Importance Of Cultural Safety In Healthcare Communication And Health Literacy: A Position Statement For NACCHO

Understanding the role of cultural safety in improving healthcare outcomes

Cultural Safety Position Statement

The National Aboriginal Community Controlled Health Organizations (NACCHO) serves over 140 Aboriginal Community Controlled Health Services (ACCHO’s) throughout the state, as a regional aboriginal primary health care body, working with both the concerns of indigenous health as well as the well-being. ACCHO is indeed a primary health care network developed and run by the local indigenous population to provide the controlling population, through a locally elected board of directors, with inclusive, integrated and social medical services.

NACCHO claims that it represents a market environment for human services that offer unique sustainable and contestable incentives when government investment is to increase health results for Aboriginal people and achieve improved efficiency (Grant and Luxford, 2011). The Organisation believes in nurses and the midwives as a pillar of the Australian health system and plays a key role in delivering Indigenous and Torres Strait Islander populations, culturally and effectively secure health services. Given that nurses and midwives are often at the forefront, their willingness to do so is important.

The objective of the organization depends on cultural safety. NACCHO sees cultural security as the final step towards a continuum of nursery and/or midwifery treatment, including cultural understanding, tolerance, cultural understanding, appreciation for culture and cultural skills.

A wide range of basic data on the health care of aboriginal people in ACCHS is presently available, providing sound evidence to equate health outcomes to results obtained from conventional programs (Australian Commission on Safety and Quality in Health Care, 2015). Such data show models for the holistic primary healthcare that are strongly aligned with the patient-oriented home model of health care; representation of the Aboriginal population over 60 per cent within major metropolitan centres; continued enhancement in results on main best practice indicators.

In the training of doctors and hiring Indigenous people, NACCHO plays an important role. ACCHSs are now facing the challenge to provide best-practice care and the extension of NACCHO into new fields is justifiable. The existing Closing the Gap funding standard should be moved to the community-controlled healthcare industry in order to achieve the best benefit.

Our Position

1. Each NACCHO –whether urban, rural or remote–has a fundamental concept of the construction and running of a primary health care system that is built by the local Aboriginal people “so as to provide the society who operates and regulates them with integrated, systematic and culturally appropriate treatment.
2. NACCHO has always been designed from the beginning to be more than just a medical centre; each ACCHS includes four major roles: main patient care, community involvement, special needs services and advocacy (Nairn et al., 2014).
3. One of the major initiative by NACCHO towards the access to health care facility by the aboriginals includes the provision of effective health care communication and health literacy among the aboriginal community people so that they can be aware of their health needs.

Importance of Position statement for providing culturally safe health care environment

The above-stated position statement is important for the provision of a culturally safe environment because the statement includes the overall targets or the goals of NACCHO towards the achievement of the common good. The NACCHO Learning Framework for Cultural Protection has provided a National Benchmark for cultural protection awareness (Beitsch et al., 2010). Social security training courses as well as services supporting all healthcare workers are being introduced across Australia in order to achieve social protection conditions that are socially secure for patients and staff of Indigenous and Torres Strait Islander.  The foundation of Human Rights, as defined by international treaties, lies in social protection, cultural recognition and the need to be involved in healthcare services. In addition, Aboriginal peoples ‘ direct participation in the development and implementation of appropriate measures is congruent with the justification for it and attitude to establishing NACCHO CST instruction and evaluation norms (Creating the NACCHO Cultural Safety Training Standards and Assessment Process: A background paper. | Australian Indigenous Psychology Education Project, 2015). This also facilitates further growth of the Aboriginal Community Health Control Service within. In addition, the Aboriginals have been fostering and campaigning for a human rights-based approach since they set up the first Aboriginal Community Based Organization, like the Aborigines Advancement League in the year 1931.

Importance of effective communication for delivering culturally safe healthcare

The key crucial component of cultural protection is communication skills. Health care providers risk misunderstanding or disregarding personal health concerns without knowing the communication pathways by others. Improper or inadequate contact can adversely affect minority communities with respect to access for other Australians to cancer services. For the delivery of culturally, responsive health care in hospitals and community health services, strong cross-cultural communication skills are important.    In the delivery of healthcare, two-way contact between aboriginal and non-indigenous cultures is as critical as recognizing the individual’s culture and heritage. Although verbal interaction has been the most simple and used way of communicating, non-verbal communication should not need to be ignored.  Aboriginal and Torres Strait Islanders people are well aware of nonverbal communication, including that of the language of their body and the message they give about whether someone feels.

The advancement of safety and quality of care is essential to health literacy as well as effective communication among practitioners and patients. We develop, encourage and curate evidence-based resources, activities and analysis of medical professionals for training and interaction (Harfield et al., 2018). Health literacy means the ability of an individual to consider medical information and act upon it. An increasing number of research indicates that people with limited health education are more prone to be misled in the light of clinical guidance compared with people with sufficient health skills, or to use medical care inadequately and infrequently; and have poorer physical or mental health (Leep and Shah, 2012). Thus clear and effective communication is essential. This is due to the poor interpersonal quality of healthcare organizations in the relationship between reduced education on nutrition and poor health.

Throughout Australia, inequalities continue to exist between the wellbeing of aboriginal and non-indigenous people. There is little knowledge of the factors affecting the health of indigenous Australians. The behaviour is generally supposed to be motivated by influences within the individual’s immediate control, such as behavioural control and attitudes of nature. There seems to be an uptick in health risk behaviour from the social interruptions like media that is associated with historical events.

Alcohol addiction and tobacco smoking, in general, have been associated with social dysfunction, and daily stress that can raise behavioural health risks including chronic health challenges Social networks have also been shown to facilitate risk-bearing actions like cigarettes which are some of the potential health risk natures (Davidson et al., 2010). In contrast, cultural identity and distinctive nature can be emotionally protective and hence encourage positive conduct in the system of health care. Media on the other hand also provides a positive contribution towards culturally safe practices at the health care setting of the organization by publishing positive stories and propagating positive health attitudes among aboriginal community people.

The significance of health literacy in providing culturally safe health services

Health quality is the development of collaboration in a supportive environment between patient and health service provider. The healthcare service quality is influenced by the personal factors of caregivers and clients and by the healthcare institution, the healthcare system and the wider sustainable environment (Hayman, Askew and Spurling, 2014). The quality of health care could be strengthened by proactive advice, proper planning, education and training, access to resources, efficient resource management, workers and systems as well as coordination and partnership between providers. In the context of the health outcomes of NACCHO, factors contributing to the improving health outcomes of the organization includes effective health communication, health literacy, connection and believing in the right to health. These factors contribute to NACCHO towards the provision of improved culturally safe organization.

While initiating to work in the field of aboriginal health, NACCHO faced several barriers towards the implementation of the position statement. These barriers still exist within the organizational practice of NACCHO. Family involvement while self-management and care by NACCHO is one of the vital ingredients that often gets missed by the health care workers of the organization (Russell, 2013). At certain time, the lack of proper finances and monetary crisis acts as one of the major barriers towards the effective implementation of the above stated position statement. Often the health care workers fail to concentrate over the degree of chronic challenges faced by the aboriginals together with the associated level of stress among them. Language differences are one of the major barriers while delivering and providing care to the aboriginal patients by NACCHO. Often there lies a mismatch and misinterpretation among the allied health care staff of the organization and the patient due to the communication barrier. Finally, the access to the medical health services in NACCHO being essential for the aboriginal and Torres Strait Islander Australians as the poor cultural safety at the health services in the mainstream limits and discourages the access of the patient towards diseasing information and finally resulting towards poor confidence regarding self-management. One of the major recommendation for NACCHO to overcome these barriers for maintaining a sustainable environment inpatient care includes the propagation of effective health communication as well as health literacy which will help the aboriginals to understand their illness and get access to help care services from NACCHO (Kingsley et al., 2013). For addressing the barrier of the communication gap, it is recommended for the organization to recruit aboriginal health workers who can understand their language and also the challenges towards healthcare access.

NACCHO as a regional primary healthcare body serving the Aboriginal Community Controlled Health Services

Conclusion

Thus it can be summarized that through cross-government initiatives and investments, the national “Closing the Gap” program is committed to increasing the continuing risk to the welfare of Australian Indigenous and Torres Strait Islanders. Aboriginal Community Health Care Services (ACCHS) has been integral to efforts to build healthy communities and has eliminated barriers to access, perceived discrimination and gradually improving individual health conditions for aboriginals. It targets mainly on the early intervention, prevention and comprehensive care. The above analysis highlights the cultural safety position statement of NACCHO followed up with the interpretation of the position statement in the field of health care of aboriginal communities.

References

Australian Commission on Safety and Quality in Health Care. (2015). Health literacy: Taking action to improve safety and quality. Australian Commission on Safety and Quality in Health Care.

Beitsch, L. M., Leep, C., Shah, G., Brooks, R. G., & Pestronk, R. M. (2010). Quality improvement in local health departments: results of the NACCHO 2008 survey. Journal of Public Health Management and Practice, 16(1), 49-54.

Creating the NACCHO Cultural Safety Training Standards and Assessment Process: A background paper. | Australian Indigenous Psychology Education Project. (2015). Retrieved 18 October 2019, from https://www.indigenouspsyched.org.au/resource/creating-naccho-cultural-safety-training-standards-and-assessment-process-background-paper

Davidson, P. M., Abbott, P., Davison, J., & DiGiacomo, M. (2010). Improving medication uptake in Aboriginal and Torres Strait Islander peoples. Heart, Lung and Circulation, 19(5-6), 372-377.

Grant, J., & Luxford, Y. (2011). ‘Culture: It’s a big term, isn’t it?’: An analysis of child and family health nurses’ understandings of culture and intercultural communication. Health Sociology Review, 20(1), 16-27. Retrieved from https://doi.org/10.5172/hesr.2011.20.1.16

Harfield, S. G., Davy, C., McArthur, A., Munn, Z., Brown, A., & Brown, N. (2018). Characteristics of indigenous primary health care service delivery models: a systematic scoping review. Globalization and Health, 14(1), 12.

Hayman, N. E., Askew, D. A., & Spurling, G. K. (2014). From vision to reality: a centre of excellence for Aboriginal and Torres Strait Islander primary health care. The Medical Journal of Australia, 200(11), 623-624.

Kingsley, J., Townsend, M., Henderson-Wilson, C., & Bolam, B. (2013). Developing an exploratory framework linking Australian Aboriginal peoples’ connection to country and concepts of wellbeing. International journal of environmental research and public health, 10(2), 678-698.

Leep, C. J., & Shah, G. H. (2012). NACCHO’s National Profile of Local Health Departments study: the premier source of data on local health departments for surveillance, research, and policymaking. Journal of Public Health Management and Practice, 18(2), 186-189.

Nairn, R., De Souza, R., Barnes, A., Rankine, J., Borell, B., & Mc Creanor, T., (2014). Nursing in media-saturated societies: Implications for cultural safety in nursing practice in Aotearoa New Zealand. Journal of Research in Nursing, 19(6),  477–487.  https://doi.org/10.1177/1744987114546724

Russell, L. M. (2013). Reports indicate that changes are needed to close the gap for Indigenous health. Med J Aust, 199(11), 1-2.