• Internal Code :
  • Subject Code : NSB202
  • University : Queensland University of Technology
  • Subject Name : Public health

Aboriginal Community Controlled Health Services (ACCHS)

Introduction

Aboriginal communities of Australia do not have any access to good healthcare facilities in the past, and also no attention was paid to their cultural needs. The community experienced a lot of mortality in the younger population. The lack of health care created a large gap in health among Australian aboriginal people and the remaining Australian population (NACCHO, 2019). The Government of Australia has started many programs aimed at providing the indigenous population with greater access to health services improving life expectancy and reducing mortality. Apart from that, the aboriginals created their own healthcare system that is run and operated by themselves. They founded Aboriginal Community Controlled Health Services (ACCHS) who focuses on providing holistic treatment to aboriginals of Australia. This essay is on the role of ACCHS in providing good health care facilities to the aboriginals (Davy, Harfield, & McArthur, et al., 2016).

ACCHS and its role in taking care of the health needs of Aboriginals.

ACCHS stands Aboriginal Community Controlled Health Services, an organization started by the aboriginal population for the betterment of their health. ACCHS was developed across Australia to provide culturally appropriate and responsive and holistic health care services. The organization is controlled by the management board which is elected by the indigenous people. A holistic approach to treatment is not about treating the physical ailments it goes much beyond it. It also deals with the individual mental-psychical-social and his relationships at that point in time. Holistic health needs to take into account a person 's overall well-being and aspects that affect the well-being of people, including economic needs (Panaretto, Wenitong, Button, & Ring, 2014).

A person's general state of health is determined by many factors including factors of personal behavior, external environment, and factors of the host. Holistic wellbeing includes individual spiritual, cultural, social, and emotional needs, and response to disease. The nurses taking care of patients should ensure that the patient is receiving holistic health care. The patient should be given the necessary medication, social support, along with the emotional or psychological support by interacting with them. The nurses should also try to build relationships and confidence with patients by offering self-care instruction and spiritual assistance. In ACCHS, holistic wellbeing means understanding the culture of indigenous peoples and how it affects their health, accessibility to services, and lifestyle of individuals (Eckersley, 2007). It eliminates barriers of the past that prevented effective access to primary care, including different social health determinants among Aboriginal people. The ACCHS integrates the culture of Aboriginal and Torres Islander people into primary care services.

ACCHSs vs GPs in providing care

ACCHS was designed with an aim to address the health-related issues of Australian aboriginals’ people. The idea was to fill the gap in health care facilities by ensuring equality to access healthcare services. Aboriginal organizations integrated ACCHS and transformed it into a local community of aboriginals, hiring staff from the local population of aboriginals, and delivering qualified health care services which take care of their cultural needs. Currently it is known that the ACCHS offers indigenous people the more effective health care services. This means ACCHS is one of Australia's most culturally secure health-care facilities for aboriginals’ people. The ACCHS also looks after the implementation of holistic healthcare principles of the indigenous people (Harfield, Davy, McArthur, et al. 2018).

The General Practice Services (GPS) of Australia have suffered seriously in delivering good health care services to the indigenous Australian population. Due to complex socio-cultural factors, aboriginal youth and children in need of psychiatric treatment faced challenges navigating the Australian health care system. This condition was observed even in other GPS healthcare units. Holistic wellbeing usually includes addressing all factors which can influence the health of individuals. The GPS did not consider the cultural dimensions of indigenous people which failed them to provide holistic care and primary health care services to this community (Davy, Harfield, & McArthur, et al., 2016).

ACCHS holds a strong capacity in maintaining a healthcare environment inclusive of the cultural needs and to take full account of the holistic patient safety needs as it was developed by the community itself. In contrast, General Practice has struggled to create a culturally healthy health-care system for Australian aboriginal communities. It was developed to meet the health-care needs of the Australian population in general. The general practice services did not have any special concern about indigenous peoples' and about their cultural needs that will help them in a healthy life. Given the fact that GPS is built for holistic treatment its failure to recognize cultural factors in the health of indigenous people makes it poorly perform in delivering holistic health care (Australian Human Rights Commission, 2019).

Role of the Aboriginal and Torres Strait Islander Health Worker (ATSIHW)

A person with clinical experience and experience in providing primary health care can have credentials of ATSIHW. These worker plays a vital role in delivering primary and comprehensive health services to the local organizations, families, and any other person seeking help for health care. Their specialties can vary from small ailments to psychological problems to drug abuse problems. The shared aim of ATSIHW is to help the Indigenous and Torres Strait Islanders take to understand, regulate, and manage their own lifestyle and wellbeing (Australian Indigenous HealthInfoNet, 2020). The main duty of these workers is to provide health care involving the cultural needs and health awareness. The ATSIHW also help to serve as communicators, interpreters, treating accidents and illnesses, and keeping track of medical records.

When the interdisciplinary team of people having different expertise work together and combine their knowledge and skills to help the patient heal from the ailment, the chances of good results are high. The ATSIHWs and nurses need to have good communication between them when they are working together (Australian Medicare Local Alliance, 2013). This will always lead to increased safety of the patient and will also help in preventing communication errors in any situation. Despite being less qualified, ATSIHWs perform functions and duties similar to that of nurses.

Therefore, it is necessary to define the duties and boundaries of both burses and ATSIHW in an interdisciplinary team, taking into account the knowledge and qualification level of ATSIHW. There should be mutual respect between the nurses and ATSIHW for their contribution in the health care system. A plan of care should be maintained, without feeling compromised, to ensure complete involvement for everyone. Both nurses and ATSIHW can also share responsibilities and function as a team to improve successful care for patients (NATSIHWA, 2020).

ACCHOS, ATSIHWs and cultural safety and their self-determination

Self-determination is vital for the improvement of indigenous health and wellbeing. It is nothing but a confidence a person holds to set his goals, in decision making and solve the problems one is facing. In order to meet their health needs, the Aboriginal and Torres Strait Islander communities should be involved in each decision-making so that they are self-determined. Active participation in planning, providing and developing health facilities for those who may use the facilities is expected. ACCHOs are health care organizations, formed for their own health care facilities by indigenous Australians.

It played a major part in the establishment of ACCHS which is totally an indigenous healthcare system for self-determination. The program is built with the goal of replacing things indigenous people didn’t like about General practice services, and GPS should have prioritized the inclusion of things they wished. ACCHS is a program where the main control of health research lies in the hand of aboriginal people as they know the problems and needs of their community (Murphy, 2014).

ATSIHWs achieve self-determination by providing health care services to aboriginal communities in a way that takes their cultural needs into consideration. It means the programs of health are provided keeping the needs of the community in mind. Since the ATSIHWs are from the same community they recognize the health needs of their people and with respect to the treatment should be followed to get good results. Indigenous people's participation in the establishment of the ACCHS made it clear that the cultural aspects need to be taken care of in the health care system. Their presence in the delivery of health care services by ATSIHWs also ensured the successful incorporation of the treatment dimensions of indigenous cultures. This led through self-determination to the development of a culturally healthy healthcare climate (NACCHO, 2019).

Conclusion

Australian aboriginal communities have faced cultural problems and discrimination in availing the primary health care services. The Aboriginals needed a culturally protected healthcare system. With their self-determination, the communities got actively engaged in the development of a healthcare system that matched their healthcare needs and maintained a healthy cultural healthcare climate. They founded ACCHS, which is praised for serving Aboriginal people in an excellent way by taking into account their cultural aspect and their holistic health care needs.

References

Australian Human Rights Commission. (2019). Achieving Aboriginal and Torres Strait Islander health equality within a generation - A human rights-based approach. Retrieved from https://humanrights.gov.au/our-work/publications/achieving-aboriginal-and-torres-strait-islander-health-equality-within

Australian Indigenous HealthInfoNet. (2020). Aboriginal and Torres Strait Islander Health Workers/Health Practitioners. Retrieved from https://healthinfonet.ecu.edu.au/key-resources/health-professionals/health-workers/

Australian Medicare Local Alliance. (2013). Aboriginal Health Worker. Retrieved from Retrieved from https://www.nbmphn.com.au/Resources/Programs-Services/Allied-Health-support/AHP-Guide-Aboriginal-Health-Worker.aspx

Davy, C., Harfield, S., McArthur, A. et al. (2016). Access to primary health care services for Indigenous peoples: A framework synthesis. Int J Equity Health 15, 163 (2016).

Eckersley, R. M. (2007). Culture, spirituality, religion and health: looking at the big picture. Medical Journal of Australia. 186 (10), S54.

Harfield, S.G., Davy, C., McArthur, A. et al. (2018). Characteristics of Indigenous primary health care service delivery models: A systematic scoping review. Global Health. 14, 12. Murphy, M. (2014). Self-Determination and Indigenous Health: Is There a Connection? E-International Relations. Retrieved from https://www.e-ir.info/2014/05/26/self-determination-and-indigenous-health-is-there-a-connection/

NACCHO. (2019).Aboriginal health in Aboriginal hands. Retrieved from https://www.naccho.org.au/

NATSIHWA. (2020). Aboriginal Health Worker. Retrieved from https://www.natsihwa.org.au/

Panaretto, K. S., Wenitong, M., Button, S., & Ring, I. T. (2014). Aboriginal community controlled health services: leading the way in primary care. Medical Journal of Australia. 200 (11), 649-652.

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