Strategies and Approaches in Aboriginal Health
Dr Ross Bailie
Associate Professor in Public Health Menzies School of Health Research Flinders NT Clinical School
Ph 08-89228835 or 08-89228196 Fax 08-89275187 email: ross.bailie@menzies.edu.au
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
Learning Objectives
Performance Objectives
Sources of information and Acknowledgements
• Australian Indigenous Health Infonet web site
• National Aboriginal and Torres Strait Islander Health Strategy
Background
• Lack of progress
• Shifting responsibility
• Competing interests
• Assimilation
• Funding pressure
• Poor coordination
Background
(continued)
• Control • Treaties
The National Aboriginal Health Strategy
National Aboriginal Health Strategy
(continued)
• Social and Physical environment • Self-determination • Health hardware • Major identified problems
National Aboriginal Health Strategy (continued)
• Failure of implementation • Office of Aboriginal and Torres Strait Islander Health (OATSIH)
Five key strategies
• Infrastructure
• Self-determination
• Access to community controlled services • Adequate resourcing
• Skilled workforce
Infrastructure
• Housing • Water • Sewage
• Roads
• Communication
• Educational facilities
• Health facilities
Infrastructure
(continued)
• Intersectoral responsibilty
• Infrastructure standards
Self-determination
• Community control
Access to community controlled health services
• AMS’s • Patchy access • Comprehensive services
• Poor coordination with the mainstream
Adequate resourcing
• Resourcing levels are inadequate • Urban/rural/remote disparity
Skilled workforce
• Education strategy
• AHWs
• Health professionals
New Solutions?
Framework Agreements
• Governments, ATSIC, NACCHO • National Council of Aboriginal and Torres Strait Islander Health
Coordinated Care Trials
• Community control
• Cashing out of MBS and PBS • Coordination of care
Priority specific health issues
• Chronic disease • Communicable disease • Social and wellbeing emotional
Comprehensive Primary Health Care
• Healthy public policy
• Prevention and health promotion • Better management
Conclusion
• Poor record
• Fundamental strategies
• Recent initiatives
• Reconciliation • Underlying determinants
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 nonEuropeans. New York: Oxford University Press, 1994
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