Dawson Anna P, Warrior Eugene, Pearson Odette, Boyd Mark, Dwyer Judith, Morey Kim, Brodie Tina, Towers Kurt, Waters Sonia, Avila Cynthia, Hammond Courtney, Lake Katherine, Lampard Uncle Frank, Wanganeen Uncle Frank, Bennell Olive, Bromley Darrien, Shearing Toni, Rigney Nathan, Czygan Schania, Clinch Nikki, Pitson Andrea, Brown Alex, Howard Natasha J
Wardliparingga Aboriginal Health Equity, South Australian Health and Research Institute, Kaurna Country, Adelaide, SA, Australia.
Adelaide Medical School, The University of Adelaide, Kaurna Country, Adelaide, SA, Australia.
BMC Health Serv Res. 2024 Dec 18;24(1):1576. doi: 10.1186/s12913-024-11656-y.
The siloed nature of the health and social service system threatens access for clients engaging numerous organisations. Many Aboriginal and Torres Strait Islander people face adverse circumstances which contribute to multiple health and social needs. Effective relationships between health and social services are integral to coordinated service provision to meet the diverse needs of Aboriginal and Torres Strait Islander clients. Place-specific insights into inter-agency relationships are needed to inform targeted strategies that bolster service coordination to benefit Aboriginal and Torres Strait Islander people.
This study sought to understand experiences of inter-agency partnerships among health and social service providers on Kaurna Country in northern Adelaide using semi-structured interviews and yarning circles to explore partnership actions, outcomes, enablers, challenges, and identify strategies to strengthen partnerships. Fifty-nine service providers (78% female, 62% Aboriginal) participated including six from non-government organisations, 17 from Aboriginal community-controlled services and 36 from government organisations.
A content analysis identified partnership actions such as client advocacy, referrals, sharing information, case management meetings and collaborative tender submissions which were seen to improve client access, navigation and outcomes and strengthen worker connectedness and job satisfaction. Motivated workers, listening to Aboriginal people, shared goals and values, and partnership agreements (e.g., memorandum of understanding, service contracts) were identified enablers of partnerships. Racism and ignorance, lack of networking events, communication breakdown, red tape and administrative barriers, competition between services, short-term funding, high turnover of staff and a focus on key performance indicators rather than community needs were among the challenges. Effective partnerships to benefit Aboriginal communities in northern Adelaide was reported to require aligned intersectoral strategic intentions, reforms to service commissioning processes, sustainable funding, regular network events for management and frontline workforce, Aboriginal practitioner-led service coordination approaches and a network of Aboriginal and Torres Strait Islander workers across organisations.
This study identified key leverage points for action on inter-agency partnerships to benefit Aboriginal and Torres Strait Islander communities on Kaurna Country. System drivers such as funded inter-agency networks and reforms to commissioning of services must support organisational- and practitioner-level enablers to strengthen partnerships between health and social services across northern Adelaide.
健康与社会服务系统的孤立性质威胁着与众多机构打交道的客户获得服务的机会。许多原住民和托雷斯海峡岛民面临着不利处境，这导致了多种健康和社会需求。健康与社会服务之间的有效关系对于协调服务提供以满足原住民和托雷斯海峡岛民客户的多样化需求至关重要。需要针对特定地点的机构间关系见解，为加强服务协调以使原住民和托雷斯海峡岛民受益的目标战略提供信息。
本研究旨在通过半结构化访谈和交流圈，了解阿德莱德北部卡乌纳地区健康与社会服务提供者之间的机构间伙伴关系经验，以探讨伙伴关系行动、成果、促成因素、挑战，并确定加强伙伴关系的策略。59名服务提供者（78%为女性，62%为原住民）参与了研究，其中包括6名来自非政府组织、17名来自原住民社区控制服务机构和36名来自政府组织的人员。
内容分析确定了伙伴关系行动，如客户倡导、转介、信息共享、病例管理会议和联合投标提交，这些行动被认为可以改善客户获得服务的机会、导航能力和成果，并加强工作人员之间的联系和工作满意度。积极主动的工作人员、倾听原住民的意见、共同的目标和价值观以及伙伴关系协议（如谅解备忘录、服务合同）被确定为伙伴关系的促成因素。种族主义和无知、缺乏社交活动、沟通中断、繁文缛节和行政障碍、服务之间的竞争、短期资金、员工高流动率以及关注关键绩效指标而非社区需求等都是挑战。据报告，要使阿德莱德北部的原住民社区受益，有效的伙伴关系需要部门间战略意图一致、服务委托流程改革、可持续资金、为管理层和一线员工定期举办社交活动、由原住民从业者主导的服务协调方法以及跨组织的原住民和托雷斯海峡岛民工作人员网络。
本研究确定了在卡乌纳地区有利于原住民和托雷斯海峡岛民社区的机构间伙伴关系行动的关键杠杆点。诸如资助的机构间网络和服务委托改革等系统驱动因素必须支持组织和从业者层面的促成因素，以加强阿德莱德北部健康与社会服务之间的伙伴关系。
