The Case for Aboriginal Health Workers in Palliative Care

Article excerpt

Abstract

Objectives: The findings are drawn from a 2-year research project, funded by the National Health and Medical Research Council (NHMRC), which aimed to develop an innovative model for Indigenous palliative care. The findings presented in this article explore one important strategy for putting Aboriginal families and their communities at the centre of the model: that is, the employment of Aboriginal Health Workers (AHWs) in relation to the provision of palliative care in the Northern Territory.

Methods: The data were collected from 72 qualitative interviews conducted throughout the regional, rural and remote areas of the Northern Territory with Indigenous patients and carers in the Northern Territory and the health professionals who care for them.

Results: While highlighting the valuable role of AHWs, the findings emphasise that the current lack of availability of such workers for palliative care provision for Indigenous peoples needs serious consideration.

Aust Health Rev 2007: 31(3): 430-439

INDIGENOUS AUSTRALIANS face significant obstacles in accessing health services, many of which are created by cross-cultural barriers between Aboriginal culture and Western medicine.1 The cultural differences between the dominant Anglo-Australian group and the Aboriginal Australian group are significant, particularly in relation to disease and death.2 Aboriginal health is not just about the physical condition of the body, but embraces spiritual notions of the family and community that many Western models of health care delivery fail to identify and, therefore, accommodate.3 As McConnel4 recommends, strategies are needed to facilitate the sharing of knowledge at the interface of Western medicine and Aboriginal culture, in a way that includes Indigenous beliefs and practices.

Research affirms that health care models that put Aboriginal families and their communities at the centre of the system and allow them control have had dramatic success in improving access to care, and ultimately the health status of Indigenous communities.5 The findings presented in this article explore one important strategy in this regard: the employment of Aboriginal Health Workers (AHWs) in relation to the provision of palliative care to Indigenous peoples. The findings are drawn from a 2-year research project funded by Australia's National Health and Medical Research Council (NHMRC), which aimed to develop an innovative model for Indigenous palliative care. This objective has been achieved and the model is now available in a final report.6

Methods

The data for model development were collected through open-ended, qualitative interviews with a cross-section of participants (consumers and health professionals) throughout the Northern Territory. The model was assessed by a national peer-review panel of experts in Indigenous health and a meeting of the project's Northern Territory Aboriginal reference group. The findings discussed in this article refer to the employment of Indigenous people, in relation to the provision of palliative care to Indigenous peoples, either as liaison staff or as AHWs.

Ethics clearance

This project was conducted in compliance with the NHMRC Values and Ethics: Guidelines for Ethical conduct in Aboriginal and Torres Strait Islander Health Research,7 and the Australian Institute of Aboriginal and Torres Strait Islander Health Research 2004, Ethical Guidelines for Research.8 Permission and authorisation was obtained from a number of research ethics committees: The Human Research Ethics Committee of the Department of Health and Community Services (previously Territory Health Services) and Menzies School of Health Research in Darwin; the Central Australian Ethical Committee in Alice Springs; the Human Research Ethics Committee of Charles Darwin University (previously Northern Territory University); and the Central Queensland University. Approval was sought from relevant Community Councils (Chairs/ Elders as appropriate) and from all individuals before participation in the project. …