Primary Health Care in Action: Social Determinants, Principles, and Cultural Competence

This article discusses the social determinants of health, principles of primary health care, and cultural competence in the context of a community rebuilding project in Kulumburu village. It highlights the importance of community participation, health promotion, and cultural safety in improving mental health and well-being.

Running head: PRIMARY HEALTH CARE IN ACTION
Primary health care in action
Name of the Student
Name of the University
Author note

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Answer to question 1
As per the given video by Rural Health Channel (2018), two social determinants that
seems to be focused are the social isolation and community environment as both found to be
major risk factor for the sexual assault, child abuse and neglect like issues. Both factors play an
important role in use of health and social care services. Therefore, the program from the rural
health education foundation developed project targeted, Kulumburu village devastated with
colonisation, and several negative experiences. The rationale for targeting the community
rebuilding project is the maximum complains of past history of trauma and lack of feeling of
safety, breach of trust, learning and educational needs, confusion and feeling of shame due to
past experiences of abuse. These factors are associated with poor use of primary health care to
maintain health and wellness (Bishop, Seirup, Pincus & Ross, 2016).
Lack of adequate resources in the community is the other reason people fail to execute
their functional role. According to Heiman & Artiga (2015), community support and
participation is very important as people can access closer network of people and access more
support when in needs. Poor community support is associated with social isolation. Social
support network is associated with good health (Park et al., 2013). This project creates strong
network for elderly women by promoting their socialisation. They are educated on coping with
daily life stress. With the help of the experts’ advice and sharing stories, they can deal with daily
life challenges and stress. With the help of such support, it is possible to address the child
neglect problems and promote their well being as well of parents. In turn it impacts the positive
mental health development across life span (Lin, 2017). In the Kulumburu village project
targeted in the given video, woman and men were given care and support. Meeting with other

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members of the community under Mango tree, can help them build bigger social network. These
strategies are based on evidence and are part of the successful community education program
that promotes physical and mental well being (Lin, 2017).
Answer to question 2
The two primary health care principles guided the project in the video are health
promotion and the community participation (McMurray & Clendon, 2015). According to Bath &
Wakerman (2015) community participation refers to helping the community to take ownership of
the wellness and health. On the other hand the health promotion is the promotion of good health
by strengthening the socio-economic condition (McMurray & Clendon, 2015). One of the
prerequisites of the health focused in this video is the “education”, social justice and equity, and
peace. In the community building project Kalumburu, an Indigenous community, the project
focused on education of elderly women with experiences of sexual assault and men coming
together for greater social network through open circles and group meetings. The project focuses
on the principle of community participation and health education. It is evident from the use of
the community resources in promoting health while addressing the problems of health at
grassroots level (McMurray & Clendon, 2015).
Further, the principle of health promotion is used for this project to treat the whole
person that is at holistic level by including elders, teenagers, young adults, grandparents, and
middle age adults. Overall this promotes social inclusion and collaboration (Nielsen et al., 2015).
Activities like dancing, story-telling, paintings are evidenced based approaches for Indigenous
communities adopted by PHC (primary health care) organisations. It acts as a medium to vent of
anger and resentment. It will help people help each other with health problems. In addition to

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contributing to the health equity it also promotes community responsiveness to child
maltreatment and other mental health risk factor It will help promote community health by
delivering tailored information on healthy lifestyle and healthy aging (Bath & Wakerman, 2015).
Illness can be prevented by the above strategies as they contribute to the personal care. These
community rebuilding strategies with holistic approach has the potential for community self-
determination, women empowerment (Park et al., 2013). Also these strategies are taking into
consideration not only social but also the cultural determinants of health. This community
rebuilding project uses the two health principles to maximise the community and individual’s
self reliance, control and participation. For example, the meetings in circle will help address any
health inequality in the community.
Answer to question 3
Mental health is the one National Health Priority Area (NHPA) that may affect the
program’s results. To address the mental health issues is the main priority of the National Mental
health strategy. It is focused on development of mental health of Australian communities. These
goals can be fulfilled by the Kalumburu community project by building the strong communities
and support network. It will help in effective functioning of the families by promotion of safe
and healthy environment. The strategies used in this project may reduce the social isolation. It
helps support families even before the child neglect and abuse can occur. The strategies like
dancing; playing, group singing, is an evidenced based option to reduce stress and depression
(Negele et al., 2015). The results of the strategies will positively reinforce the community mental
health. It will enhance the health and wellbeing of children as it is targeted to people of all age
groups. Childhood trauma and depression turns to chronic illness in the adulthood. It is in turn
the risk factor for emotional neglect and physical abuse (Truong, Paradies & Priest, 2014).

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According to Clift, Gilbert & Vella-Burrows (2018), group singing allows increased level of
social connectedness. The same is used in the Kulumburu com unity project and has the potential
to develop social capital by promoting the sense of belongingness, reduced personal stress,
emotional and physical benefits. Thus, the results will positively impact on the relational and
community levels (McMurray & Clendon, 2015). In conclusion, the program as a whole has the
potential to improve the community mental well being.
Answer to question 4
Cultural competence in the health and social care refers to the ability of the system to
provide care to people irrespective of their ethnicity, values, beliefs and behaviors, by tailoring
strategies to meet the cultural, social and linguistic needs of all the community members.
Cultural competence is the ability to interact effectively with the people of different cultures by
being responsive and respectful to their health beliefs (Garneau & Pepin, 2015). Cultural safety
refers to practices and environment that are emotionally, socially, physically and culturally safe
where people can have no fear of assault or losing their identity (Garneau & Pepin, 2015).
The benefits of considering the factors of cultural competence and cultural safety in
program like this are to help the organizations to assess people’s experiences of working with
diverse communities. It helps to assess the range of values and beliefs of people targeted to allow
working with focus communities. It will help develop policies and procedures for making
inclusion possible. Thus, culturally competent projects will use resources to strengthen
relationships with groups and communities. It will help consider the target population in all
aspects of prevent planning (Garneau & Pepin, 2015). On the other hand considering the cultural
safety is important to encourage their sense of identity and self.

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The key characteristics of the project targeted to Indigenous population include
“Communication, information sharing and transfer of care, cultural education programs and
building relationships”. These characteristics align with the key characteristics of the culturally
competent care (Truong, Paradies & Priest, 2014).). For instance, the project is promoting
supporting relationships with the Indigenous women and men through story telling. It is helping
to build the kinship network that involves large extended family members of all age groups.
In this project the culture safety is maintained by truly listening to the people’s concern.
The project promoted learning and education of the community people together in a manner that
maintained their dignity and relationship of trust, collaboration, and respect to better understand
the health issues and access care services. In this project, with the help of circles under Mango
tree, people are allowed to be comfortable with themselves to vent their feelings. Not only adults
but children are also provided with the safe, positive and nurturing environment, where they can
express their culture through dancing and painting like activities. The same is supported by their
family.
It can be said that it was justified to consider the factors of cultural safety and cultural
competence in the project as the health promoting staff can reduce the risk of discrimination or
stereotyping. It will help reduce disparity in accession of health care services by tee community
people. According to Truong, Paradies & Priest (2014) there are positive health outcomes of
staff training on cultural competency and safety. It will help develop interventions that address
the needs of the target people.

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