Mackean Tamara, Freeman Toby, Musolino Connie, Fry Denise, MacDougall Colin, Lewis Virginia, Baum Fran
College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, SA 5042, Australia.
Stretton Health Equity, University of Adelaide, Adelaide, SA 5001, Australia.
Aust J Prim Health. 2025 Apr;31. doi: 10.1071/PY24223.
Background The Aboriginal community controlled health sector has been a leader in community health in Australia. We sought to understand the influence this sector has had on the non-Indigenous community health movement in Australia since the 1970s. Methods We interviewed 87 key informants on the history of community health in Australia, including policy makers, researchers, medical doctors, allied health, social workers, nurses and politicians. Five were Aboriginal, and 11 had particular experience in Aboriginal community health. A team approach was taken to qualitative analysis using a codebook. We interrogated data to seek evidence for the influence of Aboriginal community health on non-Indigenous community health, and the relationship between the two sectors. This was complemented by construction of a policy timeline. Results Aboriginal community health services were regarded as best practice community health, and informed and influenced practice in non-Indigenous community health services. Non-Indigenous community health was sometimes more of a competitor than an ally. The respect for the Aboriginal community health sector, particularly community controlled, was seen to have grown over time, acknowledging the strengths of the model. Although establishing Aboriginal community health services was a struggle, the resulting model has better resisted managerialist control compared with non-Indigenous community health. Conclusions The Aboriginal health sector developed a vision and practice of community health that went on to inform generalist non-Indigenous community health sector in Australia. The sector continues to remain strong today as an example model of community health that is relevant to all Australians.
澳大利亚原住民社区控制的卫生部门一直是社区卫生领域的领导者。我们试图了解自20世纪70年代以来该部门对澳大利亚非原住民社区卫生运动产生的影响。方法：我们采访了87名澳大利亚社区卫生历史的关键信息提供者，包括政策制定者、研究人员、医生、专职医疗人员、社会工作者、护士和政治家。其中5人为原住民，11人在原住民社区卫生方面有特殊经验。采用团队方法，使用编码手册进行定性分析。我们对数据进行审查，以寻找原住民社区卫生对非原住民社区卫生产生影响的证据，以及两个部门之间的关系。这通过构建政策时间表得到补充。结果：原住民社区卫生服务被视为最佳实践社区卫生，并为非原住民社区卫生服务提供了信息并影响了其实践。非原住民社区卫生有时更多的是竞争对手而非盟友。随着时间的推移，人们对原住民社区卫生部门，特别是社区控制的部门的尊重有所增加，认可了该模式的优势。尽管建立原住民社区卫生服务面临困难，但与非原住民社区卫生相比，由此产生的模式更能抵御管理主义的控制。结论：原住民卫生部门发展了一种社区卫生愿景和实践，进而为澳大利亚的非专科非原住民社区卫生部门提供了信息。作为一个与所有澳大利亚人相关的社区卫生典范模式，该部门如今仍然强大。
