Thompson Sandra C, Greville Heath S, Param Rani
Centre for International Health, Curtin University of Technology, Perth, Western Australia, Australia.
Aust New Zealand Health Policy. 2008 May 19;5:3. doi: 10.1186/1743-8462-5-3.
Indigenous Australians have significantly poorer status on a large range of health, educational and socioeconomic measures and successive Australian governments at state and federal level have committed to redressing these disparities. Despite this, improvements in Aboriginal health status have been modest, and Australia has much greater disparities in the health of its Indigenous people compared to countries that share a history characterised by colonisation and the dispossession of indigenous populations such as New Zealand, Canada and the United States of America. Efforts at policy and planning must ultimately be translated into practical strategies. This article outlines an approach that was effective in Western Australia in increasing the engagement and concern of Aboriginal people about high rates of sexually transmissible infections and sexual health issues. Many aspects of the approach are relevant for other health issues.
The complexity of Indigenous sexual health necessitates inter-agency and cross-governmental collaboration, in addition to Aboriginal leadership, accurate data, and community support. A recent approach covering all these areas is described. This has resulted in Aboriginal sexual health being more actively discussed within Aboriginal health settings than it once was and additional resources for Indigenous sexual health being available, with better communication and partnership across different health service providers and sectors. The valuable lessons in capacity building, collaboration and community engagement are readily transferable to other health issues, and may be useful for other health professionals working in the challenging area of Aboriginal health.
Health service planners and providers grapple with achieving Aboriginal ownership and leadership regarding their particular health issue, despite sincere concern and commitment to addressing Aboriginal health issues. This highlights the need to secure genuine Aboriginal engagement. Building capacity that enables Indigenous people and communities to fulfill their own goals is a long-term strategy and requires sustained commitment, but we argue is a prerequisite for better Indigenous health outcomes.
澳大利亚原住民在一系列健康、教育和社会经济指标方面的状况明显较差，澳大利亚州和联邦层面的历届政府都致力于解决这些差距。尽管如此，原住民健康状况的改善幅度不大，而且与新西兰、加拿大和美利坚合众国等有着殖民和剥夺原住民人口历史的国家相比，澳大利亚原住民健康方面的差距要大得多。政策和规划方面的努力最终必须转化为切实可行的战略。本文概述了一种在西澳大利亚有效的方法，该方法提高了原住民对性传播感染高发病率和性健康问题的参与度和关注度。该方法的许多方面与其他健康问题相关。
原住民性健康的复杂性需要跨机构和跨政府的合作，此外还需要原住民的领导、准确的数据和社区支持。本文描述了一种涵盖所有这些领域的近期方法。这导致在原住民健康环境中，原住民性健康比以往得到了更积极的讨论，并且有了更多的原住民性健康资源，不同的健康服务提供者和部门之间的沟通与伙伴关系也得到了改善。能力建设、合作和社区参与方面的宝贵经验教训很容易应用于其他健康问题，可能对在具有挑战性的原住民健康领域工作的其他健康专业人员有用。
尽管真诚关注并致力于解决原住民健康问题，但卫生服务规划者和提供者仍在努力实现原住民在其特定健康问题上的自主权和领导权。这凸显了确保原住民真正参与的必要性。建设能力以使原住民个人和社区能够实现自己的目标是一项长期战略，需要持续的投入，但我们认为这是实现更好的原住民健康结果的先决条件。
