Strategies and Approaches in

Aboriginal HealthDr Ross Bailie

Associate Professor in Public Health

FlindersNT Clinical School

Menzies Schoolof Health Research

Ph 08-89228835 or 08-89228196Fax 08-89275187

email: ross.bailie@menzies.edu.au

I believe that all those employed in the medical professions must undertake the difficult task of recognising, in all its implications, that, by definition, health work is political work. If the health professions ignore the shocking state of Indigenous health in this country then they exacerbate the problems of history. On the other hand, if they take the initiative to act, to advocate and to work for significant change, they assist in the crucial work of reconciliation between black and white Australians. This stance inevitably requires a commitment to radically reformist positions about health.

Lowitja O’Donoghue 1999

LearningObjectives

PerformanceObjectives

Sources of information and Acknowledgements

• Australian Indigenous Health Infonet web site

• National Aboriginal and Torres Strait Islander Health Strategy

Background

• Lack of progress• Shifting responsibility• Competing interests• Assimilation• Funding pressure• Poor coordination

Background(continued)

• Control

• Treaties

The National Aboriginal Health

Strategy

National Aboriginal Health Strategy

(continued)

• Social and Physical environment

• Self-determination• Health hardware• Major identified problems

National AboriginalHealth Strategy (continued)

• Failure of implementation

• Office of Aboriginal and Torres Strait Islander Health (OATSIH)

Five key strategies

• Infrastructure• Self-determination• Access to community

controlled services• Adequate resourcing• Skilled workforce

Infrastructure

• Housing• Water• Sewage• Roads• Communication• Educational facilities• Health facilities

Infrastructure (continued)

• Intersectoral responsibilty

• Infrastructure standards

Self-determination

• Community control

Access to community controlled health services

• AMS’s• Patchy access• Comprehensive services• Poor coordination with

the mainstream

Adequate resourcing

• Resourcing levels are inadequate

• Urban/rural/remote disparity

Skilled workforce

• Education strategy• AHWs• Health professionals

NewSolutions?

Framework Agreements

• Governments, ATSIC, NACCHO

• National Council of Aboriginal and Torres Strait Islander Health

Coordinated Care Trials

• Community control

• Cashing out of MBS and PBS

• Coordination of care

Priority specific health issues

• Chronic disease

• Communicable disease

• Social and emotional wellbeing

Comprehensive Primary Health Care

• Healthy public policy

• Prevention and health promotion

• Better management

Conclusion

• Poor record• Fundamental strategies• Recent initiatives• Reconciliation• Underlying determinants

References• Anderson I. The National Aboriginal Health

Strategy. In Health Policy in Australia. Editor Gardner H. Oxford University Press 1997.

• Guthridge S, Cairnduff S, Gollow P, Pearce M, Kennedy K. Structure, Function and Health: a review of the health impact of infrastructure change in remote Aboriginal communities in the Top End. Territory Health Services 1999.

• Kunitz SJ. Disease and social diversity: the European impact on the health of non-Europeans. New York: Oxford University Press, 1994