NACCHO Affiliates and Members Deadly Good News : #National Our CEO Pat Turner on Final 2019 #QandA Mon 9 Dec Plus #NSW Dubbo ACCHO #VIC #VACCHO #QLD @QAIHC_QLD @DeadlyChoices Goodnir #NT @MiwatjHealth @NDIS #ACT @nimmityjah #SA Port Lincoln ACCHO

1.National : Our NACCHO CEO Pat Turner to appear on the final 2019 ABC TV Q and A Monday 9 December

2.NSW : A doctor who helped establish the Dubbo Aboriginal Medical Service (AMS) has been honoured for long-standing service to country NSW.

3.Vic : VACCHO partners with  BreastScreen Victoria to win the 2019 VicHealth IMPROVING HEALTH EQUITY award for our Aboriginal Breast Screening Shawl project, which means our beautiful women win!

4.1 QLD : QAIHC hosts the annual Awards for Excellence, celebrating leaders, organisations and communities within the Sector.

4.2 QLD : Steven Miles – Health & Ambulance Services Minister & MP for Murrumba launches the Deadly Choices FIT

4.3 QLD : A personal reflection from Steve Conn Mobile Clinic Coordinator at Goondir ACCHO

5. NT Miwatj ACCHO  NDIS have begun delivering Capacity Building Community Access services

6. ACT : Work underway to build new clinic at Winnunga ACCHO 

7.SA : Port Lincoln Aboriginal Health Service kids take part in the Woolworths Cricket Blast Test Match Training session

How to submit in 2019 a NACCHO Affiliate  or Members Good News Story ?

Email to Colin Cowell NACCHO Media 

Mobile 0401 331 251 

Wednesday by 4.30 pm for publication Friday

1.National : Our NACCHO CEO Pat Turner to appear on the final ABC TV Q and A Monday 9 December

Malcolm Turnbull, Former Prime Minister of Australia

Anthony Albanese, Opposition Leader

Sisonke Msimang, Author

Patricia Turner, CEO of National Aboriginal Community Controlled Health Organisation

Brian Schmidt, Nobel laureate and Vice-Chancellor, ANU

See More Details Here

2.NSW : A doctor who helped establish the Dubbo Aboriginal Medical Service (AMS) has been honoured for long-standing service to country NSW.

The NSW Rural Doctors Network presented Dr Rick Aitken with a prestigious 2019 Rural Medical Service Award during its annual conference at the Novotel Sydney Manly Pacific at the weekend.

From HERE

Dr Aitken was among 20 GPs to be honoured for more than 700 years of combined service to rural NSW communities.

The award recognises GPs who have spent the past 35 years or more providing healthcare to people in remote, rural and regional communities.

Dr Aitken has clocked up 35 years of service in Orange, Culburra Beach, Dubbo, Millthorpe, Moss Vale and Bundanoon.

In 2013 he was the senior medical manager during the establishment of the Dubbo AMS, also known as the Dubbo Regional Aboriginal Health Service.

Between 2012 and 2016, Dr Aitken was the regional GP educator for Bila Muuji Aboriginal Health Service in Western NSW

3.Vic : VACCHO partners with  BreastScreen Victoria to win the 2019 VicHealth IMPROVING HEALTH EQUITY award for our Aboriginal Breast Screening Shawl project, which means our beautiful women win!!

The project was piloted by VACCHO and Victorian Aboriginal Health Service -VAHS, this initiative is a culmination of months of hard work and planning by project partner BreastScreen Victoria, with Dhauwurd Wurrung DwechWinda-Maraa, Gunditj CorpKirrae Health Service Inc.Wathaurong Aboriginal Co OpRumbalara Aboriginal Co-OperativeRamahyuck District Aboriginal Corporation- SaleVictorian Department of Health & Human Services and Deakin University.

In October BreastScreen Victoria vans visited regional Aboriginal women with free beautiful handmade cultural screening shawls as part of Breast Cancer Awareness Month.

This Aboriginal community-led initiative addresses the barriers preventing Aboriginal women participating in breast screening by creating a culturally safe service.

The shawls, designed by Aboriginal women, were made for Aboriginal women in the trial to wear during their breast screen. They are a culturally safe alternative to being naked from the waist up or asking for a standard screening gown.

The shawls aim to improve Aboriginal women’s experience with breast screening. 100% of the women who participated strongly agreed the shawl increased their feeling of cultural safety, of comfort, and that it was easy to use.

Congratulations everyone.

4.1 QLD : QAIHC hosts the annual Awards for Excellence, celebrating leaders, organisations and communities within the Sector.

Established to recognise the hard work, determination and growth of the Aboriginal and Torres Strait Islander Community Controlled Health Sector, the awards acknowledge those that are making a real difference throughout their communities.

Congratulations to the winners:

– QAIHC Partnership Excellence Award – Institute for Urban Indigenous Health

– QAIHC Innovation Excellence Award – Cunnamulla Aboriginal Corporation for Health

– QAIHC Patient Satisfaction and Service Excellence Award – NPA Family and Community Services Aboriginal and Torres Strait Islander Corporation

– QAIHC Leader of the Year Award – Veronica Williams and Gary White

– QAIHC Member of the Year Award – Galangoor Duwalami Primary Healthcare Service.

4.2 QLD : Steven Miles – Health & Ambulance Services Minister & MP for Murrumba launches the Deadly Choices FIT

 

Let’s see how he pulled up after his first DC FIT session after launching the program at the Brisbane Broncos this morning.

If you’re aged 16-25 and want to kickstart your way towards a healthier lifestyle join DC FIT today: https://bit.ly/2P9uVcD

4.3 QLD : A personal reflection from Steve Conn Mobile Clinic Coordinator at Goondir ACCHO 

This photo was taken in the Mobile Medical Clinic’s outdoor waiting room.

It is a picture of myself, Steve Conn (Mobile Clinic Coordinator) enjoying an amazing didgeridoo from Gove with a baby and his Mother.

So much can and should be said about moments like these, so rather than letting it go or just giving it a caption, the following is brave admission of what it signifies to me.

The last twenty years of clinical work for me has been focused on emergency work.  Aside from continually experiencing the highs and lows of humanity, emergency work is fast-paced, mentally and physically draining and above all and relevant to this conversation, it is focussed on fixing the broken.

My new role as the MMC Coordinator keeps giving to me in ways I could not have anticipated.   The clinical focus is on primary health, essentially managing clients health with a view to preventing illness and disease and in doing so, help to ‘close the gap’.

It is a demanding job.  I perceive a massive responsibility, not just as a Registered Nurse but as a privileged white citizen of this country.  I have a head full of emergency type stories; naturally there are a few that seem never to leave me, stories of extreme loss and grieving.

Then this moment in the photo happened, it could have just been part of another day at ‘the office’, it could have only been let go or passed over except for the fact that it got beneath my thick clinical skin.

This beyond cute indigenous baby is sitting on his country. A natural connection.  He is listening to white man play didgeridoo as he taps his hands on the earth roughly to the beat.

His mother sits calmly waiting to see the doctor as this hardened emergency nurse takes two minutes out to connect.  For me, although a little brave as in out of the normal behaviour for a Registered Nurse I felt totally comfortable and I know the baby did too by his actions.

In my mind, we (Mother, child and I) shared a judgment-free connection, a genuinely human moment not tainted by skin or socioeconomic status but created by mutual respect, mutual admiration and most powerfully, hope.

All too often we are so consumed by our jobs that we in a way we forget what we are doing.  Working with our Indigenous people in remote areas has enriched my personal and professional life.  It has reminded me of why I became a nurse in the first place.

Thank you to our deadly Mob and thank you to the fantastic organisation and community that is Goondir ACCHO

Steve Conn

MMC Coordinator

As a First Nations visitor here in St George Qld, working with Aboriginal and Torres Strait Islanders, I too recognise the privilege I hold as a professional but also the privilege I experience in receiving the Strong Stories of Indigenous community members that are often hidden under the stories of loss, grief, pain and the like.

To receive your story is an excellent reminder of how humbling it is to be in this position.

Thanks, Bro

Leonard.

5. NT Miwatj ACCHO  NDIS have begun delivering Capacity Building Community Access services

In Galiwin’ku a second hand 4×4 HI Ace Bus was purchased and then modified by Darwin based company Keep Moving to add a wheelchair lift. This Specialised Disability Transport will allow NDIS Participants to have greater access to community based activities and increase independence. The 4×4 Bus includes a snorkel and lift kit, which allows the bus access to more secluded areas in and around Elcho Island, ideal for hunting and fishing!

NDIS is latju! In celebration of International Day of People with Disability earlier this week, we would like to share some words from the owner of the very first motorised scooter on Milingimbi – an island located 440km east of Darwin.

“I am very happy getting more support. I can ask for help, especially with equipment. I can get help quickly and I have the choice in that type of equipment.

With my new scooter I have a lot of freedom and I can make my own decisions. I didn’t think I would ever get an electric scooter, I thought I would always have to use my small wheelchair and it was very hard for me to use all the time

When I had my stroke, I was very sad because I couldn’t do everything I used to do when I was strong. It helped a little bit when I got my wheelchair, but now I have my new scooter, which is better. I get lots of therapy like OT and physio too, I like doing my exercises.”

6. ACT : Work underway to build new clinic at Winnunga ACCHO 

Progress at Winnunga photos from site tour this week and they are currently on track to have building completed November 2020 . The veranda at the front of admin reception and Rec 2 gone and the boardroom is a shell existing walls and roof will come down in the next couple of weeks

7.SA : Port Lincoln Aboriginal Health Service kids take part in the Woolworths Cricket Blast Test Match Training session

Aboriginal children from Port Lincoln got the chance to be a part of a celebration of Aboriginal culture, and have some fun with cricket at a Woolworths Cricket Blast event at Adelaide Oval on November 28.

Twenty five Aboriginal children from the Woolworths Community Fund program, including from Port Lincoln took part in the Woolworths Cricket Blast Test Match Training session which included the launch of a new Aboriginal-designed shirt.

Designed by 16-year-old Aboriginal artist and Dharawal man Billy Reynolds, the shirt features Aboriginal art and depicts a goanna.

SACA northwest country cricket manager Peter Brown said children involved with Mallee Park Football Club had been involved with Woolworths Cricket Blast thanks to work with Jermaine Miller at Port Lincoln Aboriginal Health Service.

“Cricket Australia and SACA have been doing a lot of work in the indigenous space in the last few years and recognising the contributions of Aboriginal people,” he said.

Cricket Australia community cricket executive general manager Belinda Clark said the launch of the shirt shined a light on cricket’s ongoing commitment to reconciliation and providing options for young cricketers to celebrate First Nations cultures.

Children involved in Woolworths Cricket Blast will have the chance to wear the new shirt from February next year.

NACCHO Aboriginal Health and Alcohol other Drugs: Peak public health bodies @_PHAA_ And @FAREAustralia respond to Health Minister @GregHuntMP launch of National Alcohol Strategy 2019-28 : Download Here

The federal government will spend $140m on drug and alcohol prevention and treatment programs but has ruled out measures such as hiking taxes on cask wine.

Health Minister Greg Hunt announced the National Alcohol Strategy 2019-28 has been agreed with the states following protract­ed negotiations.

The strategy outlines agreed policy options in four priority areas: community safety, price and promotion, treatment and prevention.

Health lobby groups have pushed for reform in two major areas: the introduction of a minimum floor price for alcohol by state governments, and the introduction of a volumetric tax, based on the amount of alcohol in a beverage, by the commonwealth. ”

From The Australian Health Editor Natasha Robinson (See in full part 1 below )

Read over 200 Aboriginal health and Alcohol other drugs articles published by NACCHO over the past 7 years 

” Overall, Aboriginal and Torres Strait Islander people are more likely to abstain from drinking alcohol than non-Aboriginal and Torres Strait Islander people (31% compared with 23% respectively).

However, among those who did drink, higher proportions drank at risky levels (20% exceeding the lifetime risk guidelines) and were more likely to experience alcohol-related injury than non-Aboriginal and Torres Strait Islander people (35% compared to 25% monthly, respectively).

For this reason, Aboriginal and Torres Strait Islander people experience disproportionate levels of harm from alcohol, including general avoidable mortality rates that are 4.9 times higher than among non-Aboriginal and Torres Strait Islander people, to which alcohol is a contributing factor.

The poorer overall health, social and emotional wellbeing of Aboriginal and Torres Islander people than non-Aboriginal and Torres Strait Islander people are also significant factors which can influence drinking behaviours. ” 

Page 8 of National Strategy Aboriginal and Torres Strait Islander people

Download the full strategy HERE

national-alcohol-strategy-2019-2028

 ” The Public Health Association of Australia (PHAA) is pleased the National Alcohol Strategy 2019-2028 is finally out but said it lacked ambition to prevent Australians suffering adverse health impacts of alcohol consumption.

“It is good news to have this strategy now finalised, albeit many years in the making and with too much influence from the alcohol industry,”

PHAA CEO Terry Slevin  : See part 2 below for full press release 

Australia has not had a national strategy since 2011 and we congratulate Health Minister Greg Hunt for spearheading this successful outcome. 

Given the high burden of harm from alcohol, including 144,000 hospitalisations each year, we trust that the NAS will support proportionate action from the Commonwealth, states and territories to protect Australians and their families,

 FARE has also welcomed the Minister’s announcement that the Government will commission a report to estimate the social costs of alcohol to the community.  

Australia faces a $36 billion a year alcohol burden, with approximately a third due to alcohol dependence, a third caused by injuries, and the final third due to chronic diseases such as cancer and cardiovascular diseases,

FARE Director of Policy and Research Trish Hepworth. See part 3 below for full press release 

 ” Alcohol places an enormous burden on our healthcare resources on our society and ultimately on us as a nation.

Alcohol is currently the sixth leading contributor to the burden of disease in Australia, as well as costing Australian taxpayers an estimated $14 billion annually in social costs.

The AMA has previously outlined the priorities we would like to see reflected in the Strategy, including action on awareness, taxation, marketing, and prevention and treatment services.

Implementing effective and practical measures that reduce harms associated with alcohol misuse will benefit all Australians.”

AMA President, Dr Tony Bartone : See Part 4 Below for full Press Release 

Part 1 The Australian Continued 

The National Alcohol Strategy lists the introduction of a volumetric tax as one policy ­option, but Mr Hunt said the commonwealth was ruling out such taxation reform.

“The government considers Australia’s current alcohol tax settings are appropriate and has no plans to make any changes,” the minister’s office said.

Mr Hunt said there were “mixed views” among the states on the introduction of a minimum floor price for alcohol — the Northern Territory is the only jurisdiction to introduce this measure — but such policy remained an option for the states.

Mr Hunt said the national strategy had laid out a path towards Australia meeting a targeted 10 per cent reduction in harmful alcohol consumption.

“There’s a balance been struck, what this represents is an attempt to lay out a pathway to reducing alcohol abuse and reducing self-harm and violence that comes with it,” Mr Hunt said.

“The deal-maker here was the commonwealth’s investment in drug and alcohol treatment. That was the most important part. Now we’d like to see the states match that with additional funds, but we won’t make our funds ­dependent upon the states.”

Health groups welcomed the finalisation of the national strategy. Alcohol Drug Foundation chief executive Erin Lalor said it was now up to governments to act on the outlined policies. “The strategy means we can now start doing and stop talking, because it’s been in development for a ­really long time,” Ms Lalor said.

“We’ve now got really clear options that we can focus on and it’s up to governments around Australia and other groups working to reduce alcohol-related harm and the alcohol industry to start to take serious measures and evidence-based measures that will reduce the significant harm from alcohol.”

Ms Lalor was disappointed the government had ruled out a volumetric tax. “We have been advocating for a long time for volumetric tax to be introduced. The strategy outlines it and we would hope to see pricing and taxation of alcohol being adopted to reduce alcohol-related harms.”

Canberra will spend $140m on programs to combat alcohol and drug addiction.

Primary Health Networks will receive $131.5m to commission new and existing drug and ­alcohol treatment services, while the government will commission a new report to estimate the social costs of alcohol to society.

Part 2 Belated alcohol strategy is a missed opportunity

The Public Health Association of Australia (PHAA) is pleased the National Alcohol Strategy 2019-2028 is finally out but said it lacked ambition to prevent Australians suffering adverse health impacts of alcohol consumption.

“It is good news to have this strategy now finalised, albeit many years in the making and with too much influence from the alcohol industry,” PHAA CEO Terry Slevin said.

“The strategy recommends important policy options that can reduce alcohol related harm via both national and state level efforts.”

“All governments should invest in and commit to reducing the health and social burden of excess alcohol consumption,” Mr Slevin said.

“It is a shame the federal government has again ruled out the option of volumetric tax on alcohol, which is a fairer and more sensible way of taxing alcohol.

“This is about stopping people from getting injured, ill or dying due to alcohol, so why rule out this option?”

“The current alcohol tax system is a mess and is acknowledged as such by anyone who has considered the tax system in Australia.”

“We hope this important reform will again be considered at a time in the near future.“

“Let’s remember that alcohol is Australia’s number one drug problem. Harmful levels of consumption are a major health issue, associated with increased risk of chronic disease, injury and premature death,” Mr Slevin said.

“The announcement of funding for drug treatment services is modest but we welcome the support for a report assessing the social cost of alcohol.”

“When that report is completed we hope it will influence alcohol policy into the future.”

Part 3 The Foundation for Alcohol Research and Education (FARE) congratulates Federal, State and Territory Ministers for finalising the National Alcohol Strategy 2019–2028 (the NAS).

“Australia has not had a national strategy since 2011 and we congratulate Health Minister Greg Hunt for spearheading this successful outcome,” said FARE Director of Policy and Research Trish Hepworth.

“Given the high burden of harm from alcohol, including 144,000 hospitalisations each year, we trust that the NAS will support proportionate action from the Commonwealth, states and territories to protect Australians and their families,” she said.

FARE has also welcomed the Minister’s announcement that the Government will commission a report to estimate the social costs of alcohol to the community.

“Australia faces a $36 billion a year alcohol burden, with approximately a third due to alcohol dependence, a third caused by injuries, and the final third due to chronic diseases such as cancer and cardiovascular diseases,” Ms Hepworth said.

“In implementation, we urge governments to take action to increase the community’s awareness of the more than 200 injury conditions and life-threatening diseases caused by alcohol,” she said.

FARE strongly encourages the Federal Government to revisit alcohol taxation reform, which would be the most effective way to reduce the death toll from alcohol-related harm, which is almost 6,000 people every year.

“We know from multiple reviews that alcohol taxation is the most cost-effective measure to reduce alcohol harm because measures can be targeted towards reducing heavy drinking, while providing government with a source of revenue,” Ms Hepworth said.

Part 4 AMA

The announcement that the National Alcohol Strategy 2019–2028 (the NAS) has been agreed to by all States and Territories is welcome, but it is disappointing that it does not include a volumetric tax on alcohol, AMA President, Dr Tony Bartone, said today.

“The last iteration of the NAS expired in 2011, so this announcement has been a long time coming,” Dr Bartone said.

“The AMA supports the positive announcements by the Government to reduce the misuse of alcohol. However, they simply do not go far enough.

“An incredibly serious problem in our community needs an equally serious and determined response.

“Doctors are at the front line in dealing with the devastating effects of excessive alcohol consumption. They treat the fractured jaws, the facial lacerations, the eye and head injuries that can occur as a result of excessive drinking.

“Doctors, and those working in hospitals and ambulance services, see the deaths and life-long injuries sustained from car accidents and violence fuelled by alcohol consumption.

“Healthcare staff, including doctors, often bear the brunt of alcohol-fuelled violence in treatment settings. Alcohol and other drugs in combination are often a deadly cocktail.

“Prolonged excessive amounts contribute to liver and heart disease, and alcohol is also implicated in certain cancers.

“All measures that reduce alcohol-fuelled violence and the harm caused by the misuse of alcohol, including taxing all products according to their alcohol content, should be considered in a national strategy.

“For this reason, we are extremely disappointed that the Government has ruled out considering a volumetric tax on alcohol.

“A national, coordinated approach to alcohol policy will significantly improve efforts to reduce harm.

“Alcohol places an enormous burden on our healthcare resources on our society and ultimately on us as a nation.

“Alcohol is currently the sixth leading contributor to the burden of disease in Australia, as well as costing Australian taxpayers an estimated $14 billion annually in social costs.

“The AMA has previously outlined the priorities we would like to see reflected in the Strategy, including action on awareness, taxation, marketing, and prevention and treatment services.

“Implementing effective and practical measures that reduce harms associated with alcohol misuse will benefit all Australians.”

Background

  • The Australian Institute of Health and Welfare found that alcohol and illicit drug use were the two leading risk factors for disease burden in males aged 15-44 in 2011.
  • The AIHW has linked alcohol use to 26 diseases and injuries, including six types of cancer, four cardiovascular diseases, chronic liver disease, and pancreatitis, and estimated that in 2013 the social costs of alcohol abuse in Australia was more than $14 billion.
  • A study conducted by the Australasian College for Emergency Medicine in 2014 found that during peak alcohol drinking times, such as the weekend, up to one in eight hospital patients were there because of alcohol-related injuries or medical conditions. The report noted that the sheer volume of alcohol-affected patients created more disruption to Emergency Departments than those patients affected by ice.

 

NACCHO Aboriginal Youth Health News #OwningFutureChange : Download @AusAAH Report : Health and wellbeing of Aboriginal and Torres Strait Islander young people : Plus The Imagination Declaration 2019 Garma festival’s youth forum

 ” Identity and connection to family and Aboriginal ways of knowing, doing and being are at the core of what it is to be an Aboriginal and/or Torres Strait Islander person.

A large proportion of Australia’s Aboriginal and Torres Strait Islander peoples are young and signify an opportunity for harnessing their energy and ideas to prevent poor health and social conditions.

While many Aboriginal and Torres Strait Islander young people lead healthy and safe lives, there is still a conscious journey required to ensure a strong connection to identity and culture that supports overall health, wellbeing and self-determination.

Identity is also informed by many other factors including gender, sexuality, disabilities, social and emotional wellbeing, location and mobility, and socioeconomic status.

For young people impacted by trauma, systemic racism and inequity, there can be lasting effects on identity, connection to culture, health and wellbeing (Atkinson, 2013).

The impact of intergenerational trauma is often overlooked by mainstream health services attempting to engage Aboriginal and Torres Strait Islander young people.

Intergenerational or historical trauma is a transference of trauma among families and communities, which is ‘the subjective experiencing and remembering of events in the mind of an individual or the life of a community, passed from adults to children in cyclic processes’ (Atkinson, 2013, p. 4).

While there are commonalities in factors important to attaining good health among Aboriginal and Torres Strait Islander young people, it is important to also acknowledge Aboriginal and Torres Strait Islander people in Australia are diverse and represent over 200 nations each with their own history, cultures and norms.

Further, young people have unique talents and strengths, have different social and cultural capital and have had varying experiences with health and the health system. “

Preface to Young persons position paper ” See extracts and recommendations below or 

Download full report

The_Health_and_Wellbeing_of_Aboriginal_and_Torres_Strait_Islander_Young_Peoples_PositionPaper_FINAL

Photo above from AAAH Website

Read over 400 Aboriginal Youth / Children’s articles published by NACCHO over the past 7 years

 ” Following the ‘Uluru Statement From The Heart’, in 2019, a group of young Indigenous people have gathered in East Arnhem Land for the Youth Forum at Garma. The forum has been facilitated by AIME and resulted in a Declaration for the Prime Minister and Education Minister’s across Australia – The Imagination Declaration.” see Part 2 below 

This message was read out by Sienna on August 5, 10:00am at the 2019 Garma festival.

Health and wellbeing of Aboriginal and Torres Strait Islander young people

The Constitution of the National Aboriginal Community Controlled Health Organisation (2011) describes health as “not just the physical well-being of an individual but refers to the social, emotional and cultural well-being of the whole Community in which each individual is able to achieve their full potential as a human being thereby bringing about the total well-being of their Community.

It is a whole of life view and includes the cyclical concept of life-death-life”.

View presentations from the recent NACCHO Youth Conference in Darwin 

Australia’s Aboriginal and Torres Strait Islander population is young, with 241,824 people between the ages of 10-24 years in 2016, which represents 5% of the Australian population of young people (Australian Institute of Health and Welfare, 2018a).

Adolescence, defined in western bio-medical terms as the life stage between age 10 and 24 years, is a period of self-discovery and growth when important biological, social and emotional changes take place which can have a long-lasting impact on future health and well-being. Information and practices to support youth life stage development from an Aboriginal and Torres Strait Islander perspective are not currently in use; these types of cultural knowledges and practices were forbidden under past government policy, which has excluded Aboriginal and Torres Strait Islander peoples from decision making about policies to protect health and bring about health and social equity.

Currently, Aboriginal and Torres Strait Islander young people have disproportionately high rates of largely preventable causes of morbidity and mortality which include: injuries, mental health and sexual and reproductive health (Australian Institute of Health and Welfare, 2018a; Azzopardi et al., 2018).

In 2011, for Aboriginal and Torres Strait Islander young people aged 10–24 years, the leading contributors to the disease burden were suicide and self-inflicted injuries (13%), anxiety disorders (8%), alcohol use disorders (7%) and road traffic injuries (6%) (Australian Institute of Health and Welfare, 2018a).

Incarceration and child removal rates continue to be disproportionately high. Aboriginal and Torres Strait Islander children and young people are over-represented at all stages of the child protection system, out of home care (OOHC) and are under-represented in services that could subvert this (SNAICC, 2018).

The Aboriginal and Torres Strait Islander Child Placement Principle (ACPP) aims to prioritise carers who are from the young person’s family in the first instance, or from the young person’s Aboriginal and Torres Strait Islander Community, or alternatively are Aboriginal and Torres Strait Islander carers, however in practice this is not always enacted (Australian Institute of Family Studies, 2019).

The ‘Family is Culture Review’ cautions that “the ACPP is not simply a hierarchy of options for the physical placement of an Aboriginal child in OOHC. The ACPP is one broad principle made up of five elements that are aimed at enhancing and preserving Aboriginal children’s sense of identity, as well as their connection to their culture, heritage, family and community” (Davis, 2019).

These five elements include prevention, partnership, placement, participation and connection (Davis, 2019).

Further, though it varies by state and territory, Aboriginal and Torres Strait Islander young people are markedly over-represented in the youth justice system and in detention; all children in the Northern Territory juvenile detention system are Aboriginal and Torres Strait Islander people (Australian Institute of Health and Welfare, 2019).

Young people who have been in youth detention are at greater risk of mental health disorders, and are more likely to experience homelessness and substance use issues (Australian Institute of Health and Welfare, 2016). Furthermore, Aboriginal and Torres Strait Islander children and young people who are in OOHC are over-represented in the youth justice system and this is a key driver of adult incarceration (Davis, 2019; Sentencing Advisory Council, 2019).

Forced separation either through OOHC or incarceration of young people (or members of their family) can have lifelong consequences for young peoples’ connection to family, Community, culture and Country. Further, transitions from OOHC as an adult or from detention back to Community can be very difficult for young adults.

In terms of social and emotional wellbeing, a majority (76%) of Aboriginal and Torres Strait Islander young people aged 15-24 years report being happy all or most of the time in the past 4 weeks (Australian Institute of Health and Welfare, 2018a).

However, it is important to note that nationally, one third of Aboriginal and Torres Strait Islander young people aged 15-24 report high to very high levels of psychological distress (Australian Institute of Health and Welfare, 2018a).

Not being able to find a job has been reported as the most common stressor (Australian Institute of Health and Welfare, 2018a). Importantly, it has also been found that having a carer with a greater number of stressful life events was associated with poorer mental health among adolescents (Williamson et al., 2016).

A study in New South Wales found that greater resilience among Aboriginal and Torres Strait Islander young people was associated with: having someone to talk to, family encouragement to attend school and engaging in physical activity (Young, Craig, Clapham, Banks, & Williamson, 2019).

The social determinants of health are the conditions in which people are born, grow, live, learn and work, which have a profound impact on health and wellbeing across the life course1. Aboriginal and Torres Strait Islander young people are diverse in their social, cultural, economic and physical living situations; however the social determinants of health are responsible for approximately 39 % of the health gap between Aboriginal and Torres Strait Islander and non-Indigenous Australians (Australian Institute of Health and Welfare, 2018b).

Housing, education, access to income, economic resources and employment are key determinants that influence the health and wellbeing of Aboriginal and Torres Strait Islander young people during adolescence and their life trajectories thereafter. These social and environmental determinants affect the health of young people living in cities and urban areas as well as those in remote areas (Andersen, Skinner, Williamson, Fernando, & Wright, 2018).

Furthermore, racism is a determinant of health, which has been associated with poor physical and mental health outcomes and increased risk for suicide among Aboriginal and Torres Strait Islanders

While the aforementioned social determinants of health are relevant to Aboriginal and Torres Strait Islander people, it is imperative to consider Aboriginal and Torres Strait Islander positive social determinants of health.

Some positive determinants of health include oral history, cultural survival, family support and connection, emotional wellbeing, community control, self-determination and affirmation of cultural practices (AbSec, 2019; Vickery, Faulkhead, Adams, & Clarke, 2007).

The formative years of adolescence are an important period for reducing inequities, promoting health, wellbeing and better access to health services to improve the current and future health of Aboriginal and Torres Strait Islander people.

The AAAH acknowledges

  1. Aboriginal and Torres Strait Islander young people are the experts in their own health and have agency in their health and health
  2. The importance of cultural, familial and kinship connections between young people today with past, present and emerging generations of Aboriginal and Torres Strait Islander peoples regarding health, wellbeing and
  3. Western pre-conceived notions of family units impact young people’s equitable access to services and culturally safe
  4. The ongoing role of colonisation, dispossession, racial discrimination and marginalisation in creating the economic and social disparity experienced by so many Aboriginal and Torres Strait Islander young
  5. Historical trauma, intergenerational trauma and racism are determinants of health and wellbeing, which are not adequately understood or addressed across multiple sectors, including the health
  6. Positive determinants of Aboriginal and Torres Strait Islander health and wellbeing include oral history, cultural survival, family support and connection, emotional wellbeing, community control, self-determination and affirmation and respect of cultural practices and Aboriginal and Torres Strait Islander ways of knowing and
  7. The social determinants of health are shaped by the distribution of money, power and resources; addressing these determinants requires political will and coordinated action in sectors beyond the health
  8. That the health sector needs to consider:
    1. Many Aboriginal and Torres Strait Islander young people have unmet health needs that reflect issues of inequity and inadequate access to appropriate services; these issues may be compounded for young people with intersecting identities due to greater discrimination and
    2. The importance of health services to be culturally safe, trauma-informed and responsive to the needs of young people and to local histories, needs and
    3. The Aboriginal community-controlled health sector are the leaders in providing culturally safe, holistic, accessible health care for communities, families and young people.
    4. The right of Aboriginal and Torres Strait Islander young people to have access to health-enablers beyond health care, employment and education, including frequently overlooked health enablers like safe and legal transport, and stable, safe and affordable
  9. The impact of forced separation from family and Community through OOHC and incarceration, including disconnection from Country and
  10. The following issues related to research and data:
    1. Aboriginal and Torres Strait Islander people have a right to data sovereignty and self- determination, which is “the right of Indigenous peoples to govern the collection, ownership and application of data about Indigenous communities, peoples, lands, and resources” (Bodkin-Andrews, Walter, Lee, Kukutai, & Lovett, 2019).
    2. Much of the research that drives policy and service provision is grounded in Western notions of empiricism rather than Indigenous knowledge systems and research methods.
    3. Risk and vulnerability are frequently (mis)used to account for health disparities without adequate consideration of social and structural inequalities created by racist policies and
    4. The limitations of existing data and statistical modelling to adequately capture and represent:
      1. Aboriginal and Torres Strait Islander peoples’ experiences of health and wellbeing
      2. The proportion of Aboriginal and Torres Strait Islander people living well and enjoying healthy
    5. The importance of emphasising the National Health and Medical Research Council’s ethical principles in underpinning ways of working with Aboriginal and Torres Strait Islander young peoples: Spirit and integrity, respect, reciprocity, equality, survival and protection, responsibility.

 

The AAAH recommendations

1.Our work with and for young people is guided by The Imagination Declaration written by young people and read at the 2019 Garma festival’s youth forum:

“set an imagination agenda for our classrooms, remove the limited thinking around our disadvantage, stop looking at us as a problem to fix, set us free to be the solution and give us the stage to light up the world.”

2.Principles to be guided by

    1. Connection to culture, Country and family is recognised as a determinant of health and wellbeing in its full
    2. Listening to the solutions that communities, families and young people already have
    3. Young people are recognised as the future leaders in determining priorities, aspirations and directions for their health and
    4. Policy, services, practitioners and researchers centre on young people, their views and their
    5. A rights-based approach to health enabling infrastructure to fulfil the right of young people to safe and legal transport, housing, education and culturally safe services. Health professionals, educators and researchers are in a powerful position to advocate for this and to highlight the costs (human, health, social and financial) of failing to ensure these issues are
    6. Aboriginal and Torres Strait Islander peoples’ experiences and understandings of family are recognised, including the importance of support from extended family and community networks for young people’s health and wellbeing, which should be incorporated into policies, programs and service delivery
    7. Aboriginal and Torres Strait Islander peoples will lead the discourse on Aboriginal and Torres Strait Islander peoples’ health and wellbeing to ensure decolonisation and self- determination.
    8. The responsibility to be informed and enact understanding of Australia’s history, including the legacy of colonisation, must be met by individuals, organisations, communities and governments.
    9. Investment in promoting cultural and historical knowledge to the broader community beyond schools and workplaces across

3.Health sector

      1. There is much that can and should be done to improve the likelihood that Aboriginal and Torres Strait Islander young people will access high quality culturally safe care. This means that both community owned and youth friendly health services are accessible to young
      2. The Aboriginal community-controlled health sector is recognised for leadership and expertise and this is reflected in appropriate indicators that reflect culturally safe and holistic health care
      3. The funding of Aboriginal community-controlled health organisations should be long term and sustainable. Wherever possible, funds for the provision of health care for Aboriginal and Torres Strait Islander peoples should be administered through Aboriginal Community Controlled health
      4. Access to timely, appropriate, high quality, culturally safe care within mainstream services including hospitals, allied health, community health, residential treatment facilities and non-government organisations – this means that services recognise that safety for young people is an ongoing process, and that the workforce is accountable for ensuring that Aboriginal and Torres Strait Islander young people receive the highest quality care that is culturally safe and free from
      5. An intersectoral approach is essential to good health and requires:
        1. Policy that recognises the social determinants of health and shapes investment in incentivised collaborative
        2. Holistic funding models that prioritise community led services and long-term investment.
  • Shared mutual understanding that centres on the needs of young people rather than prioritising competing
  1. Out of Home Care
    1. Addressing over-representation in OOHC is a priority and requires:
      1. Commitment to early intervention and prevention of child
      2. Investing in families through community led, holistic services that strengthen families and connections to
    2. The Aboriginal and Torres Strait Islander Child Placement Principle to be
    3. The AbSec – NSW Child, Family and Community Peak Aboriginal Corporation Plan on a Page for Aboriginal children and young people strategy provides a blueprint for reform to better meet the needs of young people, families and communities and address over-representation in
    4. The Family is Culture: Review Report 2019, provides insight into and recommendations of how to restructure the OOHC system to support Aboriginal and Torres Strait Islander children, families and
  2. Youth justice
    1. Ending over-representation in the youth justice system is a priority and requires:
      1. Investment in youth friendly diversion programs that are community led, including justice reinvestment
      2. Addressing social determinants that are drivers for contact with the youth justice system, including issues of trauma, mental health, early transition from school, unemployment, homelessness and substance
  • Action on inequitable policies that contribute to contact with the youth justice system, including fines enforcement and driver licensing
  1. Research and data
    1. Current conversations around self-determination and data sovereignty should be broadened to specifically include Aboriginal and Torres Strait Islander young people; this is not limited to health and medical data and includes multiple and vast digital footprints as well as lived experience and knowledge of young people and communities.
    2. Move beyond reporting of difference, deficit and disadvantage by developing meaningful indicators of Aboriginal and Torres Strait Islander peoples’ experiences of health and
    3. Research is grounded in First Nations knowledge systems and Indigenous research methods.
  2. Advocating for reforms outlined in the Uluru Statement From the Heart and for a constitutional voice in

Following the ‘Uluru Statement From The Heart’, in 2019, a group of young Indigenous people have gathered in East Arnhem Land for the Youth Forum at Garma. The forum has been facilitated by AIME and resulted in a Declaration for the Prime Minister and Education Minister’s across Australia – The Imagination Declaration.

This message was read out by Sienna on August 5, 10:00am at the 2019 Garma festival.

To the Prime Minister & Education Ministers across Australia,

In 1967, we asked to be counted.

In 2017, we asked for a voice and treaty.

Today, we ask you to imagine what’s possible.

The future of this country lies in all of our hands.

We do not want to inherit a world that is in pain. We do not want to stare down huge inequality feeling powerless to our fate. We do not want to be unarmed as we confront some of the biggest problems faced by the human race, from rising sea levels, which will lead to significant refugee challenges, to droughts and food shortages, and our own challenges around a cycle of perpetuated disadvantaged.

It’s time to think differently.

With 60,000 years of genius and imagination in our hearts and minds, we can be one of the groups of people that transform the future of life on earth, for the good of us all.

We can design the solutions that lift islands up in the face of rising seas, we can work on creative agricultural solutions that are in sync with our natural habitat, we can re-engineer schooling, we can invent new jobs and technologies, and we can unite around kindness.

We are not the problem, we are the solution.

We don’t want to be boxed.

We don’t want ceilings.

We want freedom to be whatever a human mind can dream.

When you think of an Aboriginal or Torres Strait Islander kid, or in fact, any kid, imagine what’s possible. Don’t define us through the lens of disadvantage or label us as limited.

Test us.

Expect the best of us.

Expect the unexpected.

Expect us to continue carrying the custodianship of imagination, entrepreneurial spirit and genius.

Expect us to be complex.

And then let us spread our wings, and soar higher than ever before.

We call on you and the Education Ministers across the nation to establish an imagination agenda for our Indigenous kids and, in fact, for all Australian children.

We urge you to give us the freedom to write a new story.

We want to show the world Aboriginal genius.

We want to show the nation Aboriginal leadership and imagination.

Over the coming months we’ll be sharing the declaration with thousands of Indigenous kids across our nation and together we’ll stand to say, “set an imagination agenda for our classrooms, remove the limited thinking around our disadvantage, stop looking at us as a problem to fix, set us free to be the solution and give us the stage to light up the world.”

We want the Imagination agenda in every school in the nation, from early childhood learning centres through to our most prominent universities.

To our Prime Minister & Education Ministers, we call on you to meet with us and to work on an imagination plan for our country’s education system, for all of us.

We are not the problem, we are the solution.

 

 

NACCHO Aboriginal #SexualHealth @atsihaw Resources and Events : Plus Dawn Casey ” NACCHO recognises the importance of the Aboriginal and Torres Strait Islander #HIVAwarenessWeek #WorldAIDSDay2019 “


“Exposure to STIs differs for Aboriginal and Torres Strait Islander people.

Our women are diagnosed with HIV, STIs and BBVs at a greater rate than other Australian women and are facing infertility, ectopic pregnancy, spontaneous preterm birth or still-birth.

NACCHO believes this requires greater recognition and commitment from all levels of government to work collaboratively across portfolios and mainstream organisations.

A good example is the current partnership between the Commonwealth Department of Health and NACCHO to address the syphilis outbreak, which has been extraordinary!

It highlights innovation in science and the great work done on the ground by Aboriginal health workers.

There is no better way to provide healthcare than through the 145 Aboriginal Community Controlled Health Organisations (ACCHOs), who deliver holistic, culturally safe, comprehensive primary healthcare across Australia, including those living in very remote areas

Studies have shown that ACCHOs are 23% better at attracting and retaining Aboriginal and Torres Strait Islander clients than mainstream providers. 

If funded adequately ACCHOs are the solution to addressing the increasing rates of STIs, BBVs and HIV/AIDS.”

Dr Dawn Casey, Deputy CEO of NACCHO who spoke at the 2019 parliamentary World AIDS Day breakfast this week. See continued NACCHO Press Release Part 1 and speech notes part 2 Below 

“ATSIHAW has grown bigger, with 132 ATSIHAW events to be held by 73 organisations across Australia this year – mostly in ACCHOs. ACCHOs have embraced ATSIHAW wholeheartedly and this has been key to ATSIHAW’s success.

Community engagement has been pivotal to the improvements in Australia’s HIV response and it’s time to focus on getting HIV rates down in our communities.”

South Australian Health and Medical Research Institute (SAHMRI) Head, Aboriginal Health Equity—Sexual Health and Wellbeing, A/Prof James Ward

Download the 30 Page PDF Report 

2019-SAHMRI-ATSIHAW-booklet

ATSIHAW 2019 dates are November 28 to December 5

View the ATSIHAW 2019 registered events on Facebook or below by state.

NSW | QLD | SA | VIC | WA | ACT | NT | TAS

See Web Page

Part 1 NACCHO Press Release continued 

The National Aboriginal Community Controlled Health Organisation (NACCHO) recognises the importance of the Aboriginal and Torres Strait Islander HIV Awareness Week (ATSIHAW) and the 2019 World AIDs Day to draw attention to the increasing impact of sexually transmitted infections (STIs) on Aboriginal and Torres Strait Islander communities.

In Australia, it has been recorded that the cases of new HIV diagnoses amongst Australians represent a decline of 23% in the last five years.

However, the HIV notification rates within the Aboriginal and Torres Strait Islander population in 2018 was more than twice the rate for the Australian-born non-Aboriginal and Torres Strait Islander people. Source: Kirby Institute

Australia is perceived on the global stage as a world leader in HIV prevention and treatment.

But considering the high prevalence of this issue in Aboriginal and Torres Strait Islander communities, NACCHO understands there is still some way to go.

Part 2 Dawn Casey Speaking Notes

World AIDS Day Parliamentary Breakfast – 27 November 2019

Traditional Owners of this land, the Ngunnawal and Ngambri People. I like to acknowledge other Aboriginal and Torres Strait Islander people in the room.

I would like to thank AFAO for inviting me here to speak this morning.

I would like to acknowledge the Hon Greg Hunt, Minister for Health, the Hon Chris Bowen, Shadow Minister for Health and all the Members of Parliament present here. It is just fabulous to see a bipartisan approach taken to this issue.

Exposure to STIs, HIV and BBVs differs for Aboriginal and Torres Strait Islander peoples. Research tells us that it is more likely attributed to heterosexual sex and injection drug use coming into our communities. And we know that Aboriginal and Torres Strait Islander women are diagnosed with HIV, STIs and BBVs at a greater rate than other Australian women.

This is extremely concerning as the next generation of Aboriginal and Torres Strait Islander women living in remote communities are facing infertility, ectopic pregnancy, spontaneous preterm birth or still-birth.

Let me remind you that there is no better way to provide healthcare than through Aboriginal Community Controlled Health Organisations (ACCHOs). They have been around here for many years and are established and operated by local communities, through locally elected Boards of Management, to deliver holistic and culturally safe and comprehensive primary healthcare.

They punch above their weight, with 145 services nationally providing about three million episodes of care each year for Aboriginal and Torres Strait Islander people across Australia, including those living in very remote areas.

ACCHOs provide culturally safe, comprehensive primary health care consistent with our people’s needs, this includes: home and site visits; provision of medical, public health and health promotion services; allied health, nursing services; assistance with making appointments and transport coordination; help to access child care or to deal with the justice system and drug and alcohol services.

Our people trust us with their health. Studies have shown that ACCHOs are 23% better at attracting and retaining Aboriginal and Torres Strait Islander clients than mainstream providers.

If funded adequately ACCHOs are the solutions to addressing the increasing rates of STIs, BBVs and HIV/AIDS. The current partnership between the Department of Health to address the syphilis outbreak has been extraordinary! It highlights innovation in science and the great work done on the ground by Aboriginal health workers.

I would like to leave with one message:

It is only with everyone working together that we will be able to help minimise the impact of STIs, BBVs and HIV/AIDS in the community. Mainstream organisations need to do their part and collaborate and work collectively with us.

Nationally, there is a high-quality network of Aboriginal controlled service providers that get results – understand them, connect with them and identify mutually beneficial areas to work together

Picture above Tim Wilson MP and his quote : At Parliament today, we gathered to remember & honour those lost to HIV/AIDS, redouble our efforts to stop new transmissions and stigma + mark tomorrow’s start of Aboriginal and Torres Strait Islander HIV Awareness Week.

Find out more here: atsihiv.org.au

Part 3 Health Minister Greg Hunt Press Release 

World AIDS Day is held on 1 December each year. It raises awareness across the world and in the community about HIV and AIDS.

It is a day for people to show their support for people living with HIV and to remember and honour those who we have lost.

In the 2019–20 Budget, the Morrison Government invested $45.4 million to implement Australia’s five National Blood-Borne Viruses (BBV) and Sexually Transmissible Infections (STI) Strategies.

These strategies will make a deep and profound difference in reducing the health impacts and stigma of BBV and STI, including HIV.

Today, I am pleased to announce that our Government will provide additional, ongoing support for people with HIV and other BBV and STI’s by extending funding to six national peak organisations, providing almost $3 million for 2020-21.

In addition, from 1 December 2019, Australians living with HIV will save more than $8,500 a year with the listing of a new combination medicine on the Pharmaceutical Benefits Scheme (PBS).

It is estimated that 850 Australians with HIV will benefit from the listing of Dovato® (dolutegravir with lamivudine) on the PBS, which will provide more choice for them in how they can manage their HIV.

Effective once daily treatments such as Dovato and other new medicines can control the virus so that people living with HIV can enjoy long, healthy and productive lives.

With the PBS subsidy, people living with HIV will pay just $40.30 per script, or $6.50 with a concession card for Dovato®.

Australia continues to be a world leader in the response to HIV. The number of new HIV diagnoses today is at its lowest in nearly 20 years.

Our success is built on a model of partnership between government, people living with HIV, community based organisations, health professionals and researchers.

We are seeing more people tested for HIV and initiating treatment for HIV. There are also more people living with a suppressed viral load. In addition, improved access to HIV prevention methods, including the PBS-listed pre exposure prophylaxis (PrEP), helps reduce the number of new HIV diagnoses.

We are also looking to address stigma and discrimination.

The Eighth National HIV Strategy 2018-22, guides our partnership approach over the next four years to virtual elimination of HIV transmission by 2022.

We aim to be one of the first countries in the world to eliminate new HIV transmissions.

NACCHO Aboriginal Health Workforce News : Indigenous GP Jacinta Power and @jcu medicine graduate is a “  powerful “ force for @TAIHS__ Aboriginal and Torres Strait Islander community controlled health

“I really love women’s health.  I get to see the pregnant women, the new babies and then the child.

There’s a spiritual connection there.  Whatever specialty I chose, it was always going to be something that would help my people, it’s definitely my area”

For Indigenous GP Jacinta Power she loves seeing women through their pregnancies, the birth of their babies and watching their children grow

Download full profile

Jacinta Power A4 Profile

The former JCU medical student Fellowed as a General Practitioner through JCU General Practice Training last year and is working with the Townsville Aboriginal and Islander Health Service (TAIHS).

Her goal, to use her skills to better the health of Aboriginal and Torres Strait Islander people.

Working in the Aboriginal medical service has allowed her to do just that.  A decision validated by a chance meeting with an Aboriginal Elder who helped set up Australia’s first Aboriginal Medical Service in Sydney’s Redfern.

“She came into TAIHS and she just broke down crying to see how far we had come.  From the early days when she was trying to set up the first service to being at TAIHS and to be seen by an Indigenous doctor was amazing.

“To her, that was the goal.  To get to the stage where we could be looking after our own mob.  That was a really special moment.”

Growing up on a farm in rural north Queensland Dr Power always wanted to work in health.  A desire driven by the loss of her brother to cancer as a child.

But as a shy teenager, she lacked the confidence to aim for medicine.  It wasn’t until she read the story of the inspirational African American neurosurgeon, Ben Carson that she felt she too could try for medicine.

Yet she still doubted her own ability.

“I honestly thought I couldn’t do it.  I graduated from a high school in a small rural town.  I think I was the first to go into medicine.”

Despite her misgivings, Dr Power secured a place in the JCU medicine degree, attracted to the program for its focus on rural, remote and Aboriginal and Torres Strait Islander health.

“I loved the fact that right from second year you went out into rural towns and learnt from doctors in those areas.  They’re very inspiring, their level of enthusiasm and knowledge is amazing.  It takes a lot to be a doctor in a rural town.  It’s really inspiring for students to learn in those settings.”

Dr Power believes the rural training gives students an edge going into their intern year.

“You learn a lot of skills in rural placements.  You certainly go into that year knowing you have a good set of skills.”

Having completed her GP training in rural and regional north Queensland, Dr Power is now giving back as a Cultural Mentor for current registrars.

“Having a cultural mentor gives registrars a support person.  If you come from a completely different cultural background you might not know certain practices and you might not understand why a patient acts in a particular way.  If they have a person they can ask and debrief with, it provides a more positive experience.”

“Each community is very different and having a cultural mentor in each of those places is definitely necessary.  It creates more support for registrars.”

While Dr Power is enjoying her general practice work, long term she’d like to focus on preventative health, which she sees as key to tackling chronic disease among Aboriginal and Torres Strait Islander people.

“I chose general practice because you are working in the community. I’d like to take it that step further and get involved outside the clinic as well.  To work on the root causes of the problems and so much of that is good nutrition.”

Eventually she’d like that to include a return to her farming roots and community food production, providing both employment and the foundations of good health.

But for now, she delights in her general practice.  In the mums she helps, the children she treats and the new lives she gets to meet.

 

NACCHO Aboriginal Health Research News : Download @LowitjaInstitut and @ourANU Aboriginal Health and Wellbeing Services – Putting community-driven, strengths-based approaches into practice

From the wide range of health and wellbeing practitioners we spoke to – which included nurses, midwives, Aboriginal health workers, therapists, caseworkers and more – there was clear sentiment that in a context of post- colonial power imbalance, Aboriginal people often experience inappropriate treatment in mainstream services.

There was agreement that community-driven, holistic and person-centred approaches are key to delivering better services, yet, increasingly, restrictive and metrics-focus funding regimes constrain what works. ” 

From Aboriginal Health and Wellbeing Services – Putting community-driven, strengths-based approaches into practice Report

Download 80 Page PDF here

Aboriginal_Health_and_Wellbeing_services_DD3_FINALwith_links

” Laynhapuy Health is responsive to a set of distinctly localised, Yolŋu ways of setting goals and priorities. The Traditional Owners, in combination with the local health workers, are effectively the ‘bosses’ of the Laynhapuy Health service.

They make broad decisions about the nature and pace of health delivery, in keeping with the broader self-determined ethos of the homelands movement (see the section on Laynhapuy Homelands self-determination movement).

The Aboriginal health workers, meanwhile, are responsible for the clinics in their communities (see the section Aboriginal health and wellbeing professionals).

Difficult decisions about local health are made in the first instance through adherence to Yolŋu conventions of reciprocity, relational obligation, custodianship and clan-based understandings of the right way to do things.

In the second instance, decision making in Laynhapuy Health is intercultural. The Laynha Health manager (and a range of other staff) regularly meet with community leaders, health workers and a wide range of community members on routine community visits, and the communities are the manager’s first point of contact for discussing new ideas or directions.

This is not always an easy task as it relies on subtleties beyond formal governance. The community needs to trust that the staff and clinicians of Laynhapuy Health will respect and adhere to the decisions made at a homeland level.

At the same time, the manager must ensure power in decision-making continues to reside with the Traditional Owners and the community, while also adhering to the clinical and bureaucratic conventions of biomedical systems.

As we explore here, time, communication and trust are crucial elements in making this work. However, at the heart of Laynhapuy Health’s model is a belief that the people of the homelands are best placed to make decisions about their own health care; in short, Yolŋu concepts of health create healthy Yolŋu.”

From page 32 Laynhapuy Health is an Aboriginal Community Controlled Health Service (ACCHS) operating in East Arnhem Land, Northern Territory (NT). It delivers comprehensive primary health care (CPHC) to Yolŋu people across the remote Laynhapuy Homelands

Executive summary 

This report explores strengths-based, bottom-up approaches to delivering Aboriginal health and wellbeing services.

It focuses on three case study organisations across two sites, all of which have reputations for maintaining highly positive relationships with their communities:

  • Laynhapuy Health is an Aboriginal Community Controlled Health Service (ACCHS) operating in East Arnhem Land, Northern Territory (NT). It delivers comprehensive primary health care (CPHC) to Yolŋu people across the remote Laynhapuy Homelands (see https://www.laynhapuy.com.au).
  • Waminda is an ACCHS that provides a range of health and wellbeing services to Aboriginal women and their families in the Shoalhaven region of New South Wales (NSW) and beyond. This includes general practice, antenatal and postnatal care, lifestyle programs, justice support, social enterprise programs and more (see waminda.org.au).

  • Noah’s is a community-based, not-for-profit organisation catering to children and young people with special needs and their families across the Shoalhaven. Their work includes National Disability Insurance Scheme (NDIS) services, childhood education, playgroups, and behaviour Noah’s has several programs specifically for Aboriginal clients (see https://noahs.org.au/).

Despite the substantial differences between the two field sites and the scope of the three organisations, there were strong commonalities between them in the approaches and challenges they raised.

For all three organisations, strengths-based approaches are inseparable from their community-driven, holistic design. The linking elements are their understandings of power structures and neo-liberal trends in a cross-cultural context in the Australian health and wellbeing sector.

This highlights that strengths always need to be understood in relation to constraints. For example, a narrow focus on strengths risks portraying individuals and communities as responsible for their situations, shading out wider relations of power and socio-economic inequality.

We found that all three organisations strike an important balance between confidence in the strengths of the communities they serve and represent, and consciousness of the constraints on their (and their clients’) room for manoeuvre in a post-colonial and increasingly neoliberal nation-state.

In many ways large and small, the organisations keep working at pushing those boundaries a little further – creating more room for autonomy and for strengths.

This report explores these dynamics, and, in the process, details the three organisations’ approaches and successes. This brings us back to many of the core issues that are well documented in relation to Aboriginal health and wellbeing, including the importance of community-driven design, holism, the social determinants of health, and person- and family-centred approaches.

This allows us to celebrate the organisations’ strengths and successes – highlighting ‘beautiful, big, positive’ stories, as one of our interviewees put it.

Throughout this report we have followed the terminologies of our case study organisations, participants, and/or source materials in our use of the terms ‘Aboriginal’, ‘Aboriginal and Torres Strait Islander’ and ‘Indigenous’.

The main section of the report details the organisations’ understandings of effective approaches in the sector, as they have sought to implement them. Although there is much overlap, we have divided this into three areas of focus:

Under the section What Works: Bottom-up approaches we explore broad, organisational issues relating to governance, program design and staffing.

  • Community-driven program design is fundamental to ensuring This requires building long- term relationships with communities that go well beyond superficial consultation.
  • Relationship building goes hand-in-hand with long-term learning based on local histories, culture and socio-economic
  • From these relationships and learning, innovative place-based services that are responsive to community needs and aspirations can
  • Crucial to these processes is having staff who are part of the community, but drawing on expertise and support from staff with a diversity of backgrounds can also help build robust structures and services and provide clients with a wider

Under the section What Works: Holism and wellbeing we then look at how the organisations think about health and wellbeing and what they incorporate within the scope of their work.

  • Much of the health sector treats illness in Aboriginal people, rather than promoting health and
  • Holistic health that addresses social determinants is preventative and protective. It can include supporting culture and language, connection to Country, spirituality, belonging and identity, strength of community and family, and empowerment and control.
  • Holistic health may seem broad, and therefore difficult to implement. However, because the organisations are in tune with community needs and aspirations, it is often clear to them which health-promoting services are most relevant in their context. For example, for one health organisation, enabling people to live and thrive in remote homelands communities is at the core of their work, while another explicitly promotes fitness, nutrition and career pathways among other things.

Under the section What Works: Delivering person- and community-centred care we narrow to a focus on effective approaches at the ‘clinical interface’ of the organisations’ work.

  • Much top-down intervention in the health care sector and beyond relies on externally identifying and seeking to fix Often systems operate based on practitioners’ ‘expert’ values and terms.
  • Person-centred care shifts the power balance and places clients’ needs, desires, goals, values and circumstances at the centre of the care
  • Related strengths-based approaches seek to shift the emphasis away from problems and negative labels through which a person’s or community’s identity can become defined, to instead recognising positive capabilities, goals and
  • All the case study organisations stressed the importance of their services being accessible on a regular and consistent basis. This was closely linked with making a long-term commitment to a place and a population, and building peoples’ familiarity with the service and their trust over
  • Consistency in service provision must be balanced with flexibility, adaptability and responsiveness based on community and client needs. In other words, consistently ‘being there’ for clients is important, but the form this takes need not be prescribed, rigid or
  • Brief consultation times, which are standard in the health care sector, are particularly sub-optimal in the context of Aboriginal health care for a range of reasons we detail. For example, building trust is essential,particularly in light of traumatic histories with institutional services and the prevalence of negative experiences in the health and wellbeing sector. However, building trust and rapport takes time.
  • All the case study organisations see brokering, advocacy and coordination of care as central to their work and success. This ranges from explaining to people the available services and talking them through what to expect, to (in the case of one organisation) escorting them on major hospital visits and translating between

While many of these themes are well-established ‘best practice’ in the health and wellbeing sector, the organisations had remarkably similar Challenges and Constraints in marrying bottom-up, holistic and person-centred approaches with top-down funding regimes.

  • Funding is typically for a specific purpose, falls within a siloed sector or assumes a certain set of realities. The purpose and scope of the funding is decided from the top down and it often assumes a compartmentalised approach to health and
  • Project and programme grants are also often relatively short-term. But, as noted, genuine community relationships take time to build, and many programs that address the social determinants of health are unlikely to show results in such timeframes. Even initiatives with a strong and consistent record of positive results over the long term can be defunded at short notice with little or no This is a threat to the consistency and regularity of services (factors that our participants identified as being so important). It is also a threat to staffing in a context where the organisations have strived to build up Aboriginal staff capacity and cross-cultural understandings, as it can result in the loss of long-term institutional knowledge and produce employment precarity.
  • The organisations are required to report on key performance indicators (KPIs). These are typically determined from the top down and are often strongly metrics-focused. There are frequent disconnects between what KPIs measure and what local organisations value, as well as frustrations that KPIs measure the ‘wrong’ things or fail to capture important successful activity. This is part of a broader international trend toward standardised statistical indicators, despite evidence that they often do not produce the desired

Drawing on the findings throughout the report, we make a range of recommendations for ways forward. These are targeted at funders, policy makers and associated stakeholders seeking to enable non- government organisations (NGOs) in the Aboriginal health and wellbeing field to work more effectively.

Funding that embraces holism, innovation and responsiveness

  • A prevalence of narrow, sector-specific funding may be impeding holistic health and wellbeing approaches, and those driven by community needs, values and More funding streams that allow organisations to define and respond to holistic health and wellbeing in their context are needed.
  • Designing bottom-up, holistic health and wellbeing services sometimes means innovating and taking risks. Funding streams that embrace innovation, but do not force it where it is unneeded, would benefit the

Longer term funding cycles

The availability of more long-term funding options will better allow organisations to design projects and programs from the bottom up. This includes organisations’ efforts to prioritise relationship building;

to address the social determinants of health; to ensure there is leeway for strategies to be tried and, if necessary, amended; to provide consistency of presence over time; and to help build a more skilled and stable workforce that includes training, learning and career development opportunities for Aboriginal and non-Aboriginal staff.

Co-designed KPIs

  • Funding providers should allow organisations the capacity to design or negotiate KPIs according to local realities and community-based aspirations, thereby allowing for greater local relevance, responsiveness and
  • Co-design of KPIs should be an ongoing, reflexive process, allowing for the mitigation of unintended consequences.

Narrative-based reporting

  • Reporting formats need to allow funding recipients the option and scope to detail progress, issues and outcomes in narrative/descriptive form. This may mean incorporating more open-ended questions in report
  • The capacity to integrate or attach multi-media (including videos, audio and photographs) is also merited.
  • Public servants and program managers need professional development in valuing and using qualitative information, and in the dangers of privileging statistical

Reducing over-reporting

  • It is incumbent on funding providers to ensure that reporting requirements and processes are efficient. This includes thinking carefully about how often reports fall due, how user-friendly the reporting templates are to complete, and whether the extent of what they ask applicants to produce is

Relationship building between funders and recipients

  • Policy makers and funders can gain a better understanding of the realities on the ground by talking directly to those implementing services in that Staff at funding institutions should be encouraged to view the funding relationship as a partnership, rather than as a hierarchicalrelationship in which the funder holds the power. It is, after all, usually the service provider that best understands the realities, needs and aspirations of the communities with which they work.
  • Organisations can feel that submitting reports on expended funding is like feeding information into a black hole; there is typically no engagement or feedback from the funding organisation and it is often unclear if or how the submitted information is (or might in future be) used. More transparency around the use of requested information is important, as is engagement with submitted reports.

Career public servants and time for learning

  • The Australian Public Service encourages professional mobility among its staff, but understanding Aboriginal Affairs requires relationship building, substantial cross-cultural knowledge, and comprehension of a range of complex and interrelated historical, socio-economic and political As such, there is strong merit in encouraging public servant stability and specialisation in Aboriginal Affairs.
  • Because knowledge of best practice, and cross-cultural understanding, are central to effective Aboriginal health and wellbeing policy, public servants need time for There is a vast amount of high-quality and accessible research and guidance material on these topics, as well as a plethora of other learning avenues such as courses and cultural immersions. It would be of enormous benefit for public servants to be encouraged to read such materials and to undertake learning opportunities on-the-job with allocated time to do so.

NACCHO Affiliates and Members Deadly Good News : #National Download the NACCHO 2018-2019 Annual Report #NSW @ahmrc #VIC @VACCHO_org Ballarat @VAHS1972 #QLD @QAIHC_QLD #NT @CAACongress #SA @AHCSA_ #WA @TheAHCWA

1.1 National : Download the 2018-19 NACCHO Annual Report

1.2 National : Our CEO Pat Turner presents to the Joint standing committee on the NDIS 

1.3 National : NACCHO Deputy CEO Dr Dawn Casey chairs a round table to discuss medicines priorities and challenges for Aboriginal and Torres Strait Islander people.

2. NSW : The November Edition of AHMRC Message Stick is out now!

3.1 VIC : In a Victorian first, the Andrews Labor Government has agreed with Aboriginal health organisations and Health Services to create a new forum to improve the health and wellbeing of Aboriginal Victorians across the state.

3.2 VIC : Ballarat and District Aboriginal Co-operative welcomes first patients into new $8 million medical and regional health hub

3.3 VIC : Deadly opening ceremony for new VAHS Epping Clinic in Melbourne’s northern suburbs

4. QLD : The Queensland Aboriginal and Islander Health Council (QAIHC) hosted their third annual Awards for Excellence , celebrating leaders, organisations and communities within the Sector.

5. NT : Congress ACCHO Alice Springs Care Coordination Team awarded Administrator’s Medal in Primary Health Care 2019

6. SA New traineeship pathway for AHCSA Aboriginal Health Practitioners

7. WA AHCWA’s Mappa team and Ash from Waitj Productions are on set at the Derbarl Yerrigan Health Service shooting the Mappa Promo video.

How to submit in 2019 a NACCHO Affiliate  or Members Good News Story ?

Email to Colin Cowell NACCHO Media 

Mobile 0401 331 251 

Wednesday by 4.30 pm for publication Thursday /Friday

1.1 National : Download the 2018-19 NACCHO Annual Report 

Download  in PDF from HERE 

1.2 National : Our CEO Pat Turner presents to the Joint standing committee on the NDIS 

Ms Turner:  Thank you for the opportunity to appear. We have already made a written
submission to the committee, so I hope that that answers most of your questions.

We are here to elaborate on any other points that the committee may wish to put to us.
It’s important that we point out that we serve Aboriginal and Torres Strait Islander people through our local and regional Aboriginal health services that are community controlled, with some 145 organisations spread throughout Australia.

We represent their interests in terms of policy and leadership. We work closely with both
the bureaucracy in Canberra and the minister responsible, where we have a very professional and productive ongoing relationship.

Aboriginal and Torres Strait Islander people are twice as likely to experience disability as other Australians. So there are nine per cent with a severe condition compared to four per cent for non-Indigenous people. Currently, 5.7 per cent of NDIS participants are Aboriginal and Torres Strait Islander people, with 16,417 active participants as of 30 June this year, which is considerably less than the percentage thought to have a significant disability.

The percentage of NDIS participants who are Aboriginal is indicative of the numbers of Aboriginal and Torres Strait Islander people with plans; however, it is not necessarily representative of the extent to which Aboriginal and Torres Strait Islander peoples are receiving assistance under those plans as a result of appropriate services not being readily available.

See pages 7-11 for Pat Turners presentation 

NACCHO Pat Turner NDIS

1.3 National : NACCHO Deputy CEO Dr Dawn Casey chairs a round table to discuss medicines priorities and challenges for Aboriginal and Torres Strait Islander people.

On Friday November 15th, NACCHO – the National Aboriginal Community Controlled Health Organisations – hosted a round table with Medicines Australia and representatives of its respective members to discuss medicines priorities and challenges for Aboriginal and Torres Strait Islander people.

The roundtable was also attended by Jo Watson, Chair of the Commonwealth HTA Consumer Consultative Committee.

NACCHO Deputy CEO Dr Dawn Casey  chaired the meeting and Evo Health consultants Renae Beardmore Sharon Musgrave acted as facilitators for the workshop.

The group discussed challenges and solutions to enhance medicines access for Aboriginal and Torres Strait Islander people by improving how PBS medicines are listed and how medicine supplies are maintained. The group also considered how quality use of medicines materials and activities may be improved.

Participants worked constructively to develop a list of co-designed solutions that will be taken back to their respective organisations for

2.1 NSW : The November Edition of AHMRC Message Stick is out now!

Read about Oceania Tobacco Control Conference, success stories from Waminda – South Coast Women’s Health & Welfare Aboriginal Corp. and The Glen Rehab, as well as how to prepare your service for #HIVAwarenessWeek2019.

Read more >> http://bit.ly/34alu2Y

3.1 VIC : In a Victorian first, the Andrews Labor Government has agreed with Aboriginal health organisations and Health Services to create a new forum to improve the health and wellbeing of Aboriginal Victorians across the state.

Establishing a state-wide body has been identified by Victorian Community as a vital step towards ensuring all parts of the Victorian health system are working together to improve health outcomes for Victoria’s Aboriginal people.

At last week’s roundtable senior representatives from the Victorian Government met with Aboriginal community controlled health organisations (including our Acting CEO Trevor Pearce), other health associations, peak bodies and the Australian Government.

It was a chance for Government to hear from leaders in Aboriginal health about their key priorities and to discuss how a future forum could work to advance initiatives that will have a real impact on Aboriginal lives.

VACCHO Chair and CEO of Ballarat and District Aboriginal Co-operative Karen Heap said “Finding effective solutions to the issues facing Aboriginal people must be driven by Aboriginal people working closely with Government and I am confident the new Forum will provide a much needed, high-level voice to ensure the most appropriate and effective way forward.”

3.2 VIC : Ballarat and District Aboriginal Co-operative welcomes first patients into new $8 million medical and regional health hub

The new dedicated stand-alone medical clinic and district health hub has welcomed its first patients and is now bringing communities throughout the greater western region of Victoria together.

With Aboriginal themes at the forefront of the design, this hub brings together high quality medical, health and community services under the one roof, so patients can get the treatment they need in a culturally welcoming environment.

Featuring ceiling lights curved in linear snake patterns, the facility also boasts a range of Aboriginal art as well as portraits of Elders and Founding Members to celebrate Aboriginal culture and promote understanding and respect within the community.

 

Integrating general practice rooms with specialist mental health and alcohol and other drugs consulting rooms allows for better coordinated care planning and greater interaction of services, including smoother cross referrals to the different services and programs offered by the Ballarat and District Aboriginal Co-operative.

Funding regional health infrastructure

The Victorian Government’s Regional Health Infrastructure Fund invested $6m towards this project, with the remaining $2.5m contributed by the Ballarat and District Aboriginal Co-operative to purchase the adjoining land.

The total investment allowed for the expansion of the existing premises and the build of the new facility to expand and create additional space for specialist medical and health-related services.

The Victorian Government established the Regional Health Infrastructure Fund to rebuild and refurbish rural and regional health facilities, ensuring all Victorians can access high quality care and facilities, no matter where they live.

3.3 VIC : Deadly opening ceremony for new VAHS Epping Clinic in Melbournes northern suburbs 

Image may contain: outdoor

Deadly opening ceremony for VAHS Epping Clinic. Officially opened by Life Member, Alan Brown, Long term board member, Tony McCartney and long term local community member resident, Tina Wright.

On behalf of VAHS, we acknowledge our ancestors work and in the spirit of community control, this clinic owned by the community, for the community.

4.QLD : The Queensland Aboriginal and Islander Health Council (QAIHC) hosted their third annual Awards for Excellence , celebrating leaders, organisations and communities within the Sector.

Established to recognise the hard work, determination and growth of the Aboriginal and Torres Strait Islander Community Controlled Health Sector (ATSICCHS), the awards acknowledge those that are making a real difference throughout their communities.

QAIHC Chairperson Gail Wason said the organisation was impressed by the number of nominations in each category for this year’s awards.
“The volume of nominations received by the Sector this year demonstrates the growth and success experienced in rural and remote communities across Queensland,” said Ms Wason.

“I am truly inspired by the dedication and commitment of the people who work within our Sector.”

“It is important to acknowledge individuals and organisations for the work they do in improving health outcomes for Aboriginal and Torres Strait Islander peoples in Queensland,” she said.

QAIHC Chief Executive Officer, Mr Neil Willmett is proud of the Sector and acknowledges the tireless work of individuals working for ATSICCHS in Queensland.
“Staff at our Member Services often go above and beyond to work towards providing their clients with exceptional care through every stage of their life,” said Mr Willmett.

The winners of the QAIHC 2019 Awards for Excellence are:

  • QAIHC Partnership Excellence Award – Institute for Urban Indigenous Health
  • QAIHC Innovation Excellence Award – Cunnamulla Aboriginal Corporation for Health
  • QAIHC Patient Satisfaction and Service Excellence Award – NPA Family and Community Services Aboriginal and Torres Strait Islander Corporation
  • QAIHC Leader of the Year Award – Veronica Williams and Gary White
  • QAIHC Member of the Year Award – Galangoor Duwalami Primary Healthcare Service.

The QAIHC Awards for Excellence were proudly sponsored by CheckUP, Health Workforce Queensland, Mazars, Hunter Promotional Products & Uniforms and Griffith University First Peoples Health Unit.

5. NT : Congress ACCHO Alice Springs Care Coordination Team awarded Administrator’s Medal in Primary Health Care 2019

Pictured (L-R): Rachel Godley and Balpalwanga Louise Maymuru (Laynhapuy Homelands Health), Her Honour the Honourable Vicki O’Halloran AO, Kathleen Hauth (Central Australian Aboriginal Congress) and Michelle Dowden (One Disease).

These awards celebrate and recognise the Northern Territory’s exceptional health workforce.

The Administrator’s Medals in Primary Health Care 2019 were presented on Thursday 21 November by Her Honour the Honourable Vicki O’Halloran AO, Administrator of the Northern Territory, at an official awards ceremony at Government House.

These medals recognise and reward health professionals, teams and whole practices/health services that have contributed significantly to the provision of primary health care in the Northern Territory.

The 2019 recipients are:

Individual Medal – Michelle Dowden, One Disease

Team Medal – Care Coordination Team, Central Australian Aboriginal Congress

Whole of Practice/Health Service Medal – Laynhapuy Homelands Health

Nominations were received for people, teams and practices/services from right across the Territory, including Darwin, Alice Springs and surrounding communities, Tennant Creek, Nhulunbuy and Galiwin’ku. The nominations also covered a diverse range of specialty areas, including nursing, dentistry, medicine, optometry, podiatry, physiotherapy, mental health, health promotion and health literacy.

‘Effective collaboration between individuals and teams working in primary health care in the Northern Territory is particularly important due to the inevitable challenges that remoteness poses to the delivery of high-quality health care,’ said Northern Territory PHN CEO Nicki Herriot.

‘The medal recipients are all fine examples of how to adopt innovative service delivery models to overcome these challenges.’ She continued, ‘it’s wonderful to have this annual opportunity to recognise them.’

More information on the winners:

Michelle Dowden – CEO, One Disease

Michelle has worked for 25 years in primary health care in the Northern Territory. Prior to her current role as CEO of One Disease, Michelle spent time managing the Ngalkanbuy Health Clinic and held the position of Director of Primary Health Services at Sunrise Health in the Katherine region. Michelle is admired for her innovative management style and people-centred approach to health care. She passionately delivered health promotion in the early days at the grass-roots level, travelling door-to-door in remote communities. She has worked on initiatives ranging from infant nutrition strategies to awareness campaigns designed to eliminate scabies and RHD. Michelle is commended for her long-term commitment to primary health care and her breadth of experience within the Northern Territory.

Care Coordination Team, Central Australian Aboriginal Congress

The Congress care coordinators go the extra mile in providing culturally appropriate and safe health and social services to their clients in Central Australia. They focus heavily on involving clients’ family and carers as this is central to providing holistic comprehensive primary health care. The care coordinators often bring up issues and identify gaps in service provision for their most vulnerable clients. For example, appropriate housing is an obvious and long-standing issue for many of the complex and often elderly clients. The care coordinators advocate heavily for those clients to ensure that their social needs are met, which is an essential step to improving their health outcomes.

Laynhapuy Homelands Health

The team at Laynhapuy Homelands Health is holistic, friendly and extremely passionate about their job. They service the homelands of East Arnhem Land for all primary health care needs. They drive hundreds of kilometres to service Homelands and deliver up to date clinical care, building incredible rapport with patients. Laynhapuy are commended for always searching for innovative ways to improve the health of those living in the Homelands. For example, they have begun running local grocery stores in homelands, keeping prices as they are at Woolworths. This allows people better access to food without paying up to a large taxi bill to get into town.

More information
The Administrator’s Medals in Primary Health Care are proudly sponsored by Northern Territory Primary Health Network, Aboriginal Medical Services Alliance Northern Territory, Health Providers Alliance Northern Territory, the Centre for Remote Health, CRANAplus, Northern Territory General Practice Education and the Northern Territory Government Department of Health.

6. SA New traineeship pathway for AHCSA Aboriginal Health Practitioners

“Our commitment is to invest in making our health system culturally safe and appropriately responsive for our Aboriginal communities.

“This involves full and ongoing participation by Aboriginal people and organisations in all levels of decision making affecting their health needs. “

Australian Health Council of South Australia CEO Nahtanha Davey said offering new traineeships pathways will enable the organisation to develop the next generation of upcoming Aboriginal Health Practitioners.

A new traineeship has been established to support Aboriginal Health Practitioners prepare for their vital role helping to improve health outcomes for Aboriginal and Torres Strait Islander communities.

Following an application from the Aboriginal Health Council of South Australia (AHCSA), the Training and Skills Commission (TaSC) has declared the Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care Practice a vocation, allowing the course to be delivered through a paid traineeship model for the first time.

Minister for Innovation and Skills David Pisoni says offering the qualification through an extensive two-year traineeship program advantages students, employers and patients.

“Traineeships and apprenticeships provide job seekers with a paid pathway to the skills, workplace experience and qualifications they need to establish meaningful careers,” Minister Pisoni said.

“The Marshall Liberal Government recognises this hands-on training model elevates motivated job seekers into capable employees and helps match growing industry demand for skilled workers – which is why our Skilling South Australia initiative aims to create more than 20,000 additional apprenticeships and traineeships over four years.

“The Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care Practice includes 800 hours of on-job practice – making it easier for students to build workplace confidence and master clinical skills.

“This change will support job creation, skill development, and a higher quality of tailored health services to Aboriginal and Torres Strait Islander people.”

Chair of the TaSC, Michael Boyce OAM, said elevating the Aboriginal Primary Health Care Practice course to a paid traineeship is a good example of how the training system can adapt and improve on the advice of industry.

7. WA AHCWA’s Mappa team and Ash from Waitj Productions are on set at the Derbarl Yerrigan Health Service shooting the Mappa Promo video.

NACCHO Aboriginal Health and @NDIS : Download @LowitjaInstitut 13 recommendations Report : Understanding disability through the lens of Aboriginal and/or Torres Strait Islander people – challenges and opportunities

” The 2011 Census indicated that Aboriginal and Torres Strait Islander people experience profound or severe disability at higher rates than non-Indigenous Australians at all ages, with 6.1% of Indigenous males and 5.4% of Indigenous females reporting a profound or severe disability.1

 The Australian Bureau of Statistics found in 2015 that Aboriginal and Torres Strait Islander people were 1.8 times more likely than non-Indigenous people to be living with a disability.2

 The First People Disability Network (FPDN) estimates that the current number of Aboriginal and Torres Strait Islander people nationally eligible for participation in the NDIS is around 60,000.3 “

From project background see part 2 below

Read over Aboriginal and health and NDIS articles published by NACCHO Here

Part 1 Download 13 recommendations report

Lowitja_UnderstandingDisability_291019_D4_WEB

Representing a major change in the way supports for people living with disability are funded, the National Disability Insurance Scheme (NDIS) presents both opportunities and significant challenges.

This project, Understanding disability through the lens of Aboriginal and/or Torres Strait Islander people – challenges and opportunities, was developed to examine the:

  • Implementation of the NDIS Aboriginal and Torres Strait Islander Engagement Strategy1
  • Interaction between National Disability Insurance Agency (NDIA) staff, local area co-ordinators (LACs) and Aboriginal Community Controlled Health Services (ACCHSs) and non-governmental organisations (NGOs)
  • Experiences of Aboriginal and/or Torres Strait Islander people in accessing the NDIS, planning, and receiving disability supports through the scheme

The research was conducted in collaboration with the MJD Foundation (MJDF) and Synapse, organisations which have longstanding connections with Aboriginal and/or Torres Strait Islander communities in the Northern Territory and Queensland respectively

Part 2 Background to project

From HERE

The National Disability Insurance Scheme (NDIS) represents a major change in the way the services and supports for people with disability are funded.

It presents both tremendous opportunity yet significant challenges.

Ensuring that Aboriginal and Torres Strait Islander people receive the same care as other Australians is an important human rights obligation. This project will improve the ability of the NDIS to achieve this.

At this stage, with the exception of an evaluation conducted in Barkly, very little is known about the roll-out of the NDIS to Aboriginal and Torres Strait Islander people.

This project will examine:

  • the implementation of the NDIS Aboriginal and Torres Strait Islander engagement strategy
  • the interaction between the National Disability Agency (NDIA) staff, local area co-ordinators and Aboriginal Community Controlled Health Services (ACCHSs) and NGOs
  • the experiences of Aboriginal and Torres Strait Islander people in accessing the NDIS program, planning and receiving the supports/services through the program.

Recognition that Aboriginal and Torres Strait Islander people with disabilities are not well served by mainstream services has led to strong advocacy and the development of culturally competent service models by the community controlled and NGO sector.

This project is a collaboration of 3 such organisations; Machado Joseph Disease Foundation (MJDF), Synapse and First Peoples Disability Network and the University of Melbourne.

The project will take a co-design approach to developing a study of the roll out of the NDIS for Aboriginal and Torres Strait Islander people.

Co-­design, or experience-based co-design, is not only a way to actively involve consumers in the design, delivery and/or evaluation of services but also enables the design of systems where consumer and carer experiences are central.4

Our approach to the project will bring together expertise from Aboriginal and Torres Strait Islander organisations working to provide services to people with disabilities, with researchers and policy makers.

The approach to design and data collection will support Aboriginal and Torres Strait Islander leadership, optimise existing data and knowledge, and develop local research capacity among Aboriginal and Torres Strait Islander people.

It will bring together community, researchers, providers, policy makers and NDIA staff and develop an evidence informed approach to improving the NDIS and developing a workforce to support it.

The project will involve four phases:

  1. Establishment of a project reference group
  2. Co-design
  3. Interviews
  4. Reporting and review.

It is expected that the project will identify strengths and weaknesses of the NDIS implementation. It will identify promising strategies to improve the ways the NDIA works with Aboriginal and Torres Strait Islander people and organisations.

Related resources:

NACCHO Aboriginal Health and @END_RHD #NACCHOAgm19 #ClosingTheGap #HaveYourSayCTG : Our CEO Pat Turners speech ” #RHD the greatest cause of cardiovascular inequality for Aboriginal and Torres Strait Islander people in this country. “

 ” Thank you for that introduction and warm welcome, and a special thank you to Minister Hunt for his commitment to Closing the Gap.

It is wonderful to stand here on the land of the Larrakia people in a room filled with such strength; with representation from Aboriginal and Torres Strait Islander people from around the country, all with a common goal: to improve the health and wellbeing of our mob.

Today I’m up here wearing two hats.

As CEO of NACCHO, and as Co-Chair of END RHD – an alliance of peaks, community and research organisations leading the work to end rheumatic heart disease in Australia.”

NACCHO CEO Pat Turner at NACCHO Members Conference see Part 1 Full Speech 

“Today is a game-changing step. Ending RHD is a critical, tangible target to close the gap in Indigenous life expectancy.

Our Government is building on the work of the Coalition to Advance New Vaccines Against Group A Streptococcus (CANVAS) initiative, by providing $35 million over 3 years to fund the creation of a vaccine that will bring an end, once and for all, to RHD in Australia.

The trials and development, led by Australia’s leading infectious disease experts and coordinated by the Telethon Kids Institute, will give hope to thousands of First Nations people whose lives and families have been catastrophically affected by this illness.”

The funding was announced in early 2019 by Indigenous Health Minister Ken Wyatt AM is being provided from the Medical Research Future Fund (MRFF).

Read NACCHO Aboriginal Health and RHD Articles Here

 “Aboriginal and Torres Strait Islander people know what works best for us.

We need to make sure Aboriginal and Torres Strait Islander voices are reflected and expertise is recognised in every way at every step on efforts to close the gap in life outcomes between Aboriginal and Torres Strait Islander people and other Australians.’

‘The Coalition of Peaks is leading the face to face discussions, not governments.

The Peaks are asking Aboriginal and Torres Strait Islander people to tell us what should be included in a new Closing the Gap agreement and we will take this to the negotiating table.’”

Closing the Gap / Have your say CTG online survey closes today Friday, 8 November 2019 see survey link Part 2 below

Part 1 Pat Turners Speech 

Most of you will know too well the devastation that rheumatic heart disease is causing to our people. Some of you will have lost family members and friends to RHD; some of you yourselves will be living with the disease; and as Aboriginal health workers, a lot of you will be the ones on the frontline administering the monthly injections that prevent heart failure, stroke, and death.

END RHD’s vision is simple: that no child born in Australia today dies of rheumatic heart disease. And in theory, it should be just that, simple, because RHD has already been eliminated in Australia’s non-Indigenous population. 94% of people who get RHD now are our mob.

It’s Aboriginal and Torres Strait Islander children who are most at risk of developing RHD – our kids, kids as young as five have open heart surgery. And without critical investment, the number of our mob living with the disease will triple to 15,000 over the next 11 years. That figure represents another 10,000 of our children developing a deadly disease that is preventable. We cannot let it happen.

Today, my END RHD Co-Chair, Professor Jonathan Carapetis, is going to talk about the RHD Endgame Strategy – a plan for us to prevent these unnecessary deaths; to eliminate the disease by 2031.

After him, we’ll hear from Raychelle McKenzie and her mother Noeletta. Raychelle was diagnosed with RHD aged 8. Half her life she’s been living with RHD, getting monthly injections to keep her heart strong.

But first, I want to tell you why ending RHD is so important to me.

As Aboriginal and Torres Strait Islander health professionals, the range of issues that require our urgent attention is extensive. Doing everything means that we rarely choose to focus on a single disease. There is so much to be done, we can’t afford to have ‘favourite’ diseases.

But RHD sticks out. It’s the greatest cause of cardiovascular inequality for Aboriginal and Torres Strait Islander people in this country.

We get it because of crowded houses, because a lot of our people don’t always have access to hot water, to showers that work, to washing machines that aren’t broken.

We get it because our clinics are overwhelmed with demand and sometimes skin sores and sore throats go untreated. We get it because rheumatic fever gets missed and sometimes it is too late for treatment.

At NACCHO, we became a founding partner of END RHD not because this disease is a simple fix, but because it is hard. Because it spans from housing to clinics to open heart surgery and exemplifies the gaps in the health system and in outcomes.

We are focusing on this disease because the only possible solution is a comprehensive, Indigenous-led, primary care-based strategy of both prevention and treatment.

Our people know what needs to happen to end RHD in this country. In fact, community-driven work is already underway across Australia; our communities are rising, demanding action, demanding support to prevent the next generation experiencing this unnecessary suffering.

But what we’ve been missing, is a blueprint that ties it all together. A collaborative strategy, involving community, government and research, that outlines what needs to happen, who needs to do it, and what it’s going to cost. A plan that has been informed by Aboriginal and Torres Strait Islander peoples and communities – our perspectives and expertise – and aligns with the community-controlled work and principles of the Coalition of the Peaks.

And that’s exactly what this RHD Endgame Strategy offers. If fully funded and implemented, not only will this strategy eliminate RHD, it will significantly help close the gap in health outcomes. Because by addressing the root causes of RHD, we will also eliminate other linked conditions like scabies, ear infections, and kidney disease that unfairly blight our people.

The RHD Endgame Strategy is research with an impact; a solution to RHD that we can all be part of, and I ask you all to get behind it.

Part 2 Closing the Gap / Have your say CTG online survey closes today Friday, 8 November 2019.

 

The engagements are now in full swing across Australia and this is generating more interest than we had anticipated in our survey on Closing the Gap.

The Coalition of Peaks has had requests from a number of organisations across Australia seeking, some Coalition of Peak members and some governments for more time to promote and complete the survey.

We want to make sure everyone has the opportunity to have their say on what should be included in a new agreement on Closing the Gap so it is agreed to extend the deadline for the survey to Friday, 8 November 2019.

This will help build further understanding and support for the new agreement and will not impact our timeframes for negotiating with government as we were advised at the most recent Partnership Working Group meeting that COAG will not meet until early 2020.

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

NACCHO Aboriginal cultural safety in health care: New @AIHW monitoring framework assesses progress in achieving cultural safety in the health system for Indigenous Australians

” For the purpose of developing a monitoring framework cultural safety is defined with reference to the experience of the Indigenous health care consumer, of the care they are given, their ability to access services and to raise concerns.

Some of the essential features of cultural safety include an understanding of one’s culture; an acknowledgment of difference, and a requirement that caregivers are actively mindful and respectful of this difference.

The presence or absence of cultural safety is determined by the experience of the recipient of care and is not defined by the caregiver (AHMAC 2016).” 

AIHW Online Report HERE

Or Download Summary

Cultural safety in health care_ monitoring framework

1.Culturally respectful health care services

Cultural respect is achieved when the health system is a safe environment for Indigenous Australians, and where cultural differences are respected. This module reports on how health care is provided, and whether cultural respect is reflected in structures, policies and programs.

The 2017–18 Online Services Report data showed that among Indigenous primary health care providers:

  • 95% had a formal commitment to providing culturally safe health care
  • 84% had mechanisms to gain advice on cultural matters
  • over 70% of organisations  with a formal board had over half of Board members who were Indigenous
  • nearly 4 in 10 provided interpreter services; while around one third offered culturally appropriate services such as bush tucker, bush medicine and traditional healing.
  • 41% of health staff employed in these organisations were Indigenous
  • almost all (99%) provided cultural orientation for non-Indigenous staff.

National health workforce data showed that from 2013 to 2017:

  • the number of Aboriginal and Torres Strait Islander medical practitioners employed in Australia increased from 234 to 363
  • the number of Indigenous nurses and midwives employed in Australia increased from 2,434 to 3,540.

See more info PART 2 Below for modules 2 and 3

Part 1 Cultural Safety Background

The concept of cultural safety has been around for some time, with the notion originally defined and applied in the cultural context of New Zealand. It originated there in response to the harmful effects of colonisation and the ongoing legacy of colonisation on the health and healthcare of Maori people—in particular in mainstream health care services.

A commonly accepted definition of cultural safety from the Nursing Council of New Zealand (2002:7) is the ‘effective nursing or midwifery practice of a person or family from another culture, and is determined by that person or family… Unsafe cultural practice comprises any action which diminishes, demeans or disempowers the cultural identity and wellbeing of an individual.’

A distinctive feature of this definition of cultural safety is its emphasis on the provision of culturally safe health care services as defined by the end users of those services, notably, the Maori people of Aotearoa New Zealand, not by the (non-Maori) providers of care.

The National Collaboration Centre for Indigenous Health in Canada (2013) notes that culturally safe health care systems and environments are established by a continuum of building blocks:

Cultural awareness ⟹ Cultural sensitivity ⟹ Cultural competency ⟹ Cultural safety

The centre states that cultural safety ‘…requires practitioners to be aware of their own cultural values, beliefs, attitudes and outlooks that consciously or unconsciously affect their behaviours. Certain behaviours can intentionally or unintentionally cause clients to feel accepted and safe, or rejected and unsafe. Additionally cultural safety is a systemic outcome that requires organizations to review and reflect on their own policies, procedures, and practices in order to remove barriers to appropriate care.’

In Australia, there has been increasing recognition that improving cultural safety for Aboriginal and Torres Strait Islander health care users can improve access to, and the quality of health care. This means a health system where Indigenous cultural values, strengths and differences are respected; and racism and inequality is addressed.

There are difficulties in both defining and measuring generalised concepts such as cultural respect and cultural safety. They include lack of conceptual clarity and agreement on terms, the qualitative nature of the concepts, and the diversity of Indigenous Australians and their perceptions.

The Australian literature uses various definitions of cultural safety, and related concepts such as cultural respect and cultural competency, and what these mean in relation to the provision of health care.

For the purpose of developing a monitoring framework cultural safety is defined with reference to the experience of the Indigenous health care consumer, of the care they are given, their ability to access services and to raise concerns. Some of the essential features of cultural safety include an understanding of one’s culture; an acknowledgment of difference, and a requirement that caregivers are actively mindful and respectful of this difference. The presence or absence of cultural safety is determined by the experience of the recipient of care and is not defined by the caregiver (AHMAC 2016).

Two important aspects of culturally safe health care across the literature are, how it is provided and how it is experienced, and these form the basis for the monitoring framework (see AHMAC 2016; CATSINAM 2014; AIDA 2014; DHHS 2016; NACCHO 2011; Department of Health 2015).

How health care is provided

  • behaviour, attitude and culture of providers: respects and understands Indigenous culture and people
  • defined with reference to the provision of care, including governance structures, policies and practices

How health care is experienced  by Indigenous people

  • feeling safe, connected to culture and cultural identity is respected
  • can only be defined by those who receive health care

The importance of cultural respect and cultural safety is outlined in Australian government documents such as the Cultural Respect Framework 2016–26 for Aboriginal and Torres Strait Islander Health, and the National Aboriginal and Torres Strait Islander Health Plan 2013–23.

The Australian Commission on Safety and Quality in Healthcare (ACSQHC) also included six Aboriginal and Torres Strait Islander specific actions in the National Safety and Quality Health Service Standards to improve care for Aboriginal and Torres Strait Islander people in mainstream health services.

 Part 2 Summary

The cultural safety monitoring framework covers three domains: the first focusing on how health care services are provided, the second on Indigenous patients’ experience of health care, and the third on measures regarding access to health care.

Data are reported from a wide range of available national and state and territory level sources to provide a picture of cultural safety, though there are significant data gaps. Sources include both national administrative data collections and surveys of Indigenous health care users.

2.Patient experience of health care

The experiences of Indigenous health care users, including having their cultural identity respected, is critical for assessing cultural safety. Aspects of cultural safety include good communication, respectful treatment, empowerment in decision making and the inclusion of family members.

National survey data show that:

  • in 2014–15, an estimated 80% of Indigenous Australians who consulted a doctor/specialist in the last 12 months said that their doctor always/often listened carefully, while an estimated 85% said that their doctor always/often showed respect for what was said.
  • in 2012–13, an estimated 20% of Indigenous Australians reported being treated unfairly by health care staff in the last 12 months.

The differences in rates of Indigenous and non-Indigenous hospital patients who choose to leave prior to commencing or completing treatment are frequently used as indirect measures of cultural safety. Among:

  • emergency department presentations in 2015–16, around 8% of Indigenous patients and 5% of non-Indigenous patients took own leave or did not wait
  • hospitalisations in 2013–15, around 3% of Indigenous and 0.5% of non-Indigenous patients left against medical advice or were discharged at their own risk.

3.Access to health care services

Indigenous Australians experience poorer health than non-Indigenous Australians’, but they do not always have the same level of access to health services. This is due to a range of different reasons, including remoteness and affordability. Selected measures of access to health care services for Indigenous and non-Indigenous Australians are used to monitor disparities in access.

  • BreastScreen participation rates for the two year period 2016–2017 for Indigenous women were 27% compared with 34% for non-Indigenous women.
  • Indigenous Australians waited longer to be admitted for elective surgery in 2017–18 than non-Indigenous Australians (median waiting time of 48 days and 40 days, respectively).
  • In 2015, the potentially avoidable mortality rate for Indigenous Australians was over 3 times the rate for non-Indigenous Australians (345 and 105 per 100,000 respectively).

Data gaps

Monitoring cultural safety and cultural respect in the health system, and the impact it has on access to appropriate health care, are limited by a lack of national and state level data. This is particularly the case in relation to reporting on the policies and practices of mainstream health services, such as hospitals and primary health care services.

There is also limited data on the experiences of Indigenous health care users. Most jurisdictions undertake surveys about patients’ experiences in public hospitals, but there was  not a lot of available data on Indigenous patient experience. A high proportion of Indigenous Australians use mainstream health services, so further data developments in this area are required to allow for more comprehensive reporting across the health sector.

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