Improvement of Indigenous Health through Community-Based Structures

This assignment discusses the improvement of indigenous health by developing community-based structures. It covers the evolution of Aboriginal Community Controlled Health Organisations (ACCHO) and its application to Indigenous health, differences between Western and Indigenous understandings of health and wellbeing, and the provision of culturally safe nursing care. The study also highlights the effective policies and programs introduced by the government such as close the gap program.

Running health: INDIGENOUS HEALTH
Aboriginal and Torres Strait Islander health
Name of the student
University name
Authors’ note

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Table of Contents
Introduction................................................................................................................................2
Evolution of Aboriginal Community Controlled Health Organisations (ACCHO) and its
application to Indigenous health................................................................................................2
Differences between Western and Indigenous understandings of health and wellbeing and
how these relate to the provision of culturally safe nursing care...............................................5
Conclusion..................................................................................................................................7
References..................................................................................................................................8

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Introduction
The current assignment focuses upon the aspect of improvement of indigenous health
by development of community based structures or models. In the current study, the Australia
based aboriginal and Torres Strait islander people have been taken into consideration. In this
respect, focus has been shifted upon the primary health care services. The assignment further
emphasises upon the holistic approaches for emotional and social well being of the aboriginal
and Torres Strait islander people. The indigenous health takes into consideration the physical,
social, cultural and emotional well being of the aboriginal and Torres Strait islander people.
The indigenous Australians compared to their non-indigenous counterparts have high
mortality rates. Thus, a number of factors could be discussed over here which considerably
affects the health patterns of the indigenous Australians. Some of these are social exclusion,
poverty, unemployment, cultural sensitization. One of the major factors which have
contributed to towards unequal health distribution in the indigenous Australians is paramount
social exclusion. This could be further attributed to culture and language differences which
prevents the population subsets consisting of the indigenous and the non-indigenous group
from feely intermixing with each other. The gap is further represented in the form of unequal
access to the basic living needs.
Evolution of Aboriginal Community Controlled Health Organisations (ACCHO) and its
application to Indigenous health
The particular section discusses the evolution of the aboriginal community controlled
health organizations (ACCHO). They have a history of being a sustainable, grass root
organization that contributes significantly towards making a community self sufficient. The
ACCHO continues to play a pivotal role in the empowerment of the aboriginal and Torres
Strait islander people by development and implementation of local government responses

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(naccho.org.au, 2018). Some of these are provided in the form of effective collaboration
between hospitals and local aboriginal medical services.
The aboriginal medical services (AMS) have been developed in order to provide
improved and quality primary care services to the indigenous Australians. The primary
healthcare services provision has been discussed further with regards to the Queensland
region. Some of these have been discussed in the later sections. However, a number of other
indigenous support care frameworks have been discussed over here such as close the gap. It
is an indigenous health campaign aimed at improving responsiveness to health services for
the aboriginal and Torres islander people (humanrights.gov.au, 2018). One of the main goals
of the close the gap service was to speed up the referral processes between primary and acute
healthcare services. It was aimed at improving the life expectancy of people. The close the
gap services were aimed at increasing the control over life and physical environment of the
aboriginal and Torres islander people. The close the gaps services also focuses upon the
aspect of the inclusion of more and more indigenous health workers. This could help in
dealing with the aspect of cultural sensitization within the aboriginal and Torres Strait
islander people.
Aboriginal Medical Service (AMS) of Queensland
In the current context, the Queensland region of Australia has been taken into
consideration. One of the mentionable services active in the Queensland could be mentioned
over here which is the Northern Aboriginal Torres Strait Islander Health Alliance Limited
(NATSIHAL). It is a medical service operational in Queensland with an annual turnover of
$76,323 (Northern Aboriginal and Torres Strait Islander Health Alliance Limited, 2018). It is
a registered charity and has been implemented within the Queensland region owing to large
number of indigenous population residing in the area. It was found that one in three

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aboriginal and Torres Strait islander lives in Queensland. As reported Bainbridge et al.
(2015), the Queensland population make up 3.7 % of the indigenous population. 50% of the
indigenous population living in Queensland were less than 20 years of age (Smith et al.,
2015). The indigenous group compared to their non-indigenous counterparts have been found
to experience more ill health and disability. The health gaps cost the Queensland health
system add an additional $245 million. The NATSIHAL aims to remove some of these health
disparities by free funding the primary health care (PHC) in the area (Northern Aboriginal
and Torres Strait Islander Health Alliance Limited, 2018). Some of the factors which
influence the health gap in the indigenous community are- social and economic determinants,
health system performance and health risk factors. It has been seen that the indigenous group
of people have the highest rates of discharge against medical advice (DAMA). Most of the
times, the indigenous community cannot afford the long stay at the hospital wards owing to
the costly medical bills (Carey, 2013). Additionally, there is a gap in the support and care
services from the government. The remote habitats of the indigenous community make it
difficult for the healthcare workers to reach out to them (Bennett-Levy, Singer, DuBois &
Hyde, 2017). Additionally, the high rates of addiction to smoking and drinking within the
indigenous population group can make them more prone to development of ill health.
The primary healthcare is applied within the Queensland aboriginal community with
the help “Making tracks towards closing the gap in health outcomes for indigenous
Queenslanders by 2033: policy and accountability frameworks” (humanrights.gov.au, 2018).
It is an evidence based policy framework aimed at gaining sustainable health measures for the
aboriginal and Torres islander people. As mentioned by Khoury (2015), the framework is
aimed at making the healthcare services more accessible for the indigenous Queenslanders. It
addresses two national indigenous health reforms - to close the gap expectancy in life by 2033
and halve the gap in child mortality by 2018 (Couzos & Thiele, 2016). It aims at providing

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culturally capable health services which would be readily acceptable across all culture and
religions.
Comparison of western and Indigenous understandings of health and wellbeing relating
them to the provision of culturally safe nursing care
A vast difference lies in the conception of health and well being between the western
and the indigenous aboriginal, Torres Strait islander group of people. As reported by Smith et
al. (2015), indigenous people indulge in risky health behaviours more often than non-
indigenous group of people. However as argued by Carey et al. (2017), there has been a lack
of studies effectively highlighting the reason contributing towards the adoption or indulgence
in health risk behaviour by the indigenous group of people. Some of these include the socio-
economic and psychological factors. The others include a strong desire to retain cultural
identity along with strong social connections intensified by cultural obligations. As
mentioned by Waterworth, Pescud, Braham, Dimmock & Rosenberg (2015), the social
marginalisation led to communication disruption between the two groups on matters of
health. This further developed a situation of mistrust between the two communication groups
leading to less exchange of information, which further affects their health behaviour or
patterns.
The indigenous group of people are much more attached to their cultural roots and
often lack a sense of trust in the healthcare system. 70% of the health gaps between the
indigenous and non-indigenous group of people can be explained on the basis of non-
communicable diseases. The highest rates have been noted for that of cardiovascular disease
that of 23% followed by diabetes and mental health disorders which are 12% and 10%
respectively within the indigenous population group (Hunt et al., 2015).

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Additionally, lack of cultural competence of the healthcare system has also resulted in
high rates of discharge against medical advice (DAMA) in the indigenous population group.
The high amount of vigilance associated with the intensive care units of the hospitals have
also been seen to disrupt the privacy concerns of the indigenous population group. The rate of
contraction of the mental health disorders is 5% compared to 0.5% in the non-indigenous
population group (naccho.org.au, 2018). The poverty and poor socio-economic conditions
also affects the social and emotional well being (SEWB) of the indigenous group of people.
23.7% of the indigenous community have been seen to indulge in health risk behaviours
compared to 11.1% in the non-indigenous population groups (humanrights.gov.au, 2018).
The disparity could be attributed to the high amount of social neglect present within the
population. Additionally, lack of sufficient amount of health education is another driving
factor. As mentioned by Carey et al. (2017), the social neglect often mentally aggravates one
to the point of indulging in health risking behaviours such as indulgence in drugs and alcohol.
Incorporation of cultural safety into nursing care
In this respect, the implementation of cultural competency framework can help the
nursing professional in understanding the mental dilemmas of the indigenous group of
people. The women of the indigenous group often do not feel comfortable in receiving
extended care at hospitals. As commented by McGough, Wynaden & Wright (2018), the
privacy concerns prevent moist of the indigenous population group from availing of the
healthcare services. The implementation of departmental cultural safety and policy also helps
in the helps in the development of a culturally competent nursing care.
Conclusion
The current study focuses upon the concept of delivery of effective care and support
services to the indigenous population group. This has been further discussed with the help of

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ACCHO and AMS policies and programs. The services have been introduced in order to
provide sufficient empowerment to the indigenous group of people. The study here also takes
into consideration some of the effective policies and programs introduced by the government
such as close the gap program. The policy aims at providing fast referral systems for the ones
suffering from chronic illness.
However, a number of gaps were found in the implementation of the effective health
and support care services for the indigenous population group. These could be attributed to
the different cultural and social beliefs of the population. Additionally, the social gaps results
in high level of mistrust between the different population groups. Hence, the indigenous
group of population are sceptical regarding acceptance of the healthcare services, as the
language barriers limits their ability to understand the delivery of certain medical procedures
and services. Therefore, absorption of more and more indigenous community health workers
can help in removing the biases.

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References
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practice: what are the barriers and enablers to e-mental health implementation by
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answer? Implications for policy and practice. Psychotherapy and Politics
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Carey, T. A., Dudgeon, P., Hammond, S. W., Hirvonen, T., Kyrios, M., Roufeil, L., & Smith,
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Couzos, S., & Thiele, D. D. (2016). Aboriginal peoples participation in their health care: A
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