Week 5: Aboriginal and Torres Straight Islander Health 2

Question 1

Approximately, how do the health needs of ATSI people compare to non-indigenous Australians?

Answer 1

~3 times higher for ATSI

Question 2

Describe how this hierarchy system applies to health care for ATSI people

Answer 2

This ladder illustrates the degrees of citizen participation. In health care it is desirable to achieve as high as possible citizen participation to deliver good health care. Historically ATSI people have been given little information and control over health care processes. This has moved toward a citizen consultation focus and is now looking to move toward more citizen control.

Question 3

Outline some differences between consultation and self-determination?

Answer 3

Consulation - giving information and exchanging information - agreement/partial agreement Self-determination: - taking matters into own hands - free to pursue economic, cultural and social development - rights respected

Question 4

Briefly define partnership with community in health care

Answer 4

This refers to an interdependent and equal collaboration in working toward long-term goals

Question 5

Briefly define community ownership

Answer 5

Ownership refers to community ownership and therefore responsibility and accountability for decisions made

Question 6

What are the key points of the NACCHO definition of primary healthcare?

Answer 6

-scientifically sound - socially acceptable - accessability - full community participation - aspects of self-reliance and determination

Question 7

Name 4 examples of services which deliver public health in one form or another

Answer 7

-hospitals - multi purpose health centres - primary health care centres - population health

Question 8

What is the Aboriginal and Torres Strait Islander Cultural Capability Program?

Answer 8

This program is designed to improve health care services for ATSI people through a multi-pronged approach

Question 9

What are the main priciples of the ATSICC program?

Answer 9

-cultural respect & recognition principle - communication principle - capacity building principle - Relationships & Partnerships principle

Question 10

Give some examples of how the cultural respect & recognition principle is considered

Answer 10

This focuses on cultural practices and respect for these. Examples are: kinship structures, traditional healing, protocols of dying (sorry business)

Question 11

Give some examples of how the communication principle is considered

Answer 11

This focuses on anything impacting on communication and how to deal with this: language differences, hospital liaison officers, interpreters, involving family members

Question 12

Give some examples of how thecapacity building principle is considered

Answer 12

This focuses on increasing health care system cultural capacity: increasing indigenous work force, cultural safety training for all workers

Question 13

Give some examples of how the relationship and partnership principle is considered

Answer 13

This refers to community partnership, but also to partnership with sectors outside of health like housing to improve health

Question 14

What are some issues for general practices in providing health care for ATSI people?

Answer 14

• focus on fee for service: diasdvantages lower SES - No standardised cultural safety regime. May lack cultural capacity (language, culture) - clashes between appointment system and time-general culture - inadequate remuneration for time intensive health care plans

Question 15

What are some ways to improve health care provided by general practices?

Answer 15

-incentives: already in place - active engagement with community - making efforts to increase indigenous workforce - ensuring location is accessible (transport May be limited for some) - wholistic care approach eg. having on-site Aboriginal health worker and other allied health

Question 16

Describe ACCHS. Who is in charge, what type of care, funding, staffing?

Answer 16

ACCHS are initiated by local communitites and governed by a board. They provide wholistic care and provide interdisciplinary care in one location. funded by medicare/state govt. Recruitment prioritises proportion of ATSI representation in staff

Question 17

How many ACCHS are there in QLD and nationally approximately?

Answer 17

~30 and ~180

Question 18

What is the purpose of the Institute of Urban INdigenous Health?

Answer 18

This is a Brisbane based organisation that aims to increase access of health services by ATSI people

Question 19

Describe a brief history of the Aboriginal Health worker

Answer 19

• 1950s: mostly Aboriginal women as health assistants - 1970s: recognised role of AHW in delivering healthcare locally and nationally - later increased training by health departments (Cert III and IV today) - Significant role in rural health work force

Question 20

What qualifications does an Aboriginal and Torres Strait Islander health worker have?

Answer 20

Cert III

Question 21

What qualifications does an Aboriginal and Torres Strait Islander health practitioner have?

Answer 21

cert IV

Question 22

Name some roles of AHWs in clinical care

Answer 22

• patient recall - adult health check - drug administration (remote locations with authorisation) - basic observation and history - brief intervention, counselling

Question 23

Name some roles of AHWs in community care

Answer 23

-health education eg school based programs - community development and health campaigns - patient follow up - crisis support and advice - health planning

Question 24

Describe health care expenditure for ATSI population

Answer 24

• $1.38 spent for every $1 on non-indigenous. (keeping in mind health needs are triple) - in public hospital $2 spent for every $1 spent on non-indigenous (includes dialysis which is expensive)

Question 25

What is the basic outline of the NAHS - national Aboriginal Health Strategy policy of 1989?

Answer 25

-multi sector collaboration - focus on coordinator funding - monitoring progress on health - emphasis on long-term approaches

Question 26

What is the basic outline of the CTG - close the gap policy of 2008?

Answer 26

- Reducing ATSI disadvantage - focus on life expectancy, child mortality, education, and employment gap reduction - GP incentives - ACCHS funding - state and federal commitment to funding - primary care incentives (upstream shift)

Question 27

What is the basic outline of the NATSIHP - National Aboriginal and Torres Strait Islander health plan policy of 2013-2023?

Answer 27

Key principle focus: - Health equality and human rights approach - community control and engagement - parternship - accountability

Question 28

What are the 4 main conceptos to engage ATSI people in their health? and explain them

Answer 28

1. Partnership - Partnership is a collaboration association, an alliance - The partnership is necessary with aboriginal communities to reach long term goals - This is because in partnerships there is independence, equal power and equal rights 2. Ownership - Needs to be done at community and individual level - At the community level, there needs to be corporate responsibility and accountability (more likely to do more to see success) - At the individual level, it is people taking responsibility for their own health care e.g. the self-help care 3. Self-determination - We need indigenous people to have more self-determination, to take matters into their own hands and have initiative 4. Consultation - Give information - Gather information - Exchange information - Agree / partially agree on initiative