Problem and the Context
The healthcare policies are the most essential healthcare parameters that need to be implemented in a practical scenario to develop the healthcare practices. The healthcare policies are perfect guidelines to prepare and implement the action plan to address any specific problems occurring in the target population. The identified target population in this study is the aboriginal and Torres Strait Islanders This study will analyse the aboriginal health plan under Northern Territory intervention. This policy mainly comprises of the Healthcare issues of the Aboriginal and the Torres Strait Island individuals. The background and context of the Northern Territory intervention will be discussed in an effective manner. The frame of reference of the aboriginal health plan will be analysed based on the dominant discourse shreds of evidence present in the policy. The underlying assumptions of the aboriginal health plan will be identified in a proper manner. Subsequently, the target population of the policy will be identified and analysed in a prominent manner. The subjects of the policies will be discussed in a lucid manner. Besides that, the study will focus on the developmental process of Northern Territory intervention on the context of aboriginal health plan. The potential competing interest and the power differentials of the policies signify the effectiveness of the policy delivery as per the power capability. Moreover, the possible solution of the healthcare system provided in the Northern Territory intervention policy will be analysed and gaps in the policies will be identified. Recommendations will be provided to fulfil the gaps present in the policy. Additionally, analysis of implementing and the effectiveness of the policy will be done in an efficient manner.
The analysis of problems and the problem context of the healthcare policies can be helpful to demonstrate the importance of the aboriginal health plan. A historical context is present that depicts the poor state of the health condition of the Aboriginal and the Torres Strait island community. The introduction of different diseases devastated the Aboriginal community since the time of colonization (Wigzell, 2017). The healthcare conditions of the Aboriginal and the Torres Strait Island people were neglected by the government for a long time. This results in the deterioration of the healthcare scenario of the Aboriginal and Torres Strait Island people. According to researchers and policymakers, the average life expectancy of the Aboriginal population is low compared to the non-Indigenous population of Australia (Mumford & Watson, 2018). The community is devastated with diseases like diabetes, cardiovascular disease, respiratory problem, mental health disorder due to excessive addiction to alcohol and high blood pressure level. According to the report of Australian Institute of Health and welfare aboriginals and Torres Strait Island people experience disease burden of 2.3 times more compared to the Non Indigenous population of the country (Mumford & Watson, 2018). Additionally, the aboriginal community is marginalised from the cultural perspective. These are some of the important factors for the formulation of the Northern Territory intervention policy.
The holistic formulation of the Northern intervention on the context of aboriginal health plan has analysed the healthcare perspectives of the Aboriginal and the Torres Strait Island people. The policy seeks to address the socio-economic and health perspectives of the aboriginal population (Kirby, 2014). The policy includes different intervening steeps like restriction in alcohol, change in the welfare and healthcare payment system and different health program to mitigate the disease burden of the community. The policy includes the implementation of different legislation to address the various socio-economic and health-oriented problems prevalent in the community (Kirby, 2014). The Northern Territory intervention includes the Aboriginal health policy to address the different health issues in the community. This policy gives stress to improve the holistic healthcare condition of the Aboriginal and the Torres Strait island people (Reibel, Wyndow and Walker, 2016). Moreover, culturally secured health service for the Aboriginal population is one of the major priorities included in the policy. The state authorities perform advocacy to the National authorities regarding the priorities of the Aboriginal and Torres Strait Island people (Nayebpour & Koizumi, 2018). On the other hand, the policy overlooks the link between social abuse and the healthcare perspective. The focus should be given on enhancing social health determinant like education and healthcare service among the community (Nayebpour & Koizumi, 2018).
The frame of reference of the policy
Source: Pmc.gov.au
Every policy contains a frame of reference that is essential for the formulation of the policy in a prominent manner. The frame of reference is the basic assumption on which the policies are formulated in an effective manner. The dominant discourse of the policies is the culturally secure health care service that should be provided to the aboriginal and the Torres Strait island people (Spotton Visano, 2016). The aboriginal health plan consists of a cultural framework. The cultural framework consists of the different steps that should be taken to implement cultural safety in the health service of the Aboriginal and the Torres Strait island people (Muise, 2018). The phrase cultural security is mentioned on numerous occasions inside the Aboriginal health care policy. This implies that the policy has been formulated by giving stress on the cultural aspects of the Aboriginal and Torres Strait Island people. Since the aboriginal community is culturally marginalised it is assumed by the policymakers that optimum priority should be given in providing culturally safe health care service (Celia T. Bardwell-Jones, 2018). The shreds of evidence provided in the policy include different cultural measures those are mentioned below:
- According to the Aboriginal health plan the healthcare professionals have to take professional development training to ensure the cultural safety of the Aboriginal and Torres Strait Island people (Brewster, 2017).
- The health care policy depicts that effective communicationwith aboriginal consumers should be performed to ensure the maintenance of cultural safety (Lueck, 2017).
- The Aboriginal health policy recognizes the importance of leadership in maintaining cultural security in a healthcare setting.
The above-mentioned shreds of evidence explain that cultural safety is the common frame of reference in formulating the Northern territory aboriginal health policy.
The analysis of the target stakeholders is essential to depict the significance of the Northern Territory Intervention. The Main stakeholders of the policy are the aboriginal communities and indigenous people of Torres Strait Island, government and northern territory Intervention (Crow & Baysha, 2013). The primary focus of the policy is to improve the healthcare condition of the Aboriginal and the Torres Strait island community. The overall health care services are focused in the policy especially giving stress on providing culturally safe healthcare service to the aboriginal community and the Torres Strait island people (Muise, 2018). Apart from the community people, the other stakeholders of the policy are the healthcare professional and the government officers entitled to handle the administration of the Northern territories (Burgess, 2017). Moreover the institutes those are responsible to formulate the policies by engaging with the various stakeholders are the Government department of health and indigenous affairs, non-government organizations and research institutes consisting of highly efficient policy researchers. Moreover, health service workforce, doctors and health workers are essential stakeholders of the Aboriginal health policy maintained in the Northern Territory intervention plan (Maluka, 2018). The need assessment should be performed in an effective manner before formulating any policy. The health care needs of the aboriginal community and the Torres Strait island people are considered in the policy. According to researchers, it is 33% of the adult population among the aboriginals of the Northern territory suffers from diabetes and 70% of the aboriginal population of the Northern Territory has cardiovascular problems (“Home – Australian Institute of Health and Welfare”, 2018). However, the health policy focuses on capacity building of the health workers in an effective and efficient manner. Enhancement of the quality of service is required to provide appropriate treatment to the aboriginal communities of the Northern Territory. Cultural safety is one of the most vital components that are included in the Healthcare policy of the aboriginal community (Muise, 2018). According to the researchers, it is explained that the cultural safety in healthcare service helps in the holistic development of the physical and mental health of the aboriginal community and Torres Strait Island people. The policy defines the holistic status of the aboriginal population of the focusing on the healthcare reforms that should be made to mitigate the disease burden present in the population (Wyndow, Walker & Reibel, 2018). Moreover, the aboriginal communities are marginalised and are at a disadvantageous position compared to the non – indigenous community. A moral judgement is present in the policy that determines the ethical point of view of the policy. It is essential to respect the cultural beliefs of the aboriginal community from the ethical and moral perspective (Crow & Baysha, 2013). This moral perspective is maintained during formulating the aboriginal healthcare policy under the Northern intervention plan.
Target stakeholders of the policy
The policy development process is the most essential process in the formulation of policy. A crucial role is played by the stakeholders who formulate the policy in an effective and efficient manner (Crow & Baysha, 2013). The authorities of the health department of the Northern Territory government are the main stakeholders who formulated the Northern territory intervention plan that includes the aboriginal health plan. On the contrary, the view of some researchers is that appropriate community participation is not present in the formulation of the healthcare policy. The Aboriginal health policy is formulated based on the healthcare situation of the community people (Burgess, 2017). However, more focus should be given to the opinion of the medical professionals of the local hospitals who knows the detailed need of the aboriginal community.
The poor healthcare facility is considered to be one of the largest problems among the aboriginal population. As per the Aboriginal health plan, the unavailability of the medical equipment and lack of sufficient healthcare personnel are the most notable reasons for the poor healthcare facilities (Campbell, Hunt, Scrimgeour, Davey & Jones, 2018). Additionally, the unhealthy lifestyle, mal-nutrition and unhealthy rituals can also be considered as the ultimate reasons for the poor healthcare of the aboriginals. As per the report of 2016 the rate of cardiovascular disease among the aboriginals is 33%. Moreover, the rate of abnormality among the aboriginals is 31% (“Home – Australian Institute of Health and Welfare”, 2018). The effective measures that can be taken by the Northern Territory healthcare policies to mitigate the healthcare problems are
- Free health check-up programs can be arranged among the aboriginal communities regularly. This would enable them to avail a better healthcare facility (Blum, Garcia & Epson, 2017). Free medicines can also be provided to them. As per a recent survey, the availability of free healthcare treatment might reduce the risk of cardiovascular disease from 33% to 31% (“Home – Australian Institute of Health and Welfare”, 2018).
- The can be shown the ghastliness of their present food habit after building a strong relationship with them (Blum, Garcia & Epson, 2017).
- They must be provided culturally safety environment in the healthcare organisations (Blum, Garcia & Epson, 2017).
- Indiscriminate care can be provided to them by developing effective and healthy communication with them (Iacobucci, 2016).
- Community lunches can be arranged for the aboriginal population where they would be proper information regarding the healthy food habit (Iacobucci, 2016).
Figure: aboriginal healthcare data
Source: https://www.aihw.gov.au/reports/indigenous-health-welfare-services/nkpis-indigenous-australians-health-care-2017/contents/table-of-contents
Individual communication is more effective than community communication. Thus, language can be a hindrance in the man to man communication (Weel-Baumgarten, 2018). Thus, the effectiveness of individual communication is overlooked in these solutions. Effective development of the individual communication can be beneficial to reduce the healthcare issues for the people of Aboriginal and Torres Strait Islander (Weel-Baumgarten, 2018).
The ethical implications of these policies are providing cultural safety to the aboriginal communities and providing indiscriminate healthcare facility to them.
The recommended policies are helpful in mitigating the healthcare issues from the target population. The implementation of the policies is not essential due to the social and cultural barrier (Iacobucci, 2016). The Aboriginal and Torres Strait Islander communities are an orthodox community where the people are not permitted to participate in a program other than their community program. Moreover, the language barrier and communication barrier are also key issues for the real-life implementation of the aboriginal health policies (Weel-Baumgarten, 2018). However, the appointment of an interpreter could make the task easier by working as a cord of communication between the healthcare personnel of aboriginal health plan and the aboriginal community. The exchange of information from both the stakeholders can be beneficial for the policy implementation (Crow & Baysha, 2013). Moreover, raising healthcare awareness among the aboriginal community can be a handy way to implement the proposed policies.
The accountability process for policy implementation includes five steps. These steps demonstrate ethical perspectives of healthcare policy and the implementation process. The steps are as follows:
- Development of healthy relationship with the government healthcare officials and policy stakeholders
- The healthcare information must be shared with the government
- The government officials must be ensured to be accountable for the policy-making and policy development
- The commitment towards the government must be tracked to ensure the fund
- Ensuring government healthcare officials with evidence-based and priority based healthcare information
The effective implementation of the policy would reduce the healthcare problems. The immunization against influenza and another chronic disease for the people ageing over 50 would increase from 32% to 35% (“Home – Australian Institute of Health and Welfare”, 2018). Moreover, the abnormality birth rate would reduce from 31% to 27%.
Conclusion
The study has discussed the effectiveness of healthcare policies. The standard of the healthcare policy is set by Aboriginal health plan. The aboriginal health plan was developed to mitigate the healthcare issues of Aboriginals and Torres Strait islanders. The healthcare policies are framed to reduce the abnormality in the healthcare services for the Aboriginal and Torres Strait Islander. The poor food habit, unhealthy lifestyle and the unavailability of healthcare practices are the key reasons for their healthcare issues like cardiovascular disease, diabetes and depression. The policies are framed on the stakeholders like people of aboriginal community, officials of northern territory intervention and the Australian government. Reduction of healthcare gaps in the aboriginal population, expansion of aboriginal healthcare awareness and indiscriminate treatment procedure is analysed as the solution for the problems of the policies. The policies can be implemented by the active cooperation of Northern Territory healthcare policies and the Australian health department. The effective implementation of the policy can develop the healthcare situation of the aboriginal community.
References
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