Green Anna, DiGiacomo Michelle, Luckett Tim, Abbott Penelope, Davidson Patricia Mary, Delaney Joanne, Delaney Patricia
Center for Cardiovascular and Chronic Care, Faculty of Health, University of Technology, Sydney, PO Box 123, Broadway, NSW, 2007, Australia.
University of Western Sydney, Locked Bag 1797, Penrith, NSW, 1797, Australia.
Int J Equity Health. 2014 Dec 18;13:126. doi: 10.1186/s12939-014-0126-y.
Aboriginal and Torres Strait Islander children in Australia experience a higher prevalence of disability and socio-economic disadvantage than other Australian children. Early intervention is vital for improved health outcomes, but complex and fragmented service provision impedes access. There have been international and national policy shifts towards inter-sector collaborative responses to disability, but more needs to be known about how collaboration works in practice.
A systematic integrative literature review using a narrative synthesis of peer-reviewed and grey literature was undertaken to describe components of inter- and intra-sector collaborations among services to Aboriginal and Torres Strait Islander children with a disability and their families. The findings were synthesized using the conceptual model of the ecological framework.
Thirteen articles published in a peer-reviewed journal and 18 articles from the grey literature met inclusion criteria. Important factors in inter- and intra-sector collaborations identified included: structure of government departments and agencies, and policies at the macro- (government) system level; communication, financial and human resources, and service delivery setting at the exo- (organizational) system level; and relationships and inter- and intra-professional learning at the meso- (provider) system level.
The policy shift towards inter-sector collaborative approaches represents an opportunity for the health, education and social service sectors and their providers to work collaboratively in innovative ways to improve service access for Aboriginal and Torres Strait Islander children with a disability and their families. The findings of this review depict a national snapshot of collaboration, but as each community is unique, further research into collaboration within local contexts is required to ensure collaborative solutions to improve service access are responsive to local needs and sustainable.
澳大利亚原住民和托雷斯海峡岛民儿童比其他澳大利亚儿童面临更高的残疾患病率和社会经济劣势。早期干预对于改善健康结果至关重要，但复杂且分散的服务提供阻碍了他们获得服务。国际和国内政策已转向跨部门协作应对残疾问题，但对于协作在实践中如何发挥作用，仍有更多需要了解的地方。
采用系统综合文献综述，对同行评审文献和灰色文献进行叙述性综合，以描述为残疾的原住民和托雷斯海峡岛民儿童及其家庭提供服务的部门间和部门内协作的组成部分。研究结果使用生态框架的概念模型进行综合。
13篇发表在同行评审期刊上的文章和18篇灰色文献文章符合纳入标准。确定的部门间和部门内协作的重要因素包括：宏观（政府）系统层面的政府部门和机构结构及政策；外部（组织）系统层面的沟通、财务和人力资源以及服务提供环境；以及中观（提供者）系统层面的关系和专业间及专业内学习。
向跨部门协作方法的政策转变为卫生、教育和社会服务部门及其提供者提供了一个机会，使他们能够以创新方式合作，改善残疾的原住民和托雷斯海峡岛民儿童及其家庭获得服务的机会。本综述的结果描绘了全国协作的概况，但由于每个社区都是独特的，需要进一步研究当地背景下的协作情况，以确保改善服务获取的协作解决方案能够满足当地需求并具有可持续性。
