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原住民社区控制的卫生服务:对澳大利亚新自由主义意识形态的反抗行为。

Aboriginal Community Controlled Health Services: An Act of Resistance against Australia's Neoliberal Ideologies.

机构信息

Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia.

出版信息

Int J Environ Res Public Health. 2022 Aug 15;19(16):10058. doi: 10.3390/ijerph191610058.

Abstract

The individualistic and colonial foundations of neoliberal socio-political ideologies are embedded throughout Australian health systems, services, and discourses. Not only does neoliberalism undermine Aboriginal and Torres Strait Islander collectivist values by emphasizing personal autonomy, but it has significant implications for Aboriginal and Torres Strait Islander health. Aboriginal Community Controlled Health Services (ACCHS) operate within Community-oriented holistic understandings of well-being that contradict neoliberal values that Western health services operate within. Therefore, this paper aims to explore the role of ACCHS in resisting the pervasive nature of neoliberalism through the prioritization of self-determination for Aboriginal and Torres Strait Islander Peoples. Utilizing a critical evaluative commentary, we reflect on Aboriginal political leadership and advocacy during the 1970s and 1980s and the development of neoliberalism in Australia in the context of ACCHS. Community controlled primary health services across Australia are the only remaining government-funded and Aboriginal-controlled organizations. Not only do ACCHS models resist neoliberal ideologies of reduced public expenditure and dominant individualistic models of care, but they also incontrovertibly strengthen individual and Community health. ACCHS remain the gold standard model by ensuring Aboriginal and Torres Strait Islander rights to the self-determination of health in accordance with the United Nations Declaration of the Rights of Indigenous Peoples.

摘要

新自由主义社会政治意识形态的个人主义和殖民主义基础贯穿于澳大利亚的卫生系统、服务和话语中。新自由主义不仅通过强调个人自主权破坏了原住民和托雷斯海峡岛民的集体主义价值观,而且对原住民和托雷斯海峡岛民的健康也有重大影响。原住民社区控制的卫生服务机构(ACCHS)在以社区为导向的整体福祉观念下运作,与西方卫生服务机构所遵循的新自由主义价值观相矛盾。因此,本文旨在探讨原住民社区控制的卫生服务机构通过优先考虑原住民和托雷斯海峡岛民的自决权,来抵制新自由主义普遍存在的性质。本文运用批判性评价评论,反思了 20 世纪 70 年代和 80 年代澳大利亚原住民的政治领导和倡导以及新自由主义在澳大利亚的发展背景下的 ACCHS。澳大利亚各地的社区控制初级卫生服务机构是唯一剩余的政府资助和原住民控制的组织。原住民社区控制的卫生服务机构模式不仅抵制了减少公共支出的新自由主义意识形态和占主导地位的个人主义护理模式,而且不可否认地加强了个人和社区的健康。原住民社区控制的卫生服务机构仍然是黄金标准模式,确保原住民和托雷斯海峡岛民按照《联合国土著人民权利宣言》享有健康自决权。

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