconstruction exercise

2016 ◽  
Vol 9 (1) ◽  
pp. 28-48 ◽  
Author(s):  
David Sjorberg ◽  
Dennis McDermott
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Professional ◽  
Indigenous Peoples ◽  
Indigenous Health ◽  
Indigenous Studies ◽  
Health Profession ◽  
Power Imbalance ◽  
Academic Setting ◽  
Learning Journey

The ‘deconstruction exercise’ aims to give non-Indigenous health profession students the ability to recognise language that is imbued with power imbalance, so as to avoid the perpetuation of racialised ways of interacting with Indigenous peoples in the health system. Informed by Ngarrindjeri and Malak Malak perspectives, this is a measured anti–racism strategy, one able to address unexamined, racist language in a manner that avoids the emotive or combative nature of unstructured discussions around the impacts of racism. ISSN: ISSN 1837-0144 © International Journal of Critical Indigenous Studies 29 We argue that once a health care professional is able to exhibit decolonised language, together with a re-orientation towards decolonised practice, a door opens; one vital for the development of a more-effective, culturally-safe practitioner. In an academic setting, this ‘Ngarrindjeri way’ has shaped the deconstruction exercise, which ensures that students are ‘having the hard conversations’ in a pragmatic manner that challenges ‘whiteness’, whilst honouring each student’s dignity, on a learning journey that is informed by Indigenous methodologies.

scholarly journals The Practice of Power by Regional Managers in the Implementation of an Indigenous Peoples Health Policy in the Philippines

2020 ◽  
Author(s):  
Ryan C. Guinaran ◽  
Erlinda B. Alupias ◽  
Lucy Gilson
Keyword(s):  
Health Policy ◽  
Policy Implementation ◽  
Health System ◽  
Indigenous Peoples ◽  
Indigenous Health ◽  
Organizational Factors ◽  
The Philippines ◽  
Discretionary Power ◽  
Program Managers ◽  
Health Managers

Background: Indigenous peoples are among the most marginalized groups in society. In the Philippines, a new policy aimed at ensuring equity and culture-sensitivity of health services for this population was introduced. The study aimed to determine how subnational health managers exercised power and with what consequences for how implementation unfolded. Power is manifested in the perception, decision and action of health system actors. The study also delved into the sources of power that health managers drew on and their reasons for exercising power. Methods: The study was a qualitative case study employing in-depth semi-structured interviews with 26 health managers from the case region and analysis of 15 relevant documents. Data from both sources were thematically analyzed following the framework method. In the analysis and interpretation of data on power, VeneKlasen and Miller’s categorization of the sources and expressions of power and Gilson, Schneider and Orgill’s categorization of the sources and reasons for exercising power were utilized. Results: Key managers in the case region perceived the implementation of the new Indigenous health policy as limited and weakly integrated into health operations. The forms of power exercised by actors in key administrative interfaces were greatly influenced by organizational context and perceived weak leadership and their practices of power hindered policy implementation. However, some positive experiences showed that personal commitment and motivation rooted in one’s indigeneity enabled program managers to mobilize their discretionary power to support policy implementation. Conclusion: The way power is exercised by policy actors at key interfaces influences the implementation and uptake of the Indigenous policy by the health system. Middle managers are strategic actors in translating central directions to operational action down to frontlines. Indigenous program managers are most likely to support an Indigenous health policy but personal and organizational factors can also override this inclination.

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 Perceptions and experiences of allopathic health practitioners on collaboration with traditional health practitioners in post-apartheid South Africa

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Simon M. Nemutandani ◽  
Stephen J. Hendricks ◽  
Mavis F. Mulaudzi
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Systems ◽  
Quality Of Health Care ◽  
Indigenous Health ◽  
Traditional Healers ◽  
Traditional Health ◽  
Traditional Health Practitioners ◽  
Health Practitioners

Background: The indigenous health system was perceived to be a threat to the allopathic health system. It was associated with ‘witchcraft’, and actively discouraged, and repressed through prohibition laws. The introduction of the Traditional Health Practitioners Act No 22 of 2007 brought hope that those centuries of disrespect for traditional health systems would change. The study examined the perceptions and experiences of allopathic health practitioners on collaboration with traditional health practitioners in post-apartheid South Africa.Methods: Qualitative descriptive research methodology was used to collect data from allopathic health practitioners employed by Limpopo’s Department of Health. In-depth focus group discussions and meetings were conducted between January and August 2014. Perceptions and experiences of working with traditional health practitioners were explored. Ethical clearance was obtained from the University of Pretoria and approval from the Department’s Research Committee.Results: Dominant views were that the two health systems were not compatible with respect to the science involved and the source of knowledge. Overall, quality of health care will be compromised if traditional health practitioners are allowed to work in public health facilities.Conclusion: Allopathic health practitioners do not appear ready to work with traditional health practitioners, citing challenges of quality of health care, differences regarding concept of sciences and source of knowledge; and lack of policy on collaboration. Lack of exposure to traditional medicine seems to impede opportunities to accept and work with traditional healers. Exposure and training at undergraduate level regarding the traditional health system is recommended. Policy guidelines on collaborations are urgently required.

scholarly journals Health reform and Indigenous health policy in Brazil: contexts, actors and discourses

2020 ◽  
Vol 35 (Supplement_1) ◽  
pp. i107-i114
Author(s):  
Ana Lucia de M Pontes ◽  
Ricardo Ventura Santos
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Indigenous Peoples ◽  
Health Reform ◽  
Indigenous Health ◽  
Holistic Health ◽  
Political Agenda ◽  
Final Report ◽  
The Right ◽  
Specific Health

Abstract Given the challenges related to reducing socio-economic and health inequalities, building specific health system approaches for Indigenous peoples is critical. In Brazil, following constitutional reforms that led to the universalization of health care in the late 1980s, a specific health subsystem was created for Indigenous peoples in 1999. In this paper, we use a historical perspective to contextualize the creation of the Indigenous Health Subsystem in Brazil. This study is based on data from interviews with Indigenous and non-Indigenous subjects and document-based analysis. In the 1980s, during the post-dictatorship period in Brazil, the emergence of Indigenous movements in the country and the support for pro-Indigenous organizations helped establish a political agenda that emphasized a broad range of issues, including the right to a specific health policy. Indigenous leaders established alliances with participants of the Brazilian health reform movement, which resulted in broad debates about the specificities of Indigenous peoples, and the need for a specific health subsystem. We highlight three main points in our analysis: (1) the centrality of a holistic health perspective; (2) the emphasis on social participation; (3) the need for the reorganization of health care. These points proved to be convergent with the development of the Brazilian health reform and were expressed in documents of the Indigenist Missionary Council (CIMI) and the Union of Indigenous Nations (UNI). They were also consolidated in the final report of the First National Conference on the Protection of Indigenous Health in 1986, becoming the cornerstone of the national Indigenous health policy declared in 1999. Our analysis reveals that Indigenous people and pro-Indigenous groups were key players in the development of the Indigenous Health Subsystem in Brazil.

scholarly journals Barriers to Including Indigenous Content in Canadian Health Professions Curricula

2021 ◽  
Vol 44 (3) ◽  
pp. 648-675
Author(s):  
Nicole Doria ◽  
Maya Biderman ◽  
Jad Sinno ◽  
Jordan Boudreau ◽  
Michael P. Mackley ◽  
...  
Keyword(s):  
Health Care ◽  
Indigenous Peoples ◽  
Indigenous Health ◽  
Health Professions ◽  
Faculty Training ◽  
Structured Interviews ◽  
Increased Risk ◽  
Canadian Health ◽  
Competing Priorities ◽  
Negative Health Outcomes

Indigenous peoples in Canada continue to face health care inequities despite their increased risk for various negative health outcomes. Evidence suggests that health professions students and faculty do not feel their curriculum adequately prepares learners to address these inequities. The aim of this study was to identify barriers that hinder the inclusion of adequate Indigenous content in curricula across health professions programs. Semi-structured interviews were conducted with 33 faculty members at a university in Canada from various health disciplines. Employing thematic analysis, four principal barriers were identified: (1) the limited number and overburdening of Indigenous faculty, (2) the need for non-Indigenous faculty training and capacity, (3) the lack of oversight and direction regarding curricular content and training approaches, and (4) the limited amount of time in curriculum and competing priorities. Addressing these barriers is necessary to prepare learners to provide equitable health care for Indigenous peoples. Keywords: Indigenous health, health professions, curricula, faculty perspectives, barriers, Canada

scholarly journals Health care of Brazilian indigenous peoples: Post-implementation of the National Indigenous Health Policy

2021 ◽  
Vol 10 (1) ◽  
pp. 237-244
Author(s):  
Flávia Carvalho dos Santos Batista ◽  
Firmina Hermelinda Saldanha Albuquerque ◽  
Karla Maria Carneiro Rolim ◽  
Manoel Viana Xavier ◽  
Mirian Calíope Dantas Pinheiro ◽  
...  
Keyword(s):  
Health Care ◽  
Indigenous Peoples ◽  
Health Care Policy ◽  
Indigenous Health ◽  
Health Care Information ◽  
Interethnic Relations ◽  
National Health Care ◽  
Key Points ◽  
Care Information ◽  
Definition Of

The objective was to describe, through key points of indigenous health care, what has changed after the implementation of the National Health Care Policy for Indigenous Peoples. For this, the research method chosen was the literature review with a qualitative approach of the results. The studies that composed the sample were retrieved from the SciELO and PubMed databases, from May to August 2018. The results point to the deficiency of training of professionals of the Multidisciplinary Team of Indigenous Health (EMSI) in the context of interethnic relations; the need to define the functions of Indigenous Health Agents (IHA) within EMSI; the good acceptance by indigenous peoples and EMSI regarding biomedical and traditional indigenous treatments, respectively; in addition to the food deficiency of the Indigenous Health Care Information System. That said, there should be trainings in the scope of interethnic action for EMSI and IHA with clear definition of each one’ roles within EMSI, especially the IHA.

scholarly journals Epidemiology and Estimated Cost of Surgery for Chronic Subdural Hematoma Conducted by the Unified Health System in Brazil (2008–2016)

2017 ◽  
Vol 38 (02) ◽  
pp. 079-085
Author(s):  
Marcelo José da Silva de Magalhães ◽  
Jéssica Pimenta Araújo ◽  
Ana Luísa Aguiar Simões Alves Paulino ◽  
Bárbara Helen Mendes Batista ◽  
Danielle Gonçalves de Freitas ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Professional ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Epidemiological Studies ◽  
The Past ◽  
Unified Health System ◽  
Scientific Papers ◽  
Hospital Expenses

Introduction Chronic subdural hematoma (CSH) is one of the most frequent forms of intracranial hemorrhage. It is a collection of encapsulated, well-delimited fluid and/or coagulated blood in several clotting stages located between the dura mater and the arachnoid mater. Objective To describe the epidemiological aspects of CSH described in the database of the Brazilian Unified Health System (SUS, in the Portuguese acronym) regarding admission numbers, hospitalization expenses, health care professional expenses, mortality rate, and death numbers by region from 2008 to the first half of 2016. Methods The present work was performed between August and September 2016 with a review about the epidemiological aspects of CSH in Brazil according to the Informatics Department of the Unified Health System (DATASUS) database, encompassing the period from January 2008 to June 2016, and to scientific papers from the past 10 years which were electronically published at the PubMed, Scielo, and LILACS databases. Results From 2008 to the first half of 2016, the total values were the following: hospital admission authorizations (HAAs). 33,878; hospital expenses, BRL 65,909,429.22; health care professional expenses, BRL 25,158,683.21; deaths, 2,758; and mortality rates ranging from 6.47 to 12.63%. Conclusion In spite of the high clinical relevance of CSH, epidemiological studies about this condition are limited. As such, the present paper is an updated approach on CSH, focusing on its epidemiological aspects according to the DATASUS database.

scholarly journals Gum yan asing Kaangas giidaay han hll guudang gas ga. I Will Never Again Feel That I Am Less Than: Indigenous Health Care Providers’ Perspectives on Ending Racism in Health Care

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Madeleine Kétéskwēw Dion Stout ◽  
Cornelia (Nel) Wieman ◽  
Lisa Bourque Bearskin ◽  
Becky C. Palmer ◽  
Lauren Brown ◽  
...  
Keyword(s):  
Health Care ◽  
Indigenous Peoples ◽  
Health Care Providers ◽  
Indigenous Health ◽  
Care Providers ◽  
Speaking Up ◽  
Professional Experiences ◽  
System A ◽  
Racial Injustice ◽  
Speak Up

Racism toward Indigenous Peoples continues to permeate throughout the health care system, a reality the authors know all too well in their shared and yet unique personal and professional experiences. Although acknowledging and speaking up against racial injustice is daunting, and is often met with disregard or inaction, the authors contend that this is a necessary undertaking to redress the ongoing harms of colonialism. Correspondingly, those who do not speak up must not have their voices silenced. Instead, the perspectives that Indigenous Peoples have regarding their own experiences of racism must be heeded seriously and produce real and tangible solutions. In narrating their own encounters of confronting and challenging racism, the authors juxtapose activism and resistance with the preservation of Indigenous Knowledge as a catalyst for propelling the necessary changes forward within health care to end racism. To be truly impactful, all efforts taken to address racism must occur alongside advancing equity of care and human rights for and by Indigenous Peoples at individual, community, and systemic levels. Changes are not needed after more evidence. The time to act is now.

scholarly journals Historical foundations and contemporary expressions of a right to health care in Circumpolar Indigenous contexts

Elem Sci Anth ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Josée G. Lavoie ◽  
Jon Petter Stoor ◽  
Elizabeth Rink ◽  
Katie Cueva ◽  
Elena Gladun ◽  
...  
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Indigenous Peoples ◽  
Access To Health Care ◽  
Indigenous Health ◽  
The United States ◽  
Native People ◽  
Culturally Appropriate ◽  
Access To Health ◽  
The Impact

Although numerous comparative Indigenous health policy analyses exist in the literature, to date, little attention has been paid to comparative analyses of Circumpolar health policy and the impact these policies may have on Indigenous peoples’ rights to health. In this article, we ground our discussion of Indigenous peoples’ right to access culturally appropriate and responsive health care within the context of the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP). Under UNDRIP, signatory states are obligated to guarantee that Indigenous peoples have access to the same services accessible to all citizens without discrimination. Signatory states must also guarantee access to services that are grounded in Indigenous cultures, medicines, and practices and must address Indigenous peoples’ determinants of health at least to the same extent as their national counterparts. Our analysis finds that the implementation of this declaration varies across the Circumpolar north. The United States recognizes an obligation to provide health care for American Indian and Alaska Native people in exchange for the land that was taken from them. Other countries provide Indigenous citizens access to care in the same health care systems as other citizens. Intercultural models of care exist in Alaska and to some extent across the Canadian territories. However, aside from Sámi Norwegian National Advisory Unit on Mental Health and Substance Use in northern Norway, intercultural models are absent in Nordic countries and in Greenland. While Russia has not ratified UNDRIP, Russian policy guarantees access to health care to all citizens, although access is particularly limited in rural and remote environments, including the Russian Arctic. We conclude that Circumpolar nations should begin and/or expand commitments to culturally appropriate, self-determined, access to health care in Circumpolar contexts to reduce health inequities and adhere to obligations outlined in UNDRIP.

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