ACCHS: Achieving Equality for First Nations People Through Equity - Essay Sample

The Role of Aboriginal Community Controlled Health Services (ACCHS) Play in Reducing Health Inequalities Experienced by Aboriginal and Torres Strait Islander Australians

Equality vs Equity

The ACCHSs are an example of addressing inequity to achieve equality for the First Nations people by delivering culturally appropriate, holistic and comprehensive healthcare to the community that runs the service (Weightman, 2013). Providing appropriate cultural software is part of evidence-based practice. Evidence-based practice is built on the three pillars of individual expertise, best available evidence and patient values (Steglitz, Warnick, Hoffman, Johnston & Spring, 2015). Therefore, the ACCHS allows people to provide a healthcare system that integrates the cultural practices of the Aboriginal people into the provision of care. The result is that the Aboriginal people and Torres Strait Islander can seek professional healthcare services without the fear of their cultural practices and beliefs being violated. That means that the ACCHS have helped the Aboriginal People and Torres Strait Islander Australians get the healthcare they need to achieve the same level of health and productivity as the rest of the population.

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Also, the ACCHSs can address equality for the First Nations people by reducing or eliminating the chances of discrimination against the First Nation people while seeking healthcare in regular health facilities and programs. According to Weightman (2013), an experimental program was carried out in Inala Indigenous Health Service in Southwest Brisbane, to ascertain the factors that are preventing aboriginal people from seeking health services. The researchers discovered that simple actions such as placing and indigenous receptionist and increasing the cultural appropriateness of the waiting room through local art and aboriginal radio station, increased the number of First Nations people patients at the hospital from 12 to 899 (Weightman, 2013). The study found out that the presence of indigenous staff and focusing on indigenous health increased patient satisfaction.

ACCHSs Health and Wellbeing

My local ACCHS is the Victorian Aboriginal Health Service (VAHS). Some of the programs and services that they have delivered that depicts health as social, cultural and emotional wellbeing of the community include family counselling service. The family counselling service is a program that seeks to provide culturally safe emotional wellbeing, mental health counselling, cultural healing and recovery programs for the first nations people communities (Victorian Aboriginal Health Service, n.d). The family counselling service is designed to handle the social, emotional and cultural wellbeing of aboriginal families. There are four program areas within the family counselling service.

The first one is adult social-emotional wellbeing which provides support for the aboriginal adults with mental health and social-emotional wellbeing needs. Examples of activities within the program include the outreach supports, and access to psychiatrists, counsellors and psychologists.

The second one is the Koori kids’ programs which a holistic and culturally appropriate mental health program for the aboriginal children (Victorian Aboriginal Health Service, n.d). Some of the programs that the Koori kids’ program addresses include stress, trauma, behavioural problems, school issues, anxiety and depression. Some of the interventions under the Koori Kids’ program include developmental, cognitive and language assessments. There is also access to a paediatrician that has specialized in adolescent health.

Financial wellbeing is the third program under the family counselling service. It aims are providing financial wellbeing for the aboriginal families through assistance and services such as advocacy, financial counselling, access to housing services, problem gambling counselling, and social support such as emergency relief (Victorian Aboriginal Health Service, n.d).

Finally, there is the ice pilot program which is the most recent program from the VAHS under the family counselling program. The program was created as a way of increasing access to services and support in addressing the common ice-related issues that impact the aboriginal and Torres Strait Islander people. It will provide drug services for the first nations people with alcohol, drug and ice issues.

The Role of Hospitals

From the NSQHS Standards provided, the two actions selected for this assignment are Action 1.4 and Action 2.13. One strategy that the hospital can use to implement Action 1.4 and Action 2.13.

For action 1.4, the hospital can move to develop or adopt an indicator set that can measure a change in the processes and the patient outcomes. However, since the process seeks to utilize evidence-based practice, it would be economical and resourceful to adopt and already established indicator set. There are a lot of indicator options available to the hospital that can enable them to measure patient outcomes. Patient-Reported Outcomes (PRO) is one those indicators that the hospital can utilize for the sole purpose of monitoring the strategies that seek to meet organizations safety and quality priorities for the aboriginal people (Black et al. 2016). They can also adapt, the national or territorial performance measures like the one found in the national Aboriginal and Torres Strait Islander Health Performance Framework. Some of the indicators include rates of unplanned readmissions, rates of discharge against the medical advice by ward or unit, or in-hospital mortality rates. It is important to note that the successful implementation of the strategy will rely on other actions as well.

The strategy for action 2.13 would be to establish a partnership or build on an existing relationship with the aboriginal and Torres Strait Islander groups, and other organizations. That will entail taking an approach or route that may differ for each community, but it will work towards the standard partnering with consumers. The strategy involves taking advice on the appropriate processes for the creation and maintenance of relationships with the First Nations people organizations.

The implementation of such actions will improve patient outcomes by giving the healthcare provider with a tool to measure improvements or deteriorating conditions in the quality of care that they provide. Therefore, the staff and other stakeholders will be able to implement specific measures every time the quality of care starts to decrease. The second strategy will enable the provision of individualized kind of care that adheres to the patient’s personal needs and demands. The community members can receive the kind of care that is sensitive to their culture and economic status.

The Role Individual Nurses and Midwives

Nurses, along with midwives, can take specific actions to ensure the distribution of culturally safe care and equality in the distribution of healthcare. Two of the principles of cultural safety that can be enacted are; reflecting on one’s practice and ensuring that they don’t diminish, disempower, or demean the First Nations people through their actions (Best & Fredericks, 2018).

A nurse or a midwife should reflect on one’s practice instead of always following standard policies (Cameron et al., 2014); especially if they are not mandatory. According to Cameron et al., (2014), frontline workers need to apply their knowledge of cultural practices of the First Nations people to prevent vulnerable populations from experiencing inequities in access to healthcare. That means nurses and midwives could avoid promoting inequality in healthcare by using their knowledge to access standard practices and procedures being used in an institution. It is, therefore, up to the nurse or midwife to reflect on their practise to identify these instances of unequal provision of healthcare services.

Also, nurses and midwives should ensure that they don’t diminish or disempower the First Nations people through their actions. A strategy that can prevent that from happening would be to always focus on the conditions that encourage inequality (Reutter & Kushner, 2010). Conditions such as lack of proper education, poverty, and lack of proper housing happen to encourage this unequal distribution of healthcare services. Focusing on such factors can help nurses avoid perpetuating inequality in healthcare.

The implementation of the first strategy in part 3 of the paper can help improve patient outcomes by reducing the instances of institutionalized discrimination. In institutionalized discrimination, standard procedures happen to be instruments of promoting inequality. It is important to note that individual knowledge is part of evidence-based practice (Tonelli & Guyatt, 2020). Therefore, the application of one’s knowledge is a requirement in the field of nursing.

As for the second strategy outlined in this part, evidence from Cameron et al. (2014), indicated that concerns about the stigma related to being an Aboriginal, poverty, discourses of blame and lack of system capacity are some of the reasons that discourage the participants from seeking healthcare. Knowing these things can prevent them from providing health unequally. For example, having such knowledge can help the nurse avoid assuming that everyone has access to the gym.

References

Best, O., & Fredericks, B. (2018). Yatdjuligin: Aboriginal and Torres Strait Islander nursing and midwifery care. Cambridge: Cambridge University Press.

Black, N., Burke, L., Forrest, C. B., Sieberer, U. R., Ahmed, S., Valderas, J. M., ... & Alonso, J. (2016). Patient-reported outcomes: pathways to better health, better services, and better societies. Quality of Life Research, 25(5), 1103-1112.

Cameron, B. L., Carmargo Plazas, M., Salas, A. S., Bourque Bearskin, R. L., & Hungler, K. (2014). Understanding inequalities in access to health care services for aboriginal people: a call for nursing action. ANS. Advances in nursing science, 37(3), E1–E16. https://doi.org/10.1097/ANS.0000000000000039

Reutter, L., & Kushner, K. E. (2010). ‘Health equity through action on the social determinants of health’: taking up the challenge in nursing. Nursing Inquiry, 17(3), 269–280. doi: 10.1111/j.1440-1800.2010.00500.x

Steglitz, J., Warnick, J. L., Hoffman, S. A., Johnston, W., & Spring, B. (2015). Evidence-based practice. International Encyclopedia of the Social & Behavioral Sciences, 8, 332-338.

Tonelli, M., & Guyatt, G. (2020). The role of experience in an evidence-based practice. The Medical Roundtable General Medicine Edition.

Victorian Aboriginal Health Service. (n.d.). Family Counselling Service. Retrieved June 1, 2020, from https://www.vahs.org.au/family-counselling-service/

Weightman, M. (2013, July 24). The role of Aboriginal Community Controlled Health Services in Indigenous health. Retrieved June 1, 2020, from http://www.amsj.org/archives/3012