Indigenous Health Professionals Research Articles

Underrepresentation of Indigenous mental health professionals in Bangladesh

Indigenous people worldwide are at increased risk of mental health problems compared with non-Indigenous people. Longstanding impacts of colonisation, systematic exclusion from rights and subsequent discrimination, and lack of access to quality education and healthcare, including mental healthcare, have been identified as contributory factors to these disproportionate mental health problems. With limited access, Indigenous people are less likely to seek healthcare, owing to the insufficient number of healthcare professionals representing Indigenous communities. In the face of growing numbers of mental health problems in Indigenous people in Bangladesh, this paper sheds light on the inadequate number of mental health professionals, particularly from Indigenous communities, and the potential impacts of this on the well-being of Indigenous people, and considers ways to increase representation of Indigenous mental health professionals. The aim is to ensure that the mental health system in Bangladesh is inclusive and embraces the country's diversity.

The role of Communities of Practice in improving practice in Indigenous health and education settings: A systematic review

Introduction: Several workforce development strategies have been developed to improve practice in Indigenous health and education settings. These programs are often not implemented well, and as a result, they don’t have the intended effect on Indigenous health and education outcomes. Building capability of the health and education workforce is critical to improving health and education outcomes for Indigenous Peoples. Interventions that foster communities of practice are effective at influencing practice in various sectors, however no systematic reviews have investigated the impact of communities of practice in Indigenous health or education settings. Methods: This systematic review investigates the role of communities of practice in supporting existing workforce development strategies in Indigenous health and education settings. Seven databases were searched in 2019 and again in 2020. Data synthesis was through thematic analysis. Results: Eleven qualitative studies were included. Most community of practice interventions were situated in education settings. Interventions that foster community of practice can successfully include both Indigenous and non-Indigenous health and education professionals, allowing them to share personal stories, knowledge and resources and engage in personal and group reflection. This supports them to develop culturally responsive health and education tools, assessments and strategies and, therefore, may play a role in improving Indigenous health and education outcomes. Conclusion: Participation in communities of practice coupled with increased training and teaching about Indigenous culture may play a role in improving practice of Indigenous health and education professionals. Further research is required to determine what impact this has on Indigenous Peoples.

Creating Spaces for Decolonization and Indigenization Among Mental Health Professionals in Higher Education

ABSTRACTAs Indigenous mental health professionals, we need to articulate and differentiate between uncolonizing spaces, and moving toward decolonization and indigenization in the training of mental health professionals. While these terms are frequently used, the processes involved remain to be clearly articulated. Too often practices that are intended to be decolonizing center the settler-colonizer narrative. Representation of Indigenous peoples as active agents in their own healing matters and their knowledge systems must be included in mental health training. Three necessary elements are required to create these spaces: a) centering Indigenous epistemologies in theory, practice, and research; b) co-constructing learning spaces where Indigenous peoples’ lived experiences are heard, validated, and honored and conducted with cultural humility; and c) practicing ceremonies/rituals to create healing and connectedness within these sacred spaces. Finally, we provide a case study of the creation of a Hui (group in Hawaiian) among Indigenous practitioners, scholars, and students demonstrating transformation of pedagogy and praxis for mental health professionals in training (Barnhardt, 1992; Fellner, 2018a; hook, 2013).

Decolonization the what, whyand how: A treatieson Indigenous nursing knowledge.

Decolonization the what, whyand how: A treatieson Indigenous nursing knowledge.

Bridging cultures in palliative care: A qualitative study of the care of Indigenous Australians with advanced illness

Background: Lack of access, late engagement and limited referral for palliative care remain critical issues in supporting Indigenous Australians with life limiting illness. Aim: To explore the experiences and perspectives of Indigenous and non-Indigenous health professionals regarding the provision of palliative care for Indigenous people with advanced disease. Design: Qualitative study involving semi-structured focus groups/interviews with analysis following an inductive thematic approach. Setting/participants: A purposive sample (n = 54) of medical, nursing, allied health and Indigenous Hospital Liaison Officers engaged in caring for Indigenous patients at a metropolitan teaching hospital in Australia. Results: Four overarching themes were identified regarding provision of palliative care for Indigenous patients. These were (1) the intersection of cultures – Indigenous peoples, health and palliative care, (2) bridging the cultural divide: the integral role of Indigenous Hospital Liaison Officers, (3) health professionals devolve their responsibility to provide culturally appropriate care and (4) building towards a more holistic, culturally aware provision of palliative care. Conclusions: For many Indigenous people, the health system may be experienced as inflexible, narrowly focused and even prejudiced and traumatising. For Indigenous patients at the end of life, these challenges are heightened. The Indigenous Hospital Liaison Officers, working at the intersections of these two cultures, are key to negotiating such challenges as they seek opportunities to facilitate communication and understanding between firmly held cultural needs.

Cuidados à criança indígena Tembé no acompanhamento do crescimento e desenvolvimento: um estudo de reflexão

Abstract Objective to reflect on health care for the indigenous child of the Tembé ethnicity, to monitor their growth and development. Method theoretical-reflexive study, based on the authors’ experiences and anchored in the literature on Tembé culture and health care for indigenous peoples. Results studies about ethnicity and culture are starting points to produce notes about technical care in relation to the child, based on those already performed by Tembé women. The care based on ethnic issues signals cultural dynamics and is placed, in health policies and in their processes, as primordial to direct instruments, technologies and actions of multidisciplinary teams, with the pertinent participation of indigenous people and/or indigenous health professionals in their development. Conclusions and Implications for Practice Equity in health care for the Tembé indigenous child requires the development of specific procedures and devices that consider their particularities, well-being, and cosmology. There is a need for approaching, deepening, and respecting the specificity of this ethnic group. By reflecting on the health care of Tembé children, it becomes possible to understand divergences and convergences with the content of the Ministry of Health manuals.

An ounce of prevention is worth a pound of cure—the arts as a vehicle for knowledge translation and exchange (KTE) in public health during a pandemic: a realist-informed developmental evaluation research protocol

IntroductionThe COVID-19 crisis has led to the adoption of strict and coercive preventive measures. The implementation of these measures has generated negative impacts for many communities. The situation is especially...

La salud intercultural en la Amazonia peruana. Problemas y perspectivas en tiempos de pandemia

The notion of intercultural health refers to the culturally derived practices and their place in the contemporary health system, as well as to the political strategy concerning basic healthcare in multiethnic regions. This paper addresses the differences between the related perspectives of the indigenous and non-indigenous health professionals in the Peruvian Amazon. It places the problem within the context of the COVID-19 pandemic, focusing on the initiative Comando Mático of the group Shipibo-Conibo. The study is based on online research. It involves the critical analysis of the indigenous discourse shared on social media. The results serve to uncover the underlying thinking patterns, which impede the effective implementation of intercultural health policy in Peru.

Improving Access to Cancer Treatment Services in Australia's Northern Territory-History and Progress.

Cancer is the leading cause of death in the Northern Territory (NT), Australia’s most sparsely populated jurisdiction with the highest proportion of Aboriginal people. Providing cancer care to the NT’s diverse population has significant challenges, particularly related to large distances, limited resources and cultural differences. This paper describes the developments to improve cancer treatment services, screening and end-of-life care in the NT over the past two decades, with a particular focus on what this means for the NT’s Indigenous peoples. This overview of NT cancer services was collated from peer-reviewed literature, government reports, cabinet papers and personal communication with health service providers. The establishment of the Alan Walker Cancer Care Centre (AWCCC), which provides radiotherapy, chemotherapy and other specialist cancer services at Royal Darwin Hospital, and recent investment in a PET Scanner have reduced patients’ need to travel interstate for cancer diagnosis and treatment. The new chemotherapy day units at Alice Springs Hospital and Katherine Hospital and the rapid expansion of tele-oncology have also reduced patient travel within the NT. Access to palliative care facilities has also improved, with end-of-life care now available in Darwin, Alice Springs and Katherine. However, future efforts in the NT should focus on increasing and improving travel assistance and support and increasing the availability of appropriate accommodation; ongoing implementation of strategies to improve recruitment and retention of health professionals working in cancer care, particularly Indigenous health professionals; and expanding the use of telehealth as a means of delivering cancer care and treatment.

Culturally sensitive care of Misak Indigenous patients with rheumatoid arthritis in Colombia

To describe and understand the attitudes, cultural knowledge, and therapeutic practices of the Misak people concerning rheumatoid arthritis (RA), inscribed in an emergent culturally sensitive healthcare model along with the indigenous community and health professionals, following a respectful and empathic relational contact approach to the inter-ethnic encounter. A qualitative study that used ethnographic methods using observation techniques and in-depth interviews was carried out in the Misak community, Colombia, by a multidisciplinary team (rheumatology, physiotherapy, and anthropology). A thematic analysis based around the concept of explanatory models (EMs) was carried out. Researchers interviewed 20 patients with RA, 12 traditional healers, and 5 health professionals. The following themes were identified: (1) the traditional healers are allowed to practice only if the community recognizes their vocation; (2) two types of EM were observed: Misak community EM related to conception of RA and its treatment, shared by patients and the traditional healers; and biomedical EM. The interaction of the two types is still a healthcare challenge that requires articulating to achieve better clinical outcomes for patients. The EMs of RA care identified in the Misak community are focused on both the patients and the traditional healers. However, this predominant EM and the biomedical EM of RA care need to be brought closer together to contribute to the construction of a unifying model of a culturally sensitive care.

\u2018The Drug Survey App\u2019: a protocol for developing and validating an interactive population survey tool for drug use among Aboriginal and Torres Strait Islander Australians

BackgroundDisadvantage and transgenerational trauma contribute to Aboriginal and Torres Strait Islander (Indigenous) Australians being more likely to experience adverse health consequences from alcohol and other drug use than non-Indigenous peoples. Addressing these health inequities requires local monitoring of alcohol and other drug use. While culturally appropriate methods for measuring drinking patterns among Indigenous Australians have been established, no similar methods are available for measuring other drug use patterns (amount and frequency of consumption). This paper describes a protocol for creating and validating a tablet-based survey for alcohol and other drugs (“The Drug Survey App”).MethodsThe Drug Survey App will be co-designed with stakeholders including Indigenous Australian health professionals, addiction specialists, community leaders, and researchers. The App will allow participants to describe their drug use flexibly with an interactive, visual interface. The validity of estimated consumption patterns, and risk assessments will be tested against those made in clinical interviews conducted by Indigenous Australian health professionals. We will then trial the App as a population survey tool by using the App to determine the prevalence of substance use in two Indigenous communities.DiscussionThe App could empower Indigenous Australian communities to conduct independent research that informs local prevention and treatment efforts.

Practice report: an Alberta M\xe9tis model for COVID-19 vaccine delivery

SettingIn January 2021, the COVID-19 vaccine became available to First Nations, Métis, and Inuit (FNMI) over the age of 65 living in First Nations communities or Métis settlements in Alberta. In March, vaccine eligibility in Alberta expanded to include FNMI peoples of younger ages and in urban settings. The Métis Nation of Alberta (MNA) and other Indigenous organizations recognized that FNMI populations might be better served by tailored vaccine programs.InterventionThe MNA is the government for the Métis people in Alberta. During the COVID-19 pandemic, the MNA has supported its citizens, through financial and mental wellness support, access to personal protective equipment, and messaging regarding public health orders. When vaccines became available, culturally appropriate virtual vaccine information sessions were provided. In March 2021, the MNA delivered the first Métis-led COVID-19 vaccination clinic. Unique to the clinic’s success was the location, online booking process, and community presence. The clinic focused on cultural safety, including the availability of Indigenous health professionals to community members, and cultural reference points throughout the clinic.OutcomesIn the first MNA clinic, over 1300 people were vaccinated. Visitors shared appreciation for the culturally specific aspects of the clinic, which contributed to increased safety and comfort.ImplicationsBased on the success of the first Métis-led vaccination clinic, similar services in communities with high numbers of Métis people have been approved. This innovative practice initiative could provide a model of COVID-19 vaccine service delivery that could be used to meet the needs of Métis citizens in other jurisdictions in Canada.

Processo de construção do Programa Nacional de Acesso à Água Potável em Terras Indígenas (PNATI)

Feco-oral diseases account for the largest number of notifications of morbidities recorded in the Indigenous Health Care Information System (SIASI), with diarrhea being the third cause of infant mortality, caused mainly by inadequate sanitation and hygiene conditions, which motivated the construction of the National Program for Access to Potable Water in Indigenous Lands (PNATI), which aims to universalize access to potable water in indigenous communities to provide water in adequate quantity and quality and contribute to improving the health of this population. The objective is to implement new water supply systems and repair existing ones, mobilizing government resources and strategic partners. The PNATI implementation methodology has actions planned for the next 20 years and intends, based on the improvement of the internal management of the Special Indigenous Sanitary Districts, to expand the control of water quality, carry out training on infrastructure management and the connection between water, sanitation and public health for system operators and the indigenous population. The program started in 2022 and is already showing the first results through training in some communities in the north of the country, promoting dialogue between indigenous peoples, health and sanitation professionals.

From Digital Mental Health to Digital Social and Emotional Wellbeing: How Indigenous Community-Based Participatory Research Influenced the Australian Government's Digital Mental Health Agenda.

This paper describes the first six years of a government-initiated project to train Indigenous health professionals in digital mental health (d-MH). It illustrates how community-based participatory research (CBPR) methods were used to enable this “top-down” project to be transformed into a ‘ground-up’ community-guided process; and how, in turn, the guidance from the local Indigenous community partners went on to influence the national government’s d-MH agenda. The CBPR partnership between five community partners and a university rural health department is described, with illustrations of how CBPR harnessed the community’s voice in making the project relevant to their wellbeing needs. The local Indigenous community’s involvement led to a number of unexpected outcomes, which impacted locally and nationally. At an early stage, the conceptual framework of the project was changed from d-MH to the culturally-relevant Indigenous framework of digital social and emotional wellbeing (d-SEWB). This led to a significant expansion of the range and type of digital resources; and to other notable outcomes such as successful advocacy for an Aboriginal-specific online therapy program and for a dedicated “one-stop-shop” d-SEWB website, Wellmob, which was funded by the Australian government in 2019–2021. Some of the implications of this project for future Indigenous CBPR projects are discussed.

Increasing culturally responsive care and mental health equity with indigenous community mental health workers.

There are 600 diverse American Indian/Alaska Native communities that represent strong and resilient nations throughout Indian Country. However, a history of genocidal practices, cultural assaults, and continuing oppression contribute to high rates of mental health and substance use disorders. Underresourced mental health care and numerous barriers to services maintain these disparities. Indigenous community mental health workers hold local understandings of history, culture, and traditional views of health and wellness and may reduce barriers to care while promoting tribal health and economic self-determination and sovereignty. The combination of Native community mental health workers alongside a growing workforce of Indigenous mental health professionals may create an ideal system in which tribal communities are empowered to restore balance and overall wellness, aligning with Native worldviews and healing traditions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Creating a Future of Our Own Design: The International Indigenous HealthFusion Team Challenge as a Promising Practice to Support Indigenous Students in Health Fields


 
 
 Training and recruitment of First Nations and Indigenous health professionals is part of reconciliation, addressing health disparities and embedding cultural safety and humility into the health ecosystem of the province of British Columbia (BC), Canada. Calls to develop the First Nations and Indigenous health workforce are articulated within the Truth and Reconciliation Commission of Canada’s Call to Action 23, BC’s Transformative Change Accord: First Nations Health Plan, and the seven directives that guide the work of the First Nations Health Authority in BC and its health governance partners. This article brings forward the voices of current Indigenous students training in allied health professions at the University of British Columbia and their Indigenous mentors who participated in the 2018 International Indigenous HealthFusion Team Challenge in Sydney, Australia. The Challenge represents a promising practice in training Indigenous health professionals here in BC as it: (1) Affirmed their Indigenous identity, knowledge, and aspirations, supporting them to become more “visible” as Indigenous students; (2) Created a space where both Indigenous and mainstream health discipline knowledges were encouraged, valued, and respected; (3) Provided opportunity to connect with Indigenous peers and health leaders; and (4) Built students’ confidence to take on leadership roles. First Nations and Indigenous students studying in health fields represent the future of BC’s health and wellness ecosystem that brings together the best of Indigenous and mainstream healing approaches. Creating opportunities for students to grow as Indigenous health leaders is part of reconciliation and the new relationship represented by the BC First Nations Health Governance Structure.
 
 

Arts-Based Compassion Skills Training (ABCST): Channelling Compassion Focused Therapy Through Visual Arts for Australia's Indigenous Peoples.

The last 20 years have seen the development of a new form of therapy, compassion focused therapy (CFT). Although CFT has a growing evidence base, there have been few studies of CFT outside of an Anglo-European cultural context. In this paper, we ask: Might a CFT-based approach be of value for Indigenous Australians? If so, what kind of cultural adaptations might be needed? We report the findings from a pilot study of an arts-based compassion skills training (ABCST) group, in which usual CFT group processes were significantly adapted to meet the needs of Indigenous Australians. At face value, CFT appeared to be a promising approach to enhancing the social and emotional wellbeing of Australia’s Indigenous peoples. However, despite initial consultations with Indigenous health professionals, the first attempts to offer a more conventional group-based CFT to Indigenous clients were largely unsuccessful. Following a review and advice from two Indigenous clients, we combined elements of CFT with visual arts to develop a new approach, “arts-based compassion skills training” (ABCST). This paper reports an evaluation of this pilot ABCST group. The group had 6 × 4 h sessions of ABCST, facilitated by two psychologists (1 Indigenous, 1 non-Indigenous) and two artists (1 Indigenous, 1 non-Indigenous). There were 10 participants, who attended between 2 and 6 sessions: five were clients, five were health professionals. Between 1 and 3 months later, six of the participants (2 clients, 4 health professionals) were interviewed. Qualitative analysis of interview data identified that two key processes—creating a positive group atmosphere and channeling compassion skills training through the medium of visual arts—led to four positive outcomes for participants: planting the seeds of new understandings, embodying the skills of compassion, strengthening relationships with others, and evolving a more self-compassionate relationship. We suggest that the preliminary results are sufficiently encouraging to warrant further development of ABCST in Indigenous communities.

Indigenous Health Workforce: exploring how roles impact experiences in Higher Education

Indigenous people have an integral role to play in improving Indigenous health outcomes by leading and being a part of the health workforce. Educating Indigenous health professionals is hence of great importance. Indigenous health students are not always acknowledged for their multiple professional and community roles and how these can affect their university education experience and success. This paper hence examines the experiences of 27 Indigenous health students and their lecturers at one Australian university around the concept of roles. The study used an Indigenous Research Methodology combined with theory driven thematic analysis. Results identified both positive and negative experiences of roles that significantly affect Indigenous health students. The study showed that students’ roles in family and community are complex and can come into conflict with student and future professional roles when students attend university. Academics interviewed for the research showed little to no understanding of Indigenous students’ complex existing roles. This research may assist universities and educators to support Indigenous health students to transition from community to university and achieve success.

Looking forward looking black: making the case for a radical rethink of strategies for success in Indigenous higher education

Abstract This study takes a retrospective look at the educational experiences of Indigenous health professionals who graduated from The University of Queensland's Indigenous Health Program between 1994 and 2005, to understand the enablers for growing an Indigenous health workforce capable of advancing the health of Indigenous peoples. Drawing on the qualitative accounts of 31 students and 9 staff members, this paper examines the enablers to educational success at this time, juxtaposed against current Indigenising agendas in higher education, of aspiration and capacity building alongside the task of embedding Indigenous knowledges within curricula. We look back not as a call to return to Indigenous-specific cohort courses but rather reconsider both the measures of and strategies for success in Indigenous higher education, within health and beyond, interrogating the ideological assumptions that inform them.

Communication, Collaboration and Care Coordination: The Three-Point Guide to Cancer Care Provision for Aboriginal and Torres Strait Islander Australians.

Aim:To explore health professionals’ perspectives on communication, continuity and between-service coordination for improving cancer care for Indigenous people in Queensland.Methods:Semi-structured interviews were conducted in a purposive sample of primary health care (PHC) services in Queensland with Indigenous and non-Indigenous health professionals who had experience caring for Indigenous cancer patients in the PHC and hospital setting. The World Health Organisation integrated people-centred health services framework was used to analyse the interview data.Results:Seventeen health staff from six Aboriginal Community Controlled Services and nine health professionals from one tertiary hospital participated in this study. PHC sites were in urban, regional and rural settings and the hospital was in a major city. Analysis of the data suggests that timely communication and information exchange, collaborative approaches, streamlined processes, flexible care delivery, and patient-centred care and support were crucial in improving the continuity and coordination of care between the PHC service and the treating hospital.Conclusion:Communication, collaboration and care coordination are integral in the provision of quality cancer care for Indigenous Australians. It is recommended that health policy and funding be designed to incorporate these aspects across services and settings as a strategy to improve cancer outcomes for Indigenous people in Queensland.