Abstract

Cultural security is a key element of accessible services for Indigenous peoples globally, although few studies have examined this empirically. We explored the scope, reach, quality, and cultural security of health and social services available to Aboriginal and/or Torres Strait Islander families in Western Australia (WA), from the point of view of staff from the services. We recruited staff from health and social services for Aboriginal people in the Perth, Kalgoorlie, Great Southern, and South West regions of WA between December 2015 and September 2017 to complete online surveys. We examined the proportions of participants that responded saying the service was culturally secure, the reasons for the response, and perceived factors related to a high-quality service. Sixty participants from 21 services responded to the survey. Seventy-three percent stated the service was culturally secure; however, only 36% stated that the staff employed at the service had sufficient knowledge on cultural security. Participants suggested having Aboriginal staff and better cultural awareness training as methods to improve cultural security within the service. Participants highlighted that staffing, funding for resources, and patient financial difficulties in accessing care as key areas for quality improvement. Much greater effort is required in improving knowledge through on-going training of staff in the practice of culturally safe care. Organisations must also be required to meet specific standards in cultural safety.

Highlights

  • Access to high quality and culturally secure healthcare is a key determinant of health for Aboriginal and/or Torres Strait Islander people

  • Since access to culturally secure health services is an important determinant of Aboriginal child health, we aimed to examine staff perspectives on the scope, reach, quality, and cultural security of services targeted for Aboriginal people of Western Australia

  • We found a large difference in perceptions on cultural security among staff at Aboriginal community-controlled organisations (ACCOs) compared to culturally secure, 40% stated staff had sufficient knowledge on cultural security

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Summary

Objectives

Objectives being metQuality requires a great deal of improvementsService is having a positive impactPeople attending are generally happy and satisfiedI would recommend this service to my family and friendsPeople find it easy to get an appointmentThe numbers within the boxes are proportions of respondents that “Strongly agreed/agreed” to the statements shown. Quality requires a great deal of improvements. People attending are generally happy and satisfied. I would recommend this service to my family and friends. People find it easy to get an appointment. The numbers within the boxes are proportions of respondents that “Strongly agreed/agreed” to the statements shown. A total of 53 respondents answered the questions related to quality and effectiveness of the service. Colour shading is used for visualisation purposes to show differences in proportions within categories and was determined based on the spread of the data with each category (e.g., Service Type, Location, etc.) (Green—highest value; Yellow—median value; Red—lowest value)

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