Hickey Sophie, Roe Yvette, Harvey Caroline, Kruske Sue, Clifford-Motopi Anton, Fisher Ike, Bernardino Brenna, Kildea Sue
Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Queensland, Australia.
Institute for Urban Indigenous Health, Brisbane, Queensland, Australia.
Int J Womens Health. 2021 May 18;13:467-478. doi: 10.2147/IJWH.S297479. eCollection 2021.
Little is known about sexual and reproductive health (SRH) access and health promotion for First Nations peoples in Australia. This study aimed to better understand community preferences, knowledge and access to contraception and SRH services, and use this understanding to make recommendations which support approaches led by local Aboriginal community-controlled health organisations (ACCHOs).
Qualitative First Nations-led yarning circles were conducted with 55 community members and health service providers using and/or working at ACCHOs in urban South East Queensland. Cultural protocols ensured women's and men's interviews were separately collected and analysed. Thematic analysis was conducted by multiple coders, privileging interpretations by First Nations researchers.
Family, kin and friends were described as key knowledge holders and ACCHOs as knowledge spaces for sharing information about maintaining positive SRH and wellbeing for First Nations people. Interviewees wanted accurate and timely information in an accessible, culturally appropriate way. Making informed choices about family planning was described as an important process of agency and self-determination for First Nations people, and contextualized within broader aspirations for growing strong families and healthy relationships.
Understanding SRH through the concept of "knowledge spaces" and "knowledge holders" highlights the collective importance of community relationality to support individual agency and informed SRH decision-making. ACCHOs appear to be acceptable knowledge spaces for SRH information; and evidence-based recommendations may increase their reach. Health services should consider upskilling community SRH knowledge holders to share consistent, accurate and accessible SRH information.
对于澳大利亚原住民的性与生殖健康(SRH)服务获取及健康促进情况,人们了解甚少。本研究旨在更好地理解社区对避孕及SRH服务的偏好、知识和获取途径,并利用这一理解提出建议,以支持由当地原住民社区控制的健康组织(ACCHOs)主导的方法。
在昆士兰州东南部城市,与55名在ACCHOs使用服务和/或工作的社区成员及健康服务提供者开展了由原住民主导的定性交流圈活动。文化规范确保分别收集和分析女性与男性的访谈内容。由多名编码员进行主题分析,优先采用原住民研究人员的解读。
家庭、亲属和朋友被描述为关键的知识持有者,而ACCHOs被视为为原住民分享维持积极SRH及福祉信息的知识空间。受访者希望以一种易于获取、符合文化习惯的方式获得准确及时的信息。对原住民而言,做出有关计划生育的明智选择被视为一种重要的自主和自决过程,并置于建立强大的家庭和健康关系的更广泛愿望背景之中。
通过“知识空间”和“知识持有者”概念来理解SRH突出了社区关系对于支持个人自主及明智的SRH决策的集体重要性。ACCHOs似乎是SRH信息可接受的知识空间;基于证据的建议可能会扩大其影响力。卫生服务机构应考虑提升社区SRH知识持有者的技能,以便分享一致、准确且易于获取的SRH信息。