Socially inclusive nursing roles in Aboriginal Community Controlled Health Services

Case Study on Indigenous Community
Socially inclusive nursing roles in Aboriginal Community Controlled Health Services
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Case Study on Indigenous Community
Introduction
In all countries with a history of colonization, the indigenous people are affected
with an identity loss among many other things. Australia has not recognized the impact of
colonization on aboriginal people and inhabitants of the Torres Strait for a long time
particularly in the matter of health and education. For example, comparison of life
expectancy among Aboriginal peoples and other residents of the Australian coast, show a
negative gap between 10 and 15 years. According to the report on the 2017 health
performance framework ("2017 HPF Report - 3.12 insular and island people from the
Torres Strait to the health workforce", 2019), Aboriginal people and islanders of the
Straits of Torres are having less representation among the health workers. As a result this
community is not getting the desired medical facilities. A number of studies conducted on
this aspect have found that people prefer to see health workers coming from the same
community to take care of their health-related issues. The gender of the health worker
also plays an important role as the indigenous people prefer health care personnel of the
same gender to listen to their problem. ("Improving the accessibility of health services in
urban and regional environments for indigenous peoples", 2019).
Detailed Discussion
a. Background for the formation of ACCHS
The indigenous workforce is required to ensure proper healthcare system for the
aboriginal people and the inhabitants of the Torres Strait. Indigenous healthcare
professionals can apply their special technical and socio-cultural abilities to improve
healthcare for their own community people and ensure more appropriate care and
services in comparison to their non-native counterparts (Miller & Speare, 2012).
It has often been suggested that indigenous health outcomes improve with the rise of
the indigenous labour force and Torres Strait Islanders at all levels. Cultural acceptability
is an important factor for using the necessary health services for indigenous peoples.
Among the ethnic group of people, who had difficulties in getting health services, still
believe they do not rely on the available medical service, as it is not culturally
appropriate. There are many reasons for this community people not getting desired health
services. These include a lack of recognition of the differences between non-indigenous
and indigenous health notions, lack of knowledge due to the effects of colonization still
persistent and the lukewarm response of non-indigenous health professionals towards the
ethnic group. There is also a lack of respect and mutual trust and poor intercultural
communications between these two communities. Health professions from the indigenous
community can understand better the health-related issues of their own community
people because of physical, mental, emotional, spiritual, and cultural bonding.

Case Study on Indigenous Community
The best way to solve this issue is to allow local communities to come forward and
take part in the health care system to manage their own health problems. This is the logic
behind the creation of health services controlled by the local community (ACCHS),
which has so far allowed more than hundred aboriginal communities throughout
Australia to control their care.
b. Promotion of evidence-based health care interventions
The fundamental concept according to each ACCHS is to establish a primary care
facility that is created and managed by the local indigenous people to provide integral and
appropriate medical attention to their own community people. The principle of self-
determination has helped people to achieve their own objectives. From the conceptual
stage itself , ACCHS was always thought to be more than a health centre and each
ACCHS has four key functions: community support, primary clinical care and special
needs programs (Ware, 2013).
A separate health policy for indigenous people is essential since the policy applied
for non-indigenous people cannot be applied to non-indigenous people. Many of them are
still not at home for medical service in hospitals and therefore, are reluctant to take
necessary medical assistance. Moreover, it is difficult to access healthcare due to
geographical isolation or want of proper transport system. Many of them live below the
poverty line, so the services offered is too costly for them to bear. Another factor is that it
is difficult to provide services to Aboriginal people that are offered to the non-indigenous
people, because of cultural and language disparities.
The important healthcare policy components in the ACCHS consist of the health of
the indigenous population along with initiatives from educational campaigns to
immunizations and disease detection.
Each ACCHS designs their services based on local requirements and priorities. In
addition to that, some related issues such as poor nutrition or abuse of banned substances
are to be addressed. Other programs are tailor-made for specific types of people, such as
young mothers or old-age people. The flexibility of creating special area-based services
allows each ACCHS to identify and address the major health issues in its area which is
possible when health care professionals belong to the same community.
Inadequate funding by government agencies is one of the major problems. Though
there is a significant increase but still per capita medical expenditure for this community
is much less than that for other general communities. Another major issue faced by
ACCHS is the difficulty of recruitment of doctors and nurses to run the services.
According to the recent Government bulletin, a mere 65% of indigenous community
controlled health services currently have a doctor. Hence, proper planning is to be