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Enhancing Health Care Equity with Indigenous Populations

Aboriginal and Torres Strait Islander people traditionally regarded as economically and socially disadvantaged (Li, 2017). The health plan addressed the social determinants of the Aboriginal Torres Strait Islander people which provides a wider lesson on cultural based evidence that can improve the wellbeing of Aboriginal and Torres Strait Islander people. The lesson provided instilled me on the gap that has led to the marginalization of the Aboriginal and Torres Strait Islander people. The contemporary issues helped me in identifying the key relationship between Torres Strait Islander and non-indigenous Australians. This reflective essay on Indigenous Health contemporary issue highlights the understanding of cultural identity and health practice.

The life expectancy records show contrast compared to the non-indigenous counterpart. The new idea that I learned through historical practice is the need to develop culturally sensitive practice. The course experience has given me an understanding of colonial practice and its impact on the community. The historical lesson and watching Utopia showed the grim assessment of the Aboriginal and this helped me witness the plight of the indigenous population living in poor condition and more insidious harassment that shows the abuse and bullying has not ended still. I through course readings got a deeper understanding of facilities such as Lock hospitals. The course experience has changed my perspective towards the Aboriginal and Torres Strait Islander people. I watched the move Utopia and found the title ironic as native Aboriginals district set aside with a description of physical, mental legislative indignities, and the systematic violation of their rights. Utopia uncovers the condition of first people who suffered police brutality and harassment campaigns. It made me question the historical practice of discriminatory conduct with Indigenous suffering from poor health and poverty. The earth-worker describing the multitude of preventable disease suffered by inhabitants highlights the poor health care and its compounding impact on the Aboriginal community (Utopia, 2013)

In my opinion, health care professionals should reach out to colleagues in case of culturally insensitive behavior. In indigenous relationally, strong female governance has always central to cultural diversity. The survival of indigenous relationally is supported by the indigenous women's knowledge system. The importance of antenatal care helps women and treat conditions that threaten the health of newborns as a critical measure was unknown to me. According to (Muise, 2019) 6% of Australian births are to Aboriginal, and the disparity between the non-indigenous population has led to the non-optimization of mainstream services to women. I agree with the author that providing good antenatal care for Aboriginal and Torres Islander women will improve the health of women through mainstream services. My observation on the birthing data for Aboriginal and Torres Islander women showed poor access to a medical condition, I was appalled with ongoing health engagement. The significant disadvantage in infant experience is centered on the observation of a high level of fear and anxiety among women. The attendance further reflected o inefficient communication, poor service coordination. My reading experience on the Aboriginal experience signifies health advantage mainly in the key area of life expectancy. I believe health services can contribute to the reduction in coexisting health disparity between Aboriginal and non- Aboriginal women. The key areas that require a change in the association are overcoming health service, cost, geographical location, and unsafe delivery and practice. In remote areas, the health preprofessional are inadequately trained to work cross-cultural compounding the situation worse resulting in poor health care (Clarke, 2014). Improvement in the continuity of care among child and family to antenatal care and continuity of care for Aboriginal families will result in positive care experiences. The key term identified Yatdjulgin that translates in talking in a good way which is reflected in the passing of knowledge about the country and its resources. The learning helped me known about Indigenous Australians which I found was perplexing reading the pre-invasion of the health system. I realized the importance of nurses in the health system and health care delivery.

The common themes of cultural obligations and taboo was followed by Grandmother’s law. This involved practice of involving senior women during the time of pregnancy (Best, 2017). I experienced through the reading traditionally women didn’t receive optimum care as with traditional knowledge brutal treatment of Aboriginal men, women, and children who were removed from Western Australia and taken to lock hospital were taken to lock hospital and were subjected to horrific experience. 

Ramsden's process of cultural safety reflected a three-step process from cultural awareness to cultural safety. I agree with Ramsden’s emphasis on cultural safety in the nursing and midwife curriculum. Cultural safety can be developed through nursing and midwifery education to be defined by those who receive it (Best, 2017). Nurses and midwives who do not receive cultural safety education may develop stereotypes, misleading myths to guide them on their attitude towards Indigenous Australians. Aboriginal and Torres Strait Islander women face several challenges when they encounter mainstream health services. they are linked to family and kin that takes precedence over their needs. They prioritize relationships, hence developing relationships is critical in delivering service. the aboriginal and Torres islanders have a higher birthing rate. The maternal risk factors in my opinion have impacted life expectancy. the fear and mistrust prevent them from access to good health.

The increased focus on Aboriginal and Torres Islander women to become midwives would highly improve cultural safety. I strongly feel that supporting indigenous women training in midwife practice will support cultural safety and improve outcomes of Indigenous women. The availability of care is strongly advised to improve the chances of a healthy baby. Integrating Aboriginal health service and strong communication in Aboriginal and Torres Aboriginal and Torres Strait Islanders as effective midwife care will improve the health outcomes. The CATSINaM definition of Aboriginal health affirms Australians are more likely to seek access to healthcare and chive health outcomes by accessing services that are respectful and culturally safe places (CATSINaM, 2014). The importance of cultural safety and respect in the delivery of service is more holistic. I agree with the definition placed that experience of cultural safety and respect in health settings can be described at individual and institutional levels. A potential solution can be are cultural safety training program to be implemented among target health workers in Australia. Cultural safety requires the physical, social, and cultural wellbeing of the individual. the presence of male doctor and midwives are direct contravention of the law(Rigby et al. 2011).

There have been significant changes in health care professional practice. Task shifting in unregulated health care workers in my observation has more disadvantages than advantages. This has resulted in a lack of clear policy, planning, monitoring, and equitable coordination of care. NATSHIWA has developed a professional practice framework to help health workers, health managers caring for the community, providing culturally safe care, and leading and developing self and others (Clarke, 2014). NATSIWHA professional practice framework is essential took for nurses to use while working with an indigenous health worker. The Grandmother's law has been taught by grandmothers to traditional midwives, some of these rituals use of bush medicine was helpful. The significance of Grandmother's law has diminished and has become alien in current settings. The law helped in women's support for women to prevent the feeling of being ashamed. Linking contemporary practice to traditional skills will help to keep the baby safe the increase in cultural safety will remove the concern related to health, contraception, and breastfeeding.

I learned about the urban and regional settings specific issues for Aboriginal and Torres Strait Islanders. One of them was encompassing a term named women business for all social, spiritual, cultural, and ceremonial beliefs. I agree with the statistics that can be improved by improving maternity healthcare. The key importance of recruiting and retaining Indigenous nurses will improve the midwifery workforce. The delivery program that is designed to add Indigenous midwifery will help in closing the gap. The key regulations that are centered to ensure safety and quality of health services are the Health Practitioner Regulation National Law Act 2009 (Australian government, 2013). I found that Indigenous health workers for the NRAS provide the development of health professionals to ensure public safety and quality. Indigenous health workers have been valued for their roles as cultural brokers. Comparatively the experience of discrimination against Aboriginal and Torres Islander have been regularly reported. The figures showed 30% of participants identified health settings as a source of racist experience (Humphrey, 2004). The health professional framework nurse-client relationship based on a therapeutic relationship will act as a form of professional care provider and care recipient. While in remote and regional settings I observed that dual relationships are common. I strongly believe that ethical and social dilemmas relating to family conflict, coordinating it air hours and client confidentiality might hamper the work of professional workers. My recommendation will be to work in the delivery of holistic care to the entire community to alleviate the pressure from Indigenous health workers to foster inter-professional collaboration. The biomedical is different from traditional practice for Aboriginal childbirth as part of Women's business. The power imbalance can be shifted through working in collaboration, midwives can actively participate address the vulnerability( Rigby et al, 2011). Ensuring women give consent and demonstrate sensitivity to cultural practice. History has shown that Aboriginal are restricted to lower-income jobs. The implementation of colonial policies that targeted Aboriginal and Torres Strait Islander people resulted in the emotional and ill health of the people. From the time of colonialism, Indigenous Australians have not enjoyed health and social equity. The health of Aboriginal and Torres Islanders is recognized as a social justice issue. The course study provided insights on the gap despite government initiatives as closing the gap. I found Ramsden's work in cultural safety as significant in helping people to become aware of social conditioning. The challenges observed by nurses highlight discrimination, cultural clashes that influence the practice of Indigenous nurses. The key lectures on Aboriginal health showed nurses and midwives are a significant force in the health care delivery system for Aboriginal and Torres Islander people. Community control provides a strong model for delivering health services to meet communities' needs.

The Grandmother's law has been taught by grandmothers to traditional midwives, some of these rituals use of bush medicine was helpful. I learned about the urban and regional settings specific issues for Aboriginal and Torres Strait Islanders. One of them was the encompassing a term named women business for all social, spiritual, cultural, and ceremonial belief. I agree with the statistics that can be improved by improving maternity healthcare The sociocultural and emotional awareness are important to construct of Aboriginal and Torres Islander. The OCAP principle states ownership, control, and access will help to build cultural safety and demand for equality, respect, and control by Aboriginal and Torres Islander people (Brown, 2016). The inequality of health is rooted in social inequality reinforcing building social inclusion and a safe environment.

A delivery program that is designed to add Indigenous midwifery will help in closing the gap. The law helped in women's support for women to prevent the feeling of being ashamed. Linking contemporary practice to traditional skills will help to keep the baby safe. The increase in cultural safety will remove concern related to health, contraception, and breastfeeding. Most Indigenous healthcare workers in remote areas have a greater clinical capacity. I disagree with the current shift of listed from nurses to an indigenous health professional, as this could be due to the convenience of the health manager. Improving health care services by supporting midwives will help to improve cultural equity.

Reference for Indigenous Health: Contemporary Issue

Australian government. (2013). National Aboriginal and Torres Strait Islander health plan 2013–2023. Retrieved from https://www1.health.gov.au/internet/main/publishing.nsf/content/B92E980680486C3BCA257BF0001BAF01/$File/health-plan.pdf

Best, O & Frederick, B. Yatdjuligin. (2017). Aboriginal and Torres Strait Islander Nursing and Midwifery Care. Cambridge University Press

Brown et al. (2016). Enhancing health care equity with Indigenous populations: evidence-based strategies from an ethnographic study. BMC Health Services Research. 16(1), DOI:https://doi.org/10.1186/s12913-016-1707-9

CATSINaM. (2014). Cultural Safety position Statement. Retrieved from https://www.catsinam.org.au/static/uploads/files/cultural-safety-endorsed-march-2014-wfginzphsxbz.pdf

Clarke, M.& Boyle, J. (2014). Antenatal care for Aboriginal and Torres Strait Islander women. Aust Fam Physician. 43(1):20-4. PMID: 24563888.

 Humphrey, M & Keating, S. (2004). Lack of antenatal care in far north Queensland. Australian and New Zealand Journal of Obstetrics and Gynaecology. 44(1), 10-13

Li, J. (2017). Cultural barriers lead to inequitable healthcare access for aboriginal Australians and Torres Strait Islanders. Chinese Nursing Research. 4(4), 207-210

Muise GM. (2019). Enabling cultural safety in Indigenous primary healthcare. Healthcare Management Forum. 32(1):25-31. DOI:10.1177/0840470418794204

Pigler, J. (2013). Utopia. Retrieved from http://johnpilger.com/videos/utopia-subtitled-version-

Rigby et al. (2011). Closing the Gap: Cultural safety in Indigenous health education. Contemporary nurse. 37(1), 21-30

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