Molly Wardaguga Research Centre, Charles Darwin University, Casuarina, NT, Australia.
The Northern Institute, Charles Darwin University, Casuarina, NT, Australia.
Health Promot J Austr. 2021 Feb;32 Suppl 1:192-202. doi: 10.1002/hpja.439. Epub 2021 Jan 25.
Indigenous women continue to experience reproductive health inequities. While enhancing health literacy is suggested as an approach for reducing disparities and increasing equity, there is a paucity of literature exploring Indigenous women's conceptualisation of reproductive health literacy. This paper demonstrates one approach to developing a reproductive health literacy framework for Yolŋu (Indigenous) women in a remote Northern Australian setting.
Using a decolonising participatory action research approach, a senior Yolŋu researcher led interviews, group story sharing sessions, historic site visits and on-country cultural demonstration sessions with participants on reproductive health topics. Data were collected in the participants' first language(s) and occasionally in English. Data were digitally recorded on camera, Dictaphone, video and in handwritten notes. The senior Yolŋu researcher worked with a Yolŋu interpreter to translate the data into English. Data underwent a progressive verbal relational content analysis to map and build a framework.
A reproductive health literacy framework that privileges Yolŋu reproductive knowledge, practices and language was successfully co-designed. The framework was embedded in the metaphor of Pandanus mat and uses key cultural domains of Yolŋu identity as a connecting foundation to women's reproductive knowledges and ceremonial milestones.
The framework offers a culturally responsive and multilingual approach to sensitively discuss and operationalise reproductive health literacy. The framework empowers Yolŋu cultural identities; accounts for both Yolŋu and Western medical knowledges; and honours participants' requests for "Two-Way" learning. SO WHAT?: This research demonstrates an innovative approach to co-designing a culturally responsive framework for reproductive health literacy in a complex and multilingual context. Such approaches offer a promising way forward for empowering Indigenous women to define reproductive health literacy and contribute to improving their reproductive health outcomes.
原住民妇女继续面临生殖健康方面的不平等。虽然提高健康素养被认为是减少差异和增加公平的一种方法，但关于原住民妇女对生殖健康素养的概念化的文献却很少。本文展示了一种在澳大利亚北部偏远地区为约鲁巴（原住民）妇女制定生殖健康素养框架的方法。
采用去殖民化的参与式行动研究方法，一位资深的约鲁巴研究人员带领参与者就生殖健康主题进行了访谈、小组故事分享会议、历史遗址参观和实地文化示范。数据以参与者的第一语言（有时也用英语）收集。数据通过摄像机、录音机、视频和手写笔记进行数字化记录。资深的约鲁巴研究人员与一名约鲁巴口译员合作，将数据翻译成英语。数据经过逐步的口头关系内容分析进行映射和构建框架。
成功共同设计了一个优先考虑约鲁巴生殖知识、实践和语言的生殖健康素养框架。该框架嵌入在潘达努斯草席的隐喻中，并使用约鲁巴人身份的关键文化领域作为连接基础，将女性的生殖知识和仪式里程碑联系起来。
该框架提供了一种对文化敏感的、多语言的方法来敏感地讨论和操作生殖健康素养。该框架赋予了约鲁巴文化身份权力；考虑了约鲁巴和西方医学知识；并尊重参与者对“双向”学习的要求。
这项研究展示了一种在复杂和多语言背景下共同设计文化响应框架的创新方法。这种方法为赋予原住民妇女权力，使她们能够定义生殖健康素养，并为改善其生殖健康结果做出贡献，提供了一个有前途的途径。
