The Marulu Strategy 2008–2012: overcoming Fetal Alcohol Spectrum Disorder (FASD) in the Fitzroy Valley

Abstract

Objective: Aboriginal leaders concerned about high rates of Fetal Alcohol Spectrum Disorder (FASD) in the Fitzroy Valley, remote north-western Australia, introduced restrictions on access to take-away full-strength alcohol. Following this, Aboriginal leaders engaged strategic partners in a broader strategy to address FASD in the region. The aim of this study was to develop and implement a community-led, researcher-supported, FASD strategy. Methods:A review of literature focusing on community-led FASD strategies identified key components that informed the Marulu FASD strategy. These included strategy ownership, leadership, and governance by participating communities, and a research framework.Results: Community meetings and workshops led to the development of The Marulu FASD Strategy (2008). Feasibility and community consent to conduct a FASD prevalence study (the Lililwan Project) was confirmed, and implementation was progressed (2010)(2011)(2012)(2013). Concurrent FASD prevention activities were conducted. In 2012, the Marulu FASD Unit was established within a local Aboriginal organisation to sustain and coordinate ongoing strategy activities.Conclusions: Community control of public health initiatives can be achieved when Aboriginal communities prioritise issues of significant concern, and engage strategic partners to overcome them. Implications for public health:The Marulu Strategy forms a template for action to address FASD and other public health issues in Aboriginal communities in Australia and internationally.

Stigma as a dominant discourse in fetal alcohol spectrum disorder

“…The relationship between mother’s use of alcohol and the lasting impact on the child is a focus in the articles identified from a public health perspective (Corrigan, Shah, Lara, Mitchell, Combs-Way, Simmes and Jones, 2018; Corrigan, Shah, Lara, Mitchell, Simmes and Jones, 2018; Corrigan et al , 2017; Zizzo and Racine, 2017). Other disciplines identified in the literature include neuropsychology (Davis et al , 2017; Pei et al , 2017; Glass and Mattson, 2017; Fitzpatrick, Latimer, Olson, Carter, Oscar, Lucas, Doney, Salter, Try, Hawkes, Fitzpatrick, Hand, Watkins, Tsang, Bower, Ferriera, Boulton and Elliot, 2017; Fitzpatrick, Oscar, Carter, Elliott, Latimer, Wright and Boulton, 2017); criminal justice perspective (Brown et al , 2017; Tait et al , 2017; Flannigan et al , 2018); child health, social work and child welfare (Mukherjee et al , 2017; Kapasi and Brown, 2017; Hafekost et al , 2017; Bakhireva et al , 2017; Petrenko and Alto, 2017; Gibbs and Sherwood, 2017; Myra et al , 2018); the substance use field (Washio et al , 2017); nursing (Marcellus, 2017; Howlett et al , 2017), women’s health (Cook, Green, de la Ronde, Dell, Graves, Ordean, Rutler, Steeves and Wong, 2017; Cook, Green, de la Ronde, Dell, Graves, Morgan, Ordean, Steeves and Wong, 2017; Hui et al , 2017; Hemsing et al , 2017; Osterman et al , 2017); health care ethics (Elias et al , 2018; Helgesson et al , 2018); and education (Millar et al , 2017). It is interesting to note that the literature emerging from the search terms FASD and stigma yielded results from multiple sources indicating that this topic is of interest to a variety of disciplines in the health and social sciences fields.…”

School-based intervention to address self-regulation and executive functioning in children attending primary schools in remote Australian Aboriginal communities

“…Aboriginal leaders from the remote Fitzroy Valley region of Western Australia (WA) have been concerned about the potential of FASD and exposure to ELT to impact the behaviours of children in their local community. In 2009, local leaders developed a multifaceted strategy called the Marulu FASD/ELT Strategy (Marulu means 'precious, worth nurturing' in the Bunuba language) [24]. This strategy prioritized three aims: FASD prevention and diagnosis, and appropriate support for children and families affected by FASD and ELT.…”

Understanding the Relationship between Predictors of Alcohol Consumption in Pregnancy: Towards Effective Prevention of FASD

“…In turn, for health professionals to adequately assess the alcohol consumption habits of pregnant women (or women of a childbearing age in general) and develop with them culturally adapted and effective communication strategies, the implementation of suitable continued training is required, as well as the development of institutional programs in the health system that facilitate and promote the full exercising of their role in the prevention of FASD. In this field, the experience of countries that have made a greater effort in preventing FASD to date, such as Australia, Canada, the United States, and New Zealand, among others [51][52][53], should be taken into account in particular.…”