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

Moving Forward TogetherJanet Kellyhealth care agenda. Health professionals’ recognition of the hugely complexnature of clients’ health and well being was overlooked, and simplisticselective health care programs and directives were expected to beimplemented. When inadequate selective primary care programs did not runsmoothly, health professionals felt blamed for health program failures byhigher level managers. Inadequate and at times unsafe communicationpathways prevented health professionals from safely feeding information andcritique back up the line.This situation calls into question what is accepted as evidence based practice inprimary health care and research. This research identified that culturally safeand client centered care required client and health professional knowledge tobe recognised as significant evidence, alongside technical and biologicalknowledge. Unmodified and unquestioned selective primary care can notadequately address the deep rooted social, economic and historical factors thatunderlay the health disparities that many Aboriginal people continue toexperience. Health professional and client knowledge needs to be recognisedand included in bottom up policies and decision making. Experientially basedintuitive understanding should be considered as evidence, and evolvingresearch agenda should constantly question who defines best evidence, andwho judges it (see for example MCHenna 2000 and Rycroft-Malone, Seers,Titchen, Harvey, Kitson & McCormack 2004) For this to occur, two-wayknowledge sharing between health professionals, managers, policy makers andscientists would need to occur. This would require changes in perceptionsabout power and knowledge and a swing back toward comprehensive primaryhealth care across all levels of government and the health care system.Concepts of Ganma two-way knowledge sharing and Dadirri deep listeningwere more successful in bridging understandings between different sectors andagencies, such as the health service, the youth sector and local high school. Ashared understanding of the holistic and comprehensive health needs of youngAboriginal women and the impacts of lower social determinants of healthemerged. From this specific strategies and programs were successfullydeveloped.333