The Historical Context of Developing an Aboriginal Community-Controlled Health Service: A Social History of the First Ten Years of the Central Australian Aboriginal Congress

Rosewarne, Clive; Vaarzon‐Morel, Petronella; Bell, Stephanie W.; Carter, Elizabeth; Liddle, Margaret; Liddle, Johnny

doi:10.2307/40111578

Cited by 39 publications

(13 citation statements)

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“…Often these strategies have been driven by the Aboriginal community, not just the health professionals employed at Congress. Past examples include a night shelter and pick‐up service to reduce the number of Aboriginal people being charged for public drunkenness, set up in 1975, 29 and an alcohol rehabilitation centre established in the 1980s. In 1990, Congress collaborated with other Aboriginal organisations to produce a comprehensive plan to address alcohol use, including supply reduction measures to reduce take‐away trading hours, reduce outlets and remove cheap alcohol from the market, and approaches to rehabilitation, including the establishment of an alcohol programs unit 34 .…”

Section: Resultsmentioning

confidence: 99%

“…In particular, the service employed a range of actions across the comprehensive spectrum of rehabilitation, treatment, disease prevention, and health promotion. ACCHSs have practiced such comprehensive PHC approaches since before the Alma Ata Declaration, because that was the approach deemed suitable by the community grass roots movements that formed the first ACCHSs 29 . This pioneering of a comprehensive PHC approach further highlights the value of community control to develop locally responsive and appropriate solutions, and to address local determinants of health through advocacy.…”

Section: Resultsmentioning

confidence: 99%

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Case study of a decolonising Aboriginal community controlled comprehensive primary health care response to alcohol‐related harm

Freeman

Baum

Mackean

et al. 2019

Australian and New Zealand Journal of Public Health

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Objective:This paper provides a case study of the responses to alcohol of an Aboriginal Community Controlled Health Service (The Service), and investigates the implementation of comprehensive primary health care and how it challenges the logic of colonial approaches.Methods: Data were drawn from a larger comprehensive primary health care study. Data on actions on alcohol were collected from: a) six-monthly service reports of activities; b) 29 interviews with staff and board members; c) six interviews with advocacy partners; and d) community assessment workshops with 13 service users. Results:The Service engaged in rehabilitative, curative, preventive and promotive work targeting alcohol, including advocacy and collaborative action on social determinants of health. It challenged other government approaches by increasing Aboriginal people's control, providing culturally safe services, addressing racism, and advocating to government and industry. Conclusions:This case study provides an example of implementation of the full continuum of comprehensive primary health care activities. It shows how community control can challenge colonialism and ongoing power imbalances to promote evidence-based policy and practice that support self-determination as a positive determinant for health. Implications for public health:Aboriginal Community Controlled Health Services are a good model for comprehensive primary health care approaches to alcohol control.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Case study of a decolonising Aboriginal community controlled comprehensive primary health care response to alcohol‐related harm

Freeman

Baum

Mackean

et al. 2019

Australian and New Zealand Journal of Public Health

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“…A consistent finding of this and many other studies of ACCHS is that they are underfunded, funding is fragmented, and the communities operating them live with constant uncertainty concerning funding. 31–37 More financial resources are spent per capita on mainstream health services than on Indigenous health, despite the notable inequities in mortality and morbidity rates between the 2. Medicare claims, pharmaceutical benefits scheme rebates, and general health services utilization are significantly less for Indigenous people compared to the non-Indigenous population.…”

Section: Resultsmentioning

confidence: 99%

Beyond the Biomedical Paradigm

Khoury

2015

Int J Health Serv

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This article describes the formation and development of Aboriginal Community-Controlled Health Services in Australia, with emphasis on the Redfern Aboriginal Medical Service in Sydney. These organizations were established in the 1970s by Indigenous Australians who were excluded from and denied access to mainstream health services. The aim of this research was to explore notions of Indigenous agency against a historical backdrop of dispossession, colonialism, and racism. Aboriginal Community-Controlled Health Services act as a primary source of healthcare for many Indigenous communities in rural and urban areas. This study examined their philosophy of healthcare, the range of services provided, their problems with state bureaucracies and government funding bodies, and the imposition of managerialist techniques and strategies on their governance. Essentially, these organizations transcend individualistic, biomedical, and bureaucratic paradigms of health services by conceptualizing and responding to Indigenous health needs at a grassroots level and in a broad social and political context. They are based on a social model of health.

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“…The first ACCHSs were founded in the 1970s in the context of land rights and other social movements [ 13 ]. They were established in response to racism experienced by Aboriginal people in mainstream health services as well as their poor affordability, cultural acceptability and appropriateness to health needs [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Transitioning to Aboriginal community control of primary health care: the process and strategies of one community-controlled health organisation in Queensland

et al. 2020

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Background Aboriginal Community Controlled Health Services (ACCHSs) play a critical role in providing culturally appropriate, accessible primary healthcare (PHC) for Aboriginal and Torres Strait Islander peoples in Australia. The success of many ACCHSs has led to increased policy support for their growth and development, including the transition of state government administered PHC services to Aboriginal community control in select communities. However, there is minimal published literature available which evaluates such transitions. This paper reports on an evaluation of one ACCHS (Gurriny Yealamucka Health Service)‘s experience of transitioning local PHC services to community control in Yarrabah, Queensland, with a focus on the processes and strategies which were implemented to achieve successful transition. Methods Data was collected from interviews with key personnel involved in the transition and organisational documents from the evaluation period. Face-to-face or telephone interviews were conducted with 14 key stakeholders, audio-recorded and transcribed with written consent. Historical organisational documents were provided by Gurriny. All interview transcripts and documents were imported into NVIVO, coded and analysed using grounded theory methods. Results Gurriny’s journey of achieving community control of PHC in Yarrabah entailed an almost 30 year process of building and demonstrating organisational capacity. The first stage (1986 to 2004) was focused on establishing and developing a community-controlled health service and the second stage (2005–14) on preparing for the transition. Formal handover occurred in June 2014. Stage one strategies included: addressing community social and emotional wellbeing; consulting the community; collaborating with researchers; and, strategically building services, organisation capacity and stakeholder trust. Stage two strategies were: communicating and engaging with stakeholders; ensuring strong governance; planning and developing the services and workforce; assuring quality; and, financial planning, management and modelling. Conclusion Achieving successful transition to community control of PHC for Gurriny entailed a lengthy process of substantial, ongoing organisational growth and development. Gurriny’s experience provides a framework for both governments and the ACCHS sector to inform future transitions of PHC services to Aboriginal community control.

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The Historical Context of Developing an Aboriginal Community-Controlled Health Service: A Social History of the First Ten Years of the Central Australian Aboriginal Congress

Cited by 39 publications

References 0 publications

Case study of a decolonising Aboriginal community controlled comprehensive primary health care response to alcohol‐related harm

Case study of a decolonising Aboriginal community controlled comprehensive primary health care response to alcohol‐related harm

Beyond the Biomedical Paradigm

Transitioning to Aboriginal community control of primary health care: the process and strategies of one community-controlled health organisation in Queensland

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