IssuesAccess and EquityCommunity DevelopmentCulture Safety

Noraine Princess Tabangcora

Indigenous Health

Objectives:

1. Define Indigenous Peoples

2. Learn the Aboriginal concept of Health

3. Identify Aboriginal Health Issues

4. Determine Issues on Health Access and Equity

5. Learn the role of community development in Health promotion in Indigenous peoples

6. Learn the importance of culture safety in promoting health in indigenous peoples

Indigenous

Native

Aboriginal

Born Within

Original

First

KATUTUBO

Who are the indigenous peoples?

Includes persons who:

Ω Identify themselves and are recognized and accepted by their community as indigenous.

Ω Demonstrate historical continuity with pre-colonial and/or pre-settler societies.

Ω Have strong links to territories and surrounding natural resources.

Ω Have distinct social, economic or political systems.

Ω Maintain distinct languages, cultures and beliefs.Ω Form non-dominant groups of society.Ω Resolve to maintain and reproduce their ancestral

environments and systems as distinctive people and communities.

http://www.who.int/mediacentre/factsheets/fs326/en/

Indigenous Concept of Health and Healing

Individuals

UniverseCommunity

Major health issues of Indigenous peoples:

• High infant and young child mortality

• High maternal morbidity and mortality

• Heavy infectious disease burdens

• Malnutrition and retarded growth

• Diseases caused by environmental contamination (eg, by heavy metals, industrialgases, and effluent wastes) and infectious diseases caused by faecal contamination

ISSUES

• Shortened life expectancy at birth

• Diseases and deaths associated with cigarette smoking

• Social problems, illnesses, and deaths linked to misuse of alcohol and other drugs

• Accidents, poisonings, interpersonal violence, homicide, and suicide

• Obesity, diabetes, hypertension, cardiovascular disease, and chronic renal disease(lifestyle diseases)

ISSUES

Issues on Health Access and

Equity

Aboriginal people:

• Residing farther from health services

• non-availability of transport

• Inefficient in speaking the national or universal language

• lower incomes

• lower educational achievement

Goals to maintain health access and equity

• Improved access for Aboriginal peoples’ culturally appropriate primary health

care• Increasing the number of health practitioners working within

Aboriginal health settings, and furtherdevelopment and training of the Indigenous health workforce

• Improving the responsiveness of mainstream health services and programs to Aboriginal peoples’ health needs

• Greater targeting of maternal and child health and greater support for Indigenous-specific population

programs for chronic and communicable disease

• Greater funding and support for the building blocks of good health such as awareness and availability of

nutrition, physical activity, fresh food, healthy lifestyles, and adequate housing

• Setting national targets and benchmarks towards achieving healthy equality, by which progress can be

closely monitored

Community Development

*involves changing the relationships between ordinary people and people in positions of power, so that everyone can take part in the issues that affect their lives.

Community Development and Health Promotion

Five Key Concepts:

• Strengthening community action• Building healthy public policy• Creating supportive environments• Developing personal skills• Reorienting the health system

Cultural Safety

more or less - an environment, which is safe for people; where there is no assault, challenge or denial of their identity, of who they are and what, they need. It is about shared respect, shared meaning, shared knowledge and experience, of learning together with dignity, and truly listening.

In the context of healthcare delivery, culturally unsafe practices have been defined as “any actions that diminish, demean or disempower the cultural identity and well-being of an individual” (Cooney, 1994).

Cultural safety incorporates the following:

• Cultural awareness-the acknowledgement of difference

• Cultural sensitivity- the recognition of the importance of respecting difference

• Cultural competence- which focuses on the skills, knowledge, and attitudes of practitioners

• Cultural safety involves self-reflection and an understanding that cultural values and norms of the client may be different due to unique socio-political histories.

Cultural safety incorporates the following:

• Self-reflection leads to empathy, the capability to share another being's emotions and feelings, which in turns improves the therapeutic encounter with clients and their communities, leading to better health outcomes.

• Empathy could also lead to advocacy and social justice work on behalf of clients and their communities

1. Protocols – respect for cultural forms of engagement

2. Personal knowledge – understanding one’s own cultural identity and sharing information about oneself to create a sense of equity and trust

3. Process – engaging in mutual learning, checking on cultural safety of the service recipient

4. Positive purpose – ensuring the process yields the right outcome for the service recipient according to that recipient’s values, preferences and lifestyle

5. Partnerships – promoting collaborative practice(Adapted from Ball, 2007b, p. 1)

Five Principles Necessary For Cultural Safety

“So the ultimate goal here is for participants really to come to a place of cultural safety from within and once they can feel secure in themselves, in their voice, in their culture then the true healing can begin.”

REFERENCESAbbott, P., Gordon, E., & Davison, J. (2008). Expanding roles of Aboriginal health workers in the primary care setting: seeking recognition. Contemporary Nurse, 27(2), 157-164.Retrieved July 29, 2015 from http://www.tandfonline.com/doi/abs/10.5172/conu.2008.27.2.157#.Vb1dvvOqqko

Brascoupé, S., & Waters, C. (2009). Cultural safety. Journal de la santé autochtone. Retrieved July 31 2015 frrom http://69.27.97.110/documents/journal/jah05_02/05_02_01_Cultural.pdf

Gracey, M., & King, M. (2009). Indigenous health part 1: determinants and disease patterns. The Lancet, 374(9683), 65-75. Retrieved July 28, 2015 from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60914-4/fulltext?version=printerFriendly

World Health Organization (2007).The Ottawa Charter for Health Promotion (2015). Retrieved July 28, 2015 from http://www.who.int/healthpromotion/conferences/previous/ottawa/en/index1.html

World Health Organization (2007). Health of Indigenous People Fact Sheet. Retrieved July 28, 2015 from http://www.who.int/mediacentre/factsheets/fs326/en/

Thank You!