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

Moving Forward TogetherJanet KellyToward the end of 2007 and into 2008, the Aboriginal Outreach Health Servicewas providing a wide range of services that were generally well attended. Thesame manager had been in place for over a year and both selective andcomprehensive primary health care services were meeting a range of clientneeds. Collaborative relationships with mainstream community health, thelocal Division of General Practice and the Women’s and Children’s Hospitalwere being strengthened, and women’s programs such as midwifery sharedcare were being developed. While it was not all smooth sailing (many staffmembers sought employment elsewhere or went on stress leave), the healthservice began to make significant differences in Aboriginal women’s andmen’s people’s lives. Many adults got their diabetes under control for the firsttime through ongoing group support, exercise and weight loss programs and/ornew opportunities to heal from past and present traumatic experiences. Referralto other services enabled them to get their wider health needs met. LocalAboriginal community people and visitors from other areas began buildingtrusting relationships with staff from the health service. The AboriginalOutreach Health Service had moved closer to the original vision of aresponsive Aboriginal community service that provided both comprehensiveprimary health cares. It more closely resembled the nine principles of theNational Strategic Framework for Aboriginal and Torres Strait Islander Health2003-2013 (2004). There was a stronger commitment to holistic health,responding to community needs, working together, promoting good health andbuilding the capacity of the health service and community members. From theperspective of the local Aboriginal community this was a very positiveoutcome.However, in late 2008, the service underwent massive changes that hadsignificant impact on this careful collaboration and heath service capacity. Atthe time of writing (mid December 2008), higher management decisions in theCentral Northern Adelaide Health Service (CNAHS) are signalling changes tothe way that Aboriginal health services are to beprovided at Gilles Plains, andperhaps other sites across the region. Aboriginal services are to be downsizedwith only one site manager, one receptionist and two Aboriginal HeathWorkers remaining. Clinical services are to be provided by a visiting326