Engaging healthcare for Aboriginal Australians
Angela Durey, Suzanne McEvoy, Val Swift-Otero, Kate Taylor, Judith Katzenellenbogen and Dawn Bessarab of Curtin University present an assessment of a community engagement strategy between health providers of the South Metropolitan Health Service under the Department of Health, Western Australia, and Aboriginal communities. The strategy enabled District Aboriginal Health Action Groups (DAHAGs), implemented by the South Metropolitan Public Health Unit’s Aboriginal Health Team, to partner with local service providers on culturally responsive health care services. Durey, et al. appraise the strategy for effectiveness and identify the success factors. They assess the process for how it captures a range of community perspectives on health service needs, and ask if Aboriginal participants’ expectations of the process were met. Further, the evaluation looks at the implementation of the participants’ recommendations and whether – consequently – this improved Aboriginal community access to local health services.
The evaluation involved participants from four stakeholder groups across five districts: Aboriginal DAHAG members who used Aboriginal and mainstream health services, Health Providers of Aboriginal Services (HPAS) who delivered services to local Aboriginal people, Aboriginal Specific Service Users (ASSU) who were members of the local Aboriginal community but not of DAHAG, and Mainstream Health Service Providers (MHSP) who were members of services that took part in DAHAG engagements. Data was collected through one-to-one interviews and yarning circles (narrative, Indigenous, culture-appropriate methodology that is safe and credible for qualitative research in Indigenous communities). Two-way accountability procedures were established, for both health service providers and community.
The Indigenous context for evaluation design was conscious of the work of Maori researcher Linda Tuhiwai Smith. Key themes that emerge from the evaluation indicate that, despite their initial skepticism, participants across the stakeholder groups feel that the strategy was effective, with recommendations translated into action, stronger relationships between service providers and community, and improvement in culturally appropriate health services. The engagement also seems to have positively impacted local Aboriginal community trust in, and access to, these services. The evaluation locates its findings in the broader contexts and literature on partnerships with Aboriginal communities, and identifies concerns for sustainable community engagement.