NURS3046 Nursing Project

1. Describe the 3 factors that affect the aboriginal health globally such as 1) lack of access to health service. 2) lack of education. 3) inequity in health and racism. and give example globally for each factor

2. Write solution of these challenges.

• Describe how advocacy and community engagement, in the context of principles of common good and human dignity contribute to your proposed solution
• Also describe how nursing profession can offer solution to these challenges to the common good.

1. In philosophy, the principle of common good refers to wither what is accomplished by collective action and citizenship, or what is shared and advantageous for most members who belong to a certain community (Dahl & Soss, 2014). According to AIHW (2016) Aboriginal people have reported a 2.3 times increased burden for diseases, when compared to their non-indigenous counterparts. The Aboriginals usually report reduced levels of usage of pharmaceutical benefits and Medicare benefits that accounts for the lower levels of primary care access in the target population. Ensuring adequate access to primary healthcare service has been widely accepted as a strategy for enhancing health outcomes of the indigenous population. Thus, lack of access increases their chances of suffering from chronic health abnormalities and violates the common good principle. Barriers to adequate education among the indigenous population includes use of English in the teaching materials in regions where it is not the first language of people, lack of in-depth information on Aboriginal history, few Aboriginal teachers, lack of full-time educators, and uneducated parents (Ford, 2013).

Furthermore, living conditions such as, overcrowding and poverty makes it difficult for the indigenous students to afford education services. Segregation according to the level of skills and absence of sound infrastructure also fails to accommodate enough Aboriginals in schools, thus failing to establish the common good principle. Racial minorities have also been found to bear a disproportionate burden of mortality and morbidity. These inequities are commonly explained in relation to racism, considering the fact that racism plays an important role in restricting the lives of immigrants and racial minorities (Herring et al., 2013). Owing to the fact that health inequities among the indigenous minorities are more pronounced, several diseases are prevalent among them such as, heart disease, infant and maternal mortality, and cancer. The relative socioeconomic disadvantage that is commonly experienced by the Aboriginals places them at an increased risk of being exposed to environmental and behavioural risk factors related to health.

2. Advocating for the rights of the Aboriginals helps in achieving a compassionate and just world where all Australians will get the opportunity of realizing their best potential. Population advocacy takes into account the fact that the Aboriginal and Torres Strait Islander people, who were considered the actual custodians of the land, are subjected to regular injustice that has resulted in poverty, ill health, family breakdown and frightening rates of incarceration. Advocacy will help in providing the Aboriginals adequate support, which in turn will facilitate their working towards achieving complete potential and gaining an increased control over their affairs. This in turn will also assist the process of mobilization of the Aboriginals and the wider community for establishing an equitable and just society. On the grounds of the common good principle it can be stated that the indigenous people are entitled to living a life of dignity and opportunity that is free from all sorts of disadvantage and discrimination (Westheimer, 2015). This right is common and shared by all citizens of the nation, regardless of their racial or ethnic status.

Hence, advocacy and social justice will focus on ensuring that all Australians namely, indigenous and non-indigenous get the opportunity to exercise their preferences on how they live and the ways that can be adopted to make those opinions (Freeman et al., 2014). In other words, advocacy will be grounded in the day-to-day and practical realities of life. It will help in ensuring formulation of an environment where the indigenous people get provisions for proper sanitation and running water, education for children that assists them enhance their potential and display a respect towards culture. This in turn will promote the prospect of good health and satisfying employment (Hatala, Desjardins & Bombay, 2016). Genuine engagement with the individuals belonging to the Aboriginal community has been identified as a chief aspect in overcoming the different challenges that lead to indigenous disadvantage. Community engagement can be fostered through partnerships with the indigenous organizations within a set framework of indigenous control and self-determination. The strategies that will be adopted in this regard include explicit address of the existing power inequalities, concomitant with display of genuine efforts that focus on sharing power, via agreements that are negotiated (Briskman, 2014). The cultural and social context of the indigenous people should be understood in relation to the existing social fluidity. The primary objective of community engagement would be develop long term relationship with the Aboriginals, based on trust. Partnership between the indigenous people and the mainstream healthcare services will help in meeting the common good principle.

Human dignity refers to the sense of self-worth and self-respect of an individual or group of individuals, in relation to psychological and physical integrity and empowerment. The way by which people grade themselves and others, based on some form of social and moral ladder is based on their perceptions of right and wrong (Rix et al., 2013). The principle of human dignity is based on the catholic social teaching that all human beings contain an inherent worth, value and distinction by their existence (Fischer, 2014). Regardless of different reasons and/or factors, people can think of, persons have an intrinsic and immeasurable value and dignity and each life is well thought-out as sacred. It is also suggested that severe inequality against a particular population results in leaving the people belonging to the population at the bottom, thus excluding them from the larger community (Sherwood, 2013). Hence, community engagement and advocacy would help in redefining the common good principle and will enhance the social conditions that will allow the indigenous people to reach their goal fulfillment and will enhance their progress. Hence, in the words of Waterton and Watson (2013) it is the role of the Australian government to make available the necessary cultural, moral, material, and spiritual goods, to the Aboriginals. This will allow each of them to achieve their complete development. Among the roles and responsibilities of the government lies the requirement to harmonise sectoral interests in relation to justice requirements (Barclay et al., 2014).

Meeting the health needs of the Aboriginals is the primary objective of the nursing profession. Cultural safety has been recognized as a powerful nursing concept, the explicit purpose of which is to consider the power relations that are historically determined between the indigenous people and the nurses. Hence, a culturally safe nursing practice will help in bridging the differences that have gradually evolved between them (Artuso et al., 2013). Notably, cultural safety will also help in finding expression that focus on seeking equality and are rights oriented. The over-arching ambition of a culturally competent nursing profession is associated with health development of Aboriginal people (Atkinson, 2018). A tension often exists between the entirety of one’s environment and self that is inherent in the cultural safety, which affects both indigenous people and nursing professionals. The definition of health is not just restricted to the physical wellbeing of an person, but pertains to the emotional, social, cultural, and spiritual wellbeing of the entire community (Nielsen, Alice Stuart & Gorman, 2014).

Despite maintaining a positive relationship between the community and the hospital, discussion with the elders of the Aboriginal community, celebrating accomplishment of priority activities, and community lunches held by the nursing staff with the service users will also help in successful engagement with local indigenous community, and attaining the principle of common good (Bennett, 2015). Relationship with the community can be built by holding individual conversations with the Aboriginal members, and consultant-led interaction at important community meetings. Nurses must also take efforts to utilize the statewide health resources for assisting care delivery among the Aboriginal population. Some of the primary elements of this aspect would encompass cultural awareness, providing information on emergency maternity care, communication enhancement, and displaying dignity towards the target population. These facets of nursing profession will help in achieving the principle of common good.

References

Artuso, S., Cargo, M., Brown, A., & Daniel, M. (2013). Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study. BMC Health Services Research, 13(1), 83.

Atkinson, A. (2018). The I in the past. History Australia, 1-13.

Australian Institute of Health and Welfare. (2016). Australia’s health 2016. Retrieved from https://www.aihw.gov.au/getmedia/01d88043-31ba-424a-a682-98673783072e/ah16-6-6-indigenous-australians-access-health-services.pdf.aspx.

Barclay, L., Kruske, S., Bar-Zeev, S., Steenkamp, M., Josif, C., Narjic, C. W., … & Kildea, S. (2014). Improving Aboriginal maternal and infant health services in the ‘Top End’of Australia; synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change. BMC health services research, 14(1), 241.

Bennett, B. (2015). “Stop deploying your white privilege on me!” Aboriginal and Torres Strait Islander engagement with the Australian Association of Social Workers. Australian Social Work, 68(1), 19-31.

Briskman, L. (2014). Social work with indigenous communities: A human rights approach.

Dahl, A., & Soss, J. (2014). Neoliberalism for the common good? Public value governance and the downsizing of democracy. Public Administration Review, 74(4), 496-504.

Fischer, E. F. (2014). The good life: aspiration, dignity, and the anthropology of wellbeing. Stanford University Press.

Ford, M. (2013). Achievement gaps in Australia: What NAPLAN reveals about education inequality in Australia. Race Ethnicity and Education, 16(1), 80-102.

Freeman, T., Edwards, T., Baum, F., Lawless, A., Jolley, G., Javanparast, S., & Francis, T. (2014). Cultural respect strategies in Australian Aboriginal primary health care services: beyond education and training of practitioners. Australian and New Zealand Journal of Public Health, 38(4), 355-361.

Hatala, A. R., Desjardins, M., & Bombay, A. (2016). Reframing narratives of Aboriginal health inequity: Exploring Cree elder resilience and well-being in contexts of historical trauma. Qualitative health research, 26(14), 1911-1927.

Herring, S., Spangaro, J., Lauw, M., & McNamara, L. (2013). The intersection of trauma, racism, and cultural competence in effective work with aboriginal people: Waiting for trust. Australian Social Work, 66(1), 104-117.

Nielsen, A. M., Alice Stuart, L., & Gorman, D. (2014). Confronting the cultural challenge of the whiteness of nursing: Aboriginal registered nurses’ perspectives. Contemporary nurse, 48(2), 190-196.

Rix, E. F., Barclay, L., Wilson, S., Stirling, J., & Tong, A. (2013). Service providers’ perspectives, attitudes and beliefs on health services delivery for Aboriginal people receiving haemodialysis in rural Australia: a qualitative study. BMJ open, 3(10), e003581.

Sherwood, J. (2013). Colonisation–It’s bad for your health: The context of Aboriginal health. Contemporary Nurse, 46(1), 28-40.

Waterton, E., & Watson, S. (Eds.). (2013). Heritage and community engagement: collaboration or contestation?. Routledge.

Westheimer, J. (2015). What kind of citizen?: Educating our children for the common good. Teachers College Press.