Cross-sector collaborations in Aboriginal and Torres Strait Islander childhood disability: a systematic integrative review and theory-based synthesis.

Anna Green,Patricia Delaney,Joanne Delaney,Michelle Digiacomo,Penelope Abbott,Patricia Mary Davidson,Tim Luckett

doi:10.1186/s12939-014-0126-y

Abstract

IntroductionAboriginal and Torres Strait Islander children in Australia experience a higher prevalence of disability and socio-economic disadvantage than other Australian children. Early intervention is vital for improved health outcomes, but complex and fragmented service provision impedes access. There have been international and national policy shifts towards inter-sector collaborative responses to disability, but more needs to be known about how collaboration works in practice.MethodsA systematic integrative literature review using a narrative synthesis of peer-reviewed and grey literature was undertaken to describe components of inter- and intra-sector collaborations among services to Aboriginal and Torres Strait Islander children with a disability and their families. The findings were synthesized using the conceptual model of the ecological framework.ResultsThirteen articles published in a peer-reviewed journal and 18 articles from the grey literature met inclusion criteria. Important factors in inter- and intra-sector collaborations identified included: structure of government departments and agencies, and policies at the macro- (government) system level; communication, financial and human resources, and service delivery setting at the exo- (organizational) system level; and relationships and inter- and intra-professional learning at the meso- (provider) system level.ConclusionsThe policy shift towards inter-sector collaborative approaches represents an opportunity for the health, education and social service sectors and their providers to work collaboratively in innovative ways to improve service access for Aboriginal and Torres Strait Islander children with a disability and their families. The findings of this review depict a national snapshot of collaboration, but as each community is unique, further research into collaboration within local contexts is required to ensure collaborative solutions to improve service access are responsive to local needs and sustainable.

Highlights

Aboriginal and Torres Strait Islander children in Australia experience a higher prevalence of disability and socio-economic disadvantage than other Australian children
This review examined the Ageing, No Disability and Home Care (ADHC) initiatives to achieve the goals of the Aboriginal Policy Framework and Aboriginal Consultation Strategy, and assessed whether they have resulted in better service access for Aboriginal people with a disability and their families
The findings of this review depict a national snapshot of collaboration addressing the limited understanding of how collaboration works in practice in the field of Aboriginal and Torres Strait Islander childhood disability

Summary

Introduction

Aboriginal and Torres Strait Islander children in Australia experience a higher prevalence of disability and socio-economic disadvantage than other Australian children. Intervention is vital for improved health outcomes, but complex and fragmented service provision impedes access. Aboriginal and Torres Strait Islander peoples are an exception to this rule. The gap in health outcomes and life expectancy between Aboriginal and Torres Strait Islander peoples and other Australians has been widely reported [1,2,3]. The rate of death for Aboriginal and Torres Strait Islander children is more than twice that for other children [2]. This disparity in health outcomes extends to disability [4]. There is recognition of the importance of the social determinants of health and of health as a human right

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Discussion

Conclusion