Supporting aboriginal knowledge and practice in health care: lessons from a qualitative evaluation of the strong women, strong babies, strong culture program
1
Research Centre for Health and Wellbeing, Charles Darwin University,
Ellengowan Drive, Darwin, Northern Territory, Australia
2 Midwifery Research Unit, Mater Research Institute, School of Nursing and Midwifery, University of Queensland, Brisbane, Queensland, Australia
3 Strong Women, Strong Babies, Strong Culture Program Coordinator, Department of Health, Northern Territory Government, Darwin, NT, Australia
4 Department of Health, Northern Territory Government, Darwin, NT, Australia
2 Midwifery Research Unit, Mater Research Institute, School of Nursing and Midwifery, University of Queensland, Brisbane, Queensland, Australia
3 Strong Women, Strong Babies, Strong Culture Program Coordinator, Department of Health, Northern Territory Government, Darwin, NT, Australia
4 Department of Health, Northern Territory Government, Darwin, NT, Australia
BMC Pregnancy and Childbirth 2015, 15:19
doi:10.1186/s12884-015-0433-3
The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1471-2393/15/19
The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1471-2393/15/19
| Received: | 29 July 2014 |
| Accepted: | 12 January 2015 |
| Published: | 5 February 2015 |
© 2015 Lowell et al.; licensee BioMed Central.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Abstract
Background
The Strong Women, Strong Babies, Strong Culture Program (the Program) evolved from
a recognition of the value of Aboriginal knowledge and practice in promoting maternal
and child health (MCH) in remote communities of the Northern Territory (NT) of Australia.
Commencing in 1993 it continues to operate today. In 2008, the NT Department of Health
commissioned an evaluation to identify enabling factors and barriers to successful
implementation of the Program, and to identify potential pathways for future development.
In this paper we focus on the evaluation findings related specifically to the role
of Aborignal cultural knowledge and practice within the Program.
Methods
A qualitative evaluation utilised purposive sampling to maximise diversity in program
history and Aboriginal culture. Semi-structured, in-depth interviews with 76 participants
were recorded in their preferred language with a registered Interpreter when required.
Thematic analysis of data was verified or modified through further discussions with
participants and members of the evaluation team.
Results
Although the importance of Aboriginal knowledge and practice as a fundamental component
of the Program is widely acknowledged, there has been considerable variation across
time and location in the extent to which these cultural dimensions have been included
in practice. Factors contributing to this variation are complex and relate to a number
of broad themes including: location of control over Program activities; recognition
and respect for Aboriginal knowledge and practice as a legitimate component of health
care; working in partnership; communication within and beyond the Program; access
to transport and working space; and governance and organisational support.
Conclusions
We suggest that inclusion of Aboriginal knowledge and practice as a fundamental component
of the Program is key to its survival over more than twenty years despite serious
challenges. Respect for the legitimacy of Aboriginal knowledge and practice within
health care, a high level of community participation and control supported through
effective governance and sufficient organisational commitment as well as competence
in intercultural collaborative practice of health staff are critical requirements
for realising the potential for cultural knowledge and practice to improve Aboriginal
health outcomes.
