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

Moving Forward TogetherJanet Kellyservices were more culturally responsive services, were most able to meet theircomplex needs, and were therefore the preferred option 12 . While mainstreamoptions and choices were important, many preferred to attend Aboriginal heathservices (Government of South Australia 2003b).The struggles of community based Aboriginal health servicesWithin the complex environment of mainstream biomedical dominance andAboriginal focused comprehensive primary health care funding and policypriorities, Aboriginal Health Services and Community Health Services(ACCHS) have struggled to meet Aboriginal client needs. Aboriginal healthservices in particular have raised concerns related to Federal ‘body part’funding for primary health care programs (Henry et al 2004). Separate streamsof money are provided for each differing (biomedical /technical) conditionsuch as diabetes, heart disease, and asthma. One Aboriginal medical servicereported that they had to apply, set up separate accounts for, monitor andprovide reports and evaluations to twenty six different funding streams to meetclients’ needs (Henry et al2004, p. 517). In Perth, an Aboriginal MedicalService experienced a funding cut when an ‘overspend’ arose due to theirsuccess of attracting additional Aboriginal clients. At the same time a teachinghospital overspent 120 times as much and were given an extra $100 million tocover their overspend (Henry, Houston & Mooney 2004, p. 517). Thishighlights the value and authority that continues to be placed on tertiary careand biomedical knowledge over primary health care, even in the area ofAboriginal health that has strong policies supporting the need for bothcomprehensive primary health care and selective primary care.Women’s healthAustralia’s first National Women’s Health Policy was developed in 1989 13 ,with a vision of improving the health of all Australian women. Underpinned bysocial justice, comprehensive primary health care and feminist ideology, this12 The history of Aboriginal Community Controlled health services is South Australia is unique inthat several of them (including Pika Wiya and Ceduna Koonibba) are not really communitycontrolled as their board members are appointed in the main. Generally ACCHS started throughcommunity initiatives to address exclusion from mainstream and obtained funding over seas.13 The same year as the first National Aboriginal Health Strateg.82