The George Institute for Global Health, University of New South Wales, Australia; The Australian Prevention Partnership Centre, Australia.
The George Institute for Global Health, University of New South Wales, Australia.
Int J Drug Policy. 2018 Dec;62:78-85. doi: 10.1016/j.drugpo.2018.09.011. Epub 2018 Oct 24.
Restrictions on the supply of alcohol are amongst the most effective and cost effective interventions to address harmful use. However, despite international human rights bodies recognising that self determination must be pre-eminent in efforts to improve Indigenous health, little is known about the role of Indigenous communities in designing and implementing alcohol controls as well as the degree to which government resourcing and/or regulation is utilised. This commentary explores Australian examples of the governance models used to ensure Indigenous participation and leadership when developing regulatory interventions for alcohol control within communities. We identify four models of Indigenous governance: alcohol control interventions that were community conceived and implemented, government-facilitated community-led, community coalitions backed by government intervention and government initiated community partnerships. Each model is underpinned by specific governance arrangements which incorporate rules and processes that determine authority, accountability and Indigenous participation in decision-making. The aim of this paper is to benchmark these models of governance along a spectrum of community engagement beginning with forms of non-participation and ending with full citizen control. In addition, we put forward recommendations for governments at all levels to facilitate culturally acceptable and robust models of Indigenous governance that have the potential to improve health and social outcomes.
限制酒精供应是解决有害使用问题最有效和最具成本效益的干预措施之一。然而，尽管国际人权机构认识到在努力改善原住民健康方面，自决必须是首要任务，但对于原住民社区在设计和实施酒精控制方面的作用以及政府资源投入和/或监管的利用程度知之甚少。本评论探讨了澳大利亚在确保原住民参与和领导社区内酒精管制监管干预措施的制定方面所采用的治理模式的实例。我们确定了四种原住民治理模式：社区构想和实施的酒精控制干预措施、政府协助的社区主导、政府干预支持的社区联盟以及政府发起的社区伙伴关系。每个模式都有特定的治理安排为基础，这些安排包含确定权力、问责制和原住民在决策中的参与的规则和程序。本文的目的是在社区参与的范围内，从非参与的形式开始，到完全公民控制的形式结束，对这些治理模式进行基准测试。此外，我们还向各级政府提出建议，以促进具有改善健康和社会成果潜力的文化上可接受和稳健的原住民治理模式。
