strategies and approaches in aboriginal health dr ross bailie associate professor in public health...
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Learning ObjectivesTRANSCRIPT
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Strategies and Approaches in
Aboriginal HealthDr Ross Bailie
Associate Professor in Public Health
FlindersNT Clinical School
Menzies Schoolof Health Research
Ph 08-89228835 or 08-89228196Fax 08-89275187
email: [email protected]
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I believe that all those employed in the medical professions must undertake the difficult task of recognising, in all its implications, that, by definition, health work is political work. If the health professions ignore the shocking state of Indigenous health in this country then they exacerbate the problems of history. On the other hand, if they take the initiative to act, to advocate and to work for significant change, they assist in the crucial work of reconciliation between black and white Australians. This stance inevitably requires a commitment to radically reformist positions about health.
Lowitja O’Donoghue 1999
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LearningObjectives
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PerformanceObjectives
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Sources of information and Acknowledgements
• Australian Indigenous Health Infonet web site
• National Aboriginal and Torres Strait Islander Health Strategy
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Background
• Lack of progress• Shifting responsibility• Competing interests• Assimilation• Funding pressure• Poor coordination
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Background(continued)
• Control
• Treaties
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The National Aboriginal Health
Strategy
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National Aboriginal Health Strategy
(continued)
• Social and Physical environment
• Self-determination• Health hardware• Major identified problems
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National AboriginalHealth Strategy (continued)
• Failure of implementation
• Office of Aboriginal and Torres Strait Islander Health (OATSIH)
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Five key strategies
• Infrastructure• Self-determination• Access to community
controlled services• Adequate resourcing• Skilled workforce
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Infrastructure
• Housing• Water• Sewage• Roads• Communication• Educational facilities• Health facilities
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Infrastructure (continued)
• Intersectoral responsibilty
• Infrastructure standards
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Self-determination
• Community control
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Access to community controlled health services
• AMS’s• Patchy access• Comprehensive services• Poor coordination with
the mainstream
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Adequate resourcing
• Resourcing levels are inadequate
• Urban/rural/remote disparity
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Skilled workforce
• Education strategy• AHWs• Health professionals
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NewSolutions?
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Framework Agreements
• Governments, ATSIC, NACCHO
• National Council of Aboriginal and Torres Strait Islander Health
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Coordinated Care Trials
• Community control
• Cashing out of MBS and PBS
• Coordination of care
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Priority specific health issues
• Chronic disease
• Communicable disease
• Social and emotional wellbeing
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Comprehensive Primary Health Care
• Healthy public policy
• Prevention and health promotion
• Better management
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Conclusion
• Poor record• Fundamental strategies• Recent initiatives• Reconciliation• Underlying determinants
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References• Anderson I. The National Aboriginal Health
Strategy. In Health Policy in Australia. Editor Gardner H. Oxford University Press 1997.
• Guthridge S, Cairnduff S, Gollow P, Pearce M, Kennedy K. Structure, Function and Health: a review of the health impact of infrastructure change in remote Aboriginal communities in the Top End. Territory Health Services 1999.
• Kunitz SJ. Disease and social diversity: the European impact on the health of non-Europeans. New York: Oxford University Press, 1994