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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Contribution of Aboriginal Community-Controlled Health Services to improving Aboriginal health: an evidence review

Megan Ann Campbell A D , Jennifer Hunt A , David J. Scrimgeour B , Maureen Davey C and Victoria Jones A
+ Author Affiliations
- Author Affiliations

A Aboriginal Health & Medical Research Council, Level 3, 66 Wentworth Avenue, Surry Hills, NSW 2010, Australia. Email: jhunt@ahmrc.org.au; vjones@ahmrc.org.au

B Spinifex Health Service, PMB 88, via Kalgoorlie, WA 6430, Australia. Email: David.scrimgeour@spinifexhealth.org.au

C Tasmanian Aboriginal Centre, 198 Elizabeth Street, Hobart, Tas. 7001, Australia. Email: Maureen.d@tacinc.com.au

D Corresponding author. Email: megananncampbell@hotmail.com

Australian Health Review 42(2) 218-226 https://doi.org/10.1071/AH16149
Submitted: 12 July 2016  Accepted: 20 December 2016   Published: 7 March 2017

Abstract

Objective Aboriginal Community-Controlled Health Services (ACCHSs) deliver comprehensive, culturally appropriate primary health care to Aboriginal people and communities. The published literature acknowledging and supporting the roles of ACCHSs in improving Aboriginal health is limited. This paper seeks to collate and analyse the published evidence supporting the contribution of ACCHSs to improving the health of Aboriginal people.

Methods A conceptual framework for exploring the contribution of ACCHSs was developed, drawing on the literature on the core functions of ACCHSs and the components of quality primary health care. This framework was used to structure the search strategy, inclusion criteria and analysis of the review.

Results ACCHSs contribute to improving the health and well being of Aboriginal peoples through several pathways, including community controlled governance, providing employment and training, strengthening the broader health system and providing accessible, comprehensive primary health care.

Conclusions ACCHSs make a range of important contributions to improving the health of Aboriginal peoples that are under-acknowledged. Consideration of the different ways ACCHSs contribute to improving Aboriginal health is of value in the design and evaluation of programs and policies that aim to improve the health of Aboriginal peoples.

What is known about the topic? Aboriginal communities have long argued the vital role of ACCHSs in improving Aboriginal health.

What does this paper add? This paper provides a comprehensive collation and analysis of the evidence supporting the contributions ACCHSs are making to improving Aboriginal health.

What are the implications for practitioners? The conceptual framework and findings outlined in this paper illustrate that ACCHSs are making important contributions to improving Aboriginal health through several pathways. This information can be used to ensure actions to improve Aboriginal health are appropriate and effective. There are important gaps in the literature that researchers need to address.


References

[1]  Foley G. Aboriginal Community Controlled Health Services: a short history. Aboriginal Health Project Inf Bull 1982; 2 13–15.

[2]  Couzos S, Murray R. Aboriginal primary health care: an evidence based approach. Melbourne: Oxford University Press; 2007.

[3]  Sullivan P. The Aboriginal community sector and the effective delivery of services: acknowledging the role of Indigenous sector organisations. Working Paper 73. Alice Springs: Desert Knowledge Cooperative Research Centre; 2010.

[4]  Larkins SL, Geia LK, Panaretto KS. Consultations in general practice and at an Aboriginal community controlled health service: do they differ? Rural Remote Health 2006; 6 560

[5]  National Aboriginal Community Controlled Health Organisation. Investing in healthy futures for generational change. Canberra: NACCHO; 2013.

[6]  Black A. Evidence of effective interventions to improve the social and environmental factors impacting on health: informing the development of Indigenous Community Agreements. Canberra: Department of Health and Ageing; 2007.

[7]  Deeble Institute. The relative effectiveness of Aboriginal Community Controlled Health Services compared with mainstream health service. Canberra: Australian Healthcare and Hospital Association; 2014.

[8]  Dwyer J, Silburn K, Wilson G. National strategies for improving Indigenous health and health care. Canberra: Australian Government; 2004.

[9]  Griew R, Tilton E, Cox N, Thomas D. The link between primary health care and health outcomes for Aboriginal and Torres Strait Islander Australians, a report for the Office for Aboriginal and Torres Strait Islander Health. Canberra: Department of Health and Ageing; 2008.

[10]  Halliday D, Segal L. What works in Indigenous primary health care health reform? A review of the evidence. Health Economics and Social Policy Group Research Paper. 2012. Available at: https://www.unisa.edu.au/Global/Health/Sansom/Documents/HESPG/What%20works%20in%20Indigenous%20PHC%20reform.pdf [verified 13 February 2017].

[11]  Herceg A. Improving health in Aboriginal and Torres Strait Islander mothers, babies and young children: a literature review. Canberra: Department of Health and Ageing; 2005.

[12]  Shannon C, Wakerman J, Hill P, Barnes T, Griew R. Achievements in Aboriginal and Torres Strait Islander health: final report. Canberra: Department of Health and Ageing; 2002.

[13]  Aboriginal Health & Medical Research Council (AHMRC). Aboriginal communities improving Aboriginal health: an evidence review on the contribution of Aboriginal Community Controlled Health Services to improving Aboriginal health. Sydney: AHMRC; 2015.

[14]  Maxwell RJ. Quality assessment in health. BMJ 1984; 288 1470–2.
Quality assessment in health.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL2c3gsVGmtA%3D%3D&md5=473b5747d997c08633ad3c7e5bc88706CAS |

[15]  National Aboriginal Health Strategy Working Party (NAHSWP). A national Aboriginal health strategy. Canberra: NAHSWP; 1989.

[16]  Tilton E, Thomas D. Core functions of primary health care: a framework for the Northern Territory. Darwin: Lowitja Institute; 2011.

[17]  Commonwealth of Australia. Aboriginal and Torres Strait Islander health performance framework 2012. Canberra: Commonwealth of Australia; 2012.

[18]  Mays N, Pope C, Popay J. Systematically reviewing qualitative and quantitative evidence to inform management and policy-making in the health field. J Health Serv Res Policy 2005; 10 6–20.
Systematically reviewing qualitative and quantitative evidence to inform management and policy-making in the health field.Crossref | GoogleScholarGoogle Scholar |

[19]  Lavoie JG, Forget EL, Prakash T, Dahl M, Martens P, O’Neil JD. Have investments in on-reserve health services and initiatives promoting community control improved First Nations’ health in Manitoba? Soc Sci Med 2010; 71 717–24.
Have investments in on-reserve health services and initiatives promoting community control improved First Nations’ health in Manitoba?Crossref | GoogleScholarGoogle Scholar |

[20]  Chandler MJ, Lalonde CE. Cultural continuity as a hedge against suicide in Canada’s First Nations. Transcult Psychiatry 1998; 35 191–219.
Cultural continuity as a hedge against suicide in Canada’s First Nations.Crossref | GoogleScholarGoogle Scholar |

[21]  Baba JT, Brolan CE, Hill PS. Aboriginal medical services cure more than illness: a qualitative study of how Indigenous services address the health impacts of discrimination in Brisbane communities. Int J Equity Health 2014; 13 56–66.
Aboriginal medical services cure more than illness: a qualitative study of how Indigenous services address the health impacts of discrimination in Brisbane communities.Crossref | GoogleScholarGoogle Scholar |

[22]  Weightman M.. The role of Aboriginal Community Controlled Health Services in Indigenous health. Aust Med Student J 2013; 4 49–52.

[23]  Black A, Vally H, Morris PS, Daniel M, Esterman AJ, Smith FE, O’Dea K. Health outcomes of a subsidised fruit and vegetable program for Aboriginal children in northern New South Wales. Med J Aust 2013; 199 46–50.
Health outcomes of a subsidised fruit and vegetable program for Aboriginal children in northern New South Wales.Crossref | GoogleScholarGoogle Scholar |

[24]  Laugharne J, Glennen M, Austin J. The ‘Maga Barndi’ mental health service for Aboriginal people in Western Australia. Australas Psychiatry 2002; 10 13–17.
The ‘Maga Barndi’ mental health service for Aboriginal people in Western Australia.Crossref | GoogleScholarGoogle Scholar |

[25]  Longstreet DA, Griffiths MM, Heath D, Marshall GEG, Morisco P, Geary N, Larkins S, Panaretto K. Improving diabetes care in an urban Aboriginal medical centre. Aust J Primary Health 2005; 11 25–31.
Improving diabetes care in an urban Aboriginal medical centre.Crossref | GoogleScholarGoogle Scholar |

[26]  Marley J, Dent HK, Wearne M, Fitzclarence C, Nelson C, Siu K, Atkinson D. Haemodialysis outcomes for Aboriginal and Torres Strait Islander patients of remote Kimberley region origin. Med J Aust 2010; 193 516–20.

[27]  Nel P, Pashen D. Shared antenatal care for Indigenous patients in a rural and remote community. Aust Fam Physician 2003; 32 127–31.

[28]  Simmons D. Impact of an integrated approach to diabetes care at the Rumbalara Aboriginal Health Service. Intern Med J 2003; 33 581–5.
Impact of an integrated approach to diabetes care at the Rumbalara Aboriginal Health Service.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3srns12ltA%3D%3D&md5=89bc8e945c77b2ee2736347d30989ba1CAS |

[29]  Bartlett B, Boffa J. The impact of Aboriginal community controlled health service advocacy on Aboriginal health policy. Aust J Primary Health 2005; 11 53–61.
The impact of Aboriginal community controlled health service advocacy on Aboriginal health policy.Crossref | GoogleScholarGoogle Scholar |

[30]  Bartlett B, Boffa J. Aboriginal community controlled comprehensive primary health care: the Central Australian Aboriginal Congress. Aust J Primary Health 2001; 7 74–82.
Aboriginal community controlled comprehensive primary health care: the Central Australian Aboriginal Congress.Crossref | GoogleScholarGoogle Scholar |

[31]  Boffa J, George C, Tsey K. Sex, alcohol and violence: a community collaboration against striptease shows. Aust J Public Health 1994; 18 359–66.
Sex, alcohol and violence: a community collaboration against striptease shows.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2M3jsVOrtQ%3D%3D&md5=ab3a438bcbb5a2e70a9e83f6dfed0e17CAS |

[32]  Hogan E, Boffa J, Rosewarne C, Bell S, Ah Chee D. What price do we pay to prevent alcohol-related harms in Aboriginal communities? The Alice Springs trial of liquor licensing restrictions. Drug Alcohol Rev 2006; 25 207–12.
What price do we pay to prevent alcohol-related harms in Aboriginal communities? The Alice Springs trial of liquor licensing restrictions.Crossref | GoogleScholarGoogle Scholar |

[33]  Panaretto KS, Lee HM, Mitchell MR, Larkins SL, Manessis V, Buettner PG, Watson D. Impact of a collaborative shared antenatal care program for urban Indigenous women: a prospective cohort study. Med J Aust 2005; 182 514–19.

[34]  Alford K. Investing in Aboriginal community controlled health makes economic sense. Canberra: National Aboriginal Community Controlled Health Organisation; 2014.

[35]  Australian Institute of Health and Welfare (AIHW). Aboriginal and Torres Strait Islander health organisations: online services report – key results 2012–13. Catalogue no. 139. Canberra: AIHW; 2014.

[36]  Osborne K, Baum F, Brown L. What works? A review of actions addressing the social and economic determinants of Indigenous health. Issues Paper no.7 produced for the Closing the Gap Clearinghouse. Canberra: Australian Institute of Health and Welfare; Melbourne: Australian Institute of Family Studies; 2013.

[37]  Martin ME, Reath JS. General practice training in Aboriginal and Torres Strait Islander health. Med J Aust 2011; 194 67–70.

[38]  Dimer L, Dowling T, Jones J, Cheetham C, Thomas T, Smith J, McManus A, Maiorana AJ. Build it and they will come: outcomes from a successful cardiac rehabilitation program at an Aboriginal Medical Service. Aust Health Rev 2013; 37 79–82.
Build it and they will come: outcomes from a successful cardiac rehabilitation program at an Aboriginal Medical Service.Crossref | GoogleScholarGoogle Scholar |

[39]  Dwyer J, Kelly J, Willis E, Glover J, Mackean T, Pekarsky B, Battersby M. Managing two worlds together: city hospital care for country Aboriginal people – project report. Melbourne: The Lowitja Institute; 2011.

[40]  Eades S. Maternal and child health care services: actions in the primary health care setting to improve the health of Aboriginal and Torres Strait Islander women of childbearing age, infants and young children. Canberra: Australian Department of Health and Ageing; 2004.

[41]  Parker EJ, Misan G, Shearer M, Richards L, Russell A, Mills H, Jamieson M. Planning, implementing, and evaluating a program to address the oral health needs of Aboriginal children in Port Augusta, Australia. Int J Pediatr 2012; 2012 496236
Planning, implementing, and evaluating a program to address the oral health needs of Aboriginal children in Port Augusta, Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC38nitlenuw%3D%3D&md5=0311fefe2c2433a123b32d4d789f3074CAS |

[42]  Turner AW, Xie J, Arnold AL, Dunn RA, Taylor HR. Eye health service access and utilization in the National Indigenous Eye Health Survey. Clin Experiment Ophthalmol 2011; 39 598–603.
Eye health service access and utilization in the National Indigenous Eye Health Survey.Crossref | GoogleScholarGoogle Scholar |

[43]  Department of Health and Aged Care. Better health care: studies in the successful delivery of primary health care services for Aboriginal and Torres Strait Islander Australians. Canberra: Department of Health and Aged Care; 2001.

[44]  Davey M, Moore W, Walters J. Tasmanian Aborigines step up to health: evaluation of a cardiopulmonary rehabilitation and secondary prevention program. BMC Health Serv Res 2014; 14 349
Tasmanian Aborigines step up to health: evaluation of a cardiopulmonary rehabilitation and secondary prevention program.Crossref | GoogleScholarGoogle Scholar |

[45]  Huang RL, Torzillo PJ, Hammond VA, Coulter ST, Kirby AC. Epidemiology of sexually transmitted infections on the Anangu Pitjantjatjara Yankuntjatjara Lands: results of a comprehensive control program. Med J Aust 2008; 189 442–5.

[46]  Miller PJ, Torzillo PJ, Hateley W. Impact of improved diagnosis and treatment on prevalence of gonorrhoea and chlamydial infection in remote Aboriginal communities on Anangu Pitjantjatjara Lands. Med J Aust 1999; 170 429–32.
| 1:STN:280:DyaK1M3ntlehsw%3D%3D&md5=fe84dfba540957a2d80f9601d5cb9058CAS |

[47]  Carter E, Lumley J, Wilson G, Bell S. ‘Alukura…for my daughters and their daughters and their daughters’: a review of Congress Alukura. Aust N Z J Public Health 2004; 28 229–34.
‘Alukura…for my daughters and their daughters and their daughters’: a review of Congress Alukura.Crossref | GoogleScholarGoogle Scholar |

[48]  Jan S, Conaty S, Hecker R, Bartlett M, Delaney S, Capon T. An holistic economic evaluation of an Aboriginal community-controlled midwifery programme in Western Sydney. J Health Serv Res Policy 2004; 9 14–21.
An holistic economic evaluation of an Aboriginal community-controlled midwifery programme in Western Sydney.Crossref | GoogleScholarGoogle Scholar |

[49]  Scrimgeour M, Scrimgeour D. Health care access for Aboriginal and Torres Strait Islander people living in urban areas, and related research issues: a review of the literature. Darwin: Cooperative Research Centre for Aboriginal Health; 2007.

[50]  Aspin C, Brown N, Jowsey T, Yen L, Leeder S. Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic illness: a qualitative study. BMC Health Serv Res 2012; 12 143
Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic illness: a qualitative study.Crossref | GoogleScholarGoogle Scholar |

[51]  Govil D, Lin I, Dodd T, Cox R, Moss P, Thompson S, Maiorana A. Identifying culturally appropriate strategies for coronary heart disease secondary prevention in a regional Aboriginal medical service. Aust J Primary Health 2014; 20 266–72.
Identifying culturally appropriate strategies for coronary heart disease secondary prevention in a regional Aboriginal medical service.Crossref | GoogleScholarGoogle Scholar |

[52]  Jowsey T, Yen L, Ward N, McNabb J, Aspin C, Usherwood T. It hinges on the door: time, spaces and identity in Australian Aboriginal health services. Health Sociol Rev 2012; 21 196–207.
It hinges on the door: time, spaces and identity in Australian Aboriginal health services.Crossref | GoogleScholarGoogle Scholar |

[53]  Ward J, Bryant J, Worth H, Hull P, Solar S, Bailey S. Use of health services for sexually transmitted and blood-borne viral infections by young Aboriginal people in New South Wales. Aust J Primary Health 2013; 19 81–6.
Use of health services for sexually transmitted and blood-borne viral infections by young Aboriginal people in New South Wales.Crossref | GoogleScholarGoogle Scholar |

[54]  Mooney-Somers J, Erick W, Scott R, Akee A, Kaldor J, Maher L. Enhancing Aboriginal and Torres Strait Islander young people’s resilience to blood-borne and sexually transmitted infections: findings from a community-based participatory research project. Health Promot J Austr 2009; 20 195–201.

[55]  Hurley C, Baum F, Johns J, Labonte R. Comprehensive primary health care in Australia: findings from a narrative review of the literature. Australas Med J 2010; 1 147–52.

[56]  Wakerman J, Humphreys JS, Wells R, Kuipers P, Entwistle P, Jones J. Primary health care delivery models in rural and remote Australia – a systematic review. BMC Health Serv Res 2008; 8 276

[57]  Shannon C, Longbottom H. Capacity development in Aboriginal and Torres Strait Islander health service delivery – case studies. Consultant Report No. 4. Canberra: Commonwealth of Australia; 2004.

[58]  Campbell MA, Finlay S, Lucas K, Neal N, Williams R. Kick the habit: a social marketing campaign by Aboriginal communities in NSW. Aust J Primary Health 2014; 20 327–33.
Kick the habit: a social marketing campaign by Aboriginal communities in NSW.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC2M7ltlajtw%3D%3D&md5=f390a48ce603afc73e6fd460c792c08aCAS |

[59]  Couzos S, Sheedy V, Thiele DD. Improving Aboriginal and Torres Strait Islander people’s access to medicines – the QUMAX program. Med J Aust 2011; 195 62–3.

[60]  Dwyer J, O’Donnell K, Lavoie J, Marlina U, Sullivan P. The Overburden Report: contracting for Indigenous health services. Casurina: Flinders University and Cooperative Research Centre for Aboriginal Health; 2009.

[61]  Malseed C, Nelson A, Ware R, Lacey I, Lander K. Deadly Choices community health events: a health promotion initiative for urban Aboriginal and Torres Strait Islander people. Aust J Primary Health 2014; 20 379–83.
Deadly Choices community health events: a health promotion initiative for urban Aboriginal and Torres Strait Islander people.Crossref | GoogleScholarGoogle Scholar |

[62]  Rowley KG, O’Dea K, Anderson I, McDermott R, Saraswati K, Tilmouth R, Roberts I, Fitz J, Wang Z, Jenkins A, Best JD, Wang Z, Brown A. Lower than expected morbidity and mortality for an Australian Aboriginal population: 10 year follow-up in a decentralised community. Med J Aust 2008; 188 283–7.

[63]  Ong K. Indigenous population results Pamphlet E: the Indigenous health service delivery template. Melbourne: Deakin University; and Brisbane: University of Queensland; 2010.

[64]  Thomas DP, Heller RF, Hunt JM. Clinical consultations in an Aboriginal community-controlled health service: a comparison with general practice. Aust N Z J Public Health 1998; 22 86–91.
Clinical consultations in an Aboriginal community-controlled health service: a comparison with general practice.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c3mt1GqsA%3D%3D&md5=a687a72f3424e7023398acf4622a3388CAS |

[65]  Aspery W, Jarrett J, Donovan I. Durri Aboriginal Corporation medical service – Djuligalban Program. In: Groos A, Engeler T, Miller M, McDonald MA, editors. Stories and ideas from around Australia giving Aboriginal and Torres Strait Islander babies the best start in life: supporting breastfeeding and good food choices for infants. Cairns: Department of Social and Preventative Medicine, Northern Clinical School, University of Queensland and the Tropical Public Health Unit and Apunipima Cape York Health Council; 1998. pp. 75–77.

[66]  Warchivker I, Hayter A. An evaluation of a nutrition program in a remote community in central Australia. Proceedings of the 6th National Rural Health Conference, 4–7 March 2001, Canberra. Canberra: National Rural Health Alliance; 2001.

[67]  Marley JCN, O’Donnell V, Atkinson D. Quality indicators of diabetes care: an example of remote-area Aboriginal primary health care over 10 years. Med J Aust 2012; 197 404–8.
Quality indicators of diabetes care: an example of remote-area Aboriginal primary health care over 10 years.Crossref | GoogleScholarGoogle Scholar |

[68]  Abbott PA, Davison JE, Moore LF, Rubinstein R. Effective nutrition education for Aboriginal Australians: lessons from a diabetes cooking course. J Nutr Educ Behav 2012; 44 55–9.
Effective nutrition education for Aboriginal Australians: lessons from a diabetes cooking course.Crossref | GoogleScholarGoogle Scholar |

[69]  Su JY, Skov S. An assessment of the effectiveness of the Tiwi Sexual Health Program 2002–2005. Aust N Z J Public Health 2008; 32 554–8.
An assessment of the effectiveness of the Tiwi Sexual Health Program 2002–2005.Crossref | GoogleScholarGoogle Scholar |

[70]  Keleher H. Why primary health care offers a more comprehensive approach for tackling health inequities than primary care. Aust J Primary Health 2001; 7 57–61.
Why primary health care offers a more comprehensive approach for tackling health inequities than primary care.Crossref | GoogleScholarGoogle Scholar |

[71]  Browne AJ, Varcoe CM, Wong ST, Smye VL, Lavoie J, Littlejohn D, Tu D, Godwin O, Krause M, Khan KB, Fridkin A, Rodney P, O’Neill J, Lennox S. Closing the health equity gap: evidence-based strategies for primary health care organizations. Int J Equity Health 2012; 11 59
Closing the health equity gap: evidence-based strategies for primary health care organizations.Crossref | GoogleScholarGoogle Scholar |

[72]  World Health Organization (WHO). Declaration of Alma Ata. 1978. Available at: http://www.who.int/publications/almaata_declaration_en.pdf?ua=1 [verified 13 February 2017.

[73]  Derrick GE, Hayen A, Chapman S, Haynes A, Webster BM, Anderson I. A biblioimetric analysis of research on Indigenous health in Australia, 1972–2008. Aust N Z J Public Health 2012; 36 269–73.
A biblioimetric analysis of research on Indigenous health in Australia, 1972–2008.Crossref | GoogleScholarGoogle Scholar |

[74]  Lawless A, Freeman T, Bentley M, Baum F, Jolley G. Developing a good practice model to evaluate the effectiveness of comprehensive primary health care in communities. BMC Fam Pract 2014; 15 99
Developing a good practice model to evaluate the effectiveness of comprehensive primary health care in communities.Crossref | GoogleScholarGoogle Scholar |

[75]  Lee KP, Boyd EA, Holroyd-Leduc JM, Bacchetti P, Bero LA. Predictors of publication: characteristics of submitted manuscripts associated with acceptance at major biomedical journals. Med J Aust 2006; 184 621–6.

[76]  Standing Senate Committee on Social Affairs Science and Technology (SSCSAST). The health of Canadians: the federal role. Volume 1 – the story so far. Ottawa: SSCSAST; 2001.