Moving Forward Together in Aboriginal Women's Health: - Theses ...

Moving Forward TogetherJanet Kellywomen more regularly while co-facilitating their group and providing clinicalservices. In 2004 I attended a Family Well-being Training at Gilles Plainsalongside Aboriginal community women, conducted a small participatoryaction research project and began providing sexual health clinical and healthpromotion services on site.SummaryIn this chapter I have provided an overview of health service development atthe Gilles Plains Community Campus. At times health professionals have beensupported to be based at Gilles Plains, working collaboratively with localresidents and local services in democratic partnerships, addressing locallyidentified needs. During these times, relationships of trust and reciprocity wereformed between health staff and Aboriginal community members (AboriginalHealth Services Interagency Forum 2001; Gilles Plains Community HealthCentre 2004). Bottom up policies enabled local priorities and issues to beaddressed in ways considered most appropriate by community members, localhealth professionals and onsite managers. Evidence based practiceincorporated external biomedical and policy knowledge as well as localcommunity, individual client, local health professional and managerialknowledge. Decisions were made in the context of people’s lives guided byconcepts within comprehensive primary health care, community developmentand capacity building programs and policies. Specific expectations regardingdemocratic knowledge and power sharing, working together collaborativelyand addressing issues in locally meaningful ways were established betweenhealth professionals, community members and managers.At other times, organisational and health policies focused on mainstreamingand centralisation, with top down decision making and external changes.During these times, staff were taken off campus and/or directed into specificprimary care programs resulting in relationships with community becomingstrained, and local community expectations largely unmet (Communityconsultations 2005). When this coincided with other support services beingremoved from the area, there was strong community backlash. Evidence basedpractice during these times was considered (by top down policies) to be based158