Indigenous Storytelling and Participatory Action Research: Allies Toward Decolonization? Reflections From the Peoples' International Health Tribunal.

Science.gov (United States)

Caxaj, C Susana

2015-01-01

Storytelling, in its various forms, has often been described as a practice with great emancipatory potential. In turn, Indigenous knowledge shows great promise in guiding a participatory action research (PAR) methodology. Yet these two approaches are rarely discussed in relation to one another, nor, has much been written in terms of how these two approaches may work synergistically toward a decolonizing research approach. In this article, I report on a community-driven knowledge translation activity, the Peoples' International Health Tribunal, as an exemplar of how narrative and PAR approaches, guided by local Indigenous knowledge, have great potential to build methodologically and ethically robust research processes. Implications for building globally relevant research alliances and scholarship are further discussed, particularly in relation to working with Indigenous communities.

An overall approach to health care for indigenous peoples.

Science.gov (United States)

King, Malcolm

2009-12-01

Indigenous peoples across all the continents of the globe live with major gaps in health status and health outcomes associated with well-described social determinants of health, such as poverty and poor education. Indigenous peoples face additional health determinant issues associated with urbanization, isolation from traditional territories, and loss of cultural continuity. Indigenous children are particularly vulnerable as they grow up in isolation from their cultural and social roots and yet are also separated from the mainstream environment of their society. Programs to address these difficult health issues should be viewed as complex clinical interventions with health researchers, social scientists, and clinicians working together with Indigenous peoples to identify the most pressing needs and most appropriate and workable solutions that will result in effective policies and practices.

Reducing the health disparities of Indigenous Australians: time to change focus.

Science.gov (United States)

Durey, Angela; Thompson, Sandra C

2012-06-10

Indigenous peoples have worse health than non-Indigenous, are over-represented amongst the poor and disadvantaged, have lower life expectancies, and success in improving disparities is limited. To address this, research usually focuses on disadvantaged and marginalised groups, offering only partial understanding of influences underpinning slow progress. Critical analysis is also required of those with the power to perpetuate or improve health inequities. In this paper, using Australia as a case example, we explore the effects of 'White', Anglo-Australian cultural dominance in health service delivery to Indigenous Australians. We address the issue using race as an organising principle, underpinned by relations of power. Interviews with non-Indigenous medical practitioners in Western Australia with extensive experience in Indigenous health encouraged reflection and articulation of their insights into factors promoting or impeding quality health care to Indigenous Australians. Interviews were audio-taped and transcribed. An inductive, exploratory analysis identified key themes that were reviewed and interrogated in light of existing literature on health care to Indigenous people, race and disadvantage. The researchers' past experience, knowledge and understanding of health care and Indigenous health assisted with data interpretation. Informal discussions were also held with colleagues working professionally in Indigenous policy, practice and community settings. Racism emerged as a key issue, leading us to more deeply interrogate the role 'Whiteness' plays in Indigenous health care. While Whiteness can refer to skin colour, it also represents a racialized social structure where Indigenous knowledge, beliefs and values are subjugated to the dominant western biomedical model in policy and practice. Racism towards Indigenous patients in health services was institutional and interpersonal. Internalised racism was manifest when Indigenous patients incorporated racist

Walking the Path Together: Indigenous Health Data at ICES.

Science.gov (United States)

Pyper, Evelyn; Henry, David; Yates, Erika A; Mecredy, Graham; Ratnasingham, Sujitha; Slegers, Brian; Walker, Jennifer D

2018-01-01

Indigenous data governance principles assert that Indigenous communities have a right to data that identifies their people or communities, and a right to determine the use of that data in ways that support Indigenous health and self-determination. Indigenous-driven use of the databases held at the Institute for Clinical Evaluative Sciences (ICES) has resulted in ongoing partnerships between ICES and diverse Indigenous organizations and communities. To respond to this emerging and complex landscape, ICES has established a team whose goal is to support the infrastructure for responding to community-initiated research priorities. ICES works closely with Indigenous partners to develop unique data governance agreements and supports processes, which ensure that ICES scientists must work with Indigenous organizations when conducting research that involves Indigenous peoples. © 2018 Longwoods Publishing.

CASE STUDY: Chile — Health, environment, and indigenous culture ...

International Development Research Centre (IDRC) Digital Library (Canada)

2011-01-06

Jan 6, 2011 ... CASE STUDY: Chile — Health, environment, and indigenous culture .... For example, the National Corporation for Indigenous Development (CONADI) ... Institute for Agriculture Development (INDAP), and applied research on ...

Indigenous Māori perspectives on urban transport patterns linked to health and wellbeing.

Science.gov (United States)

Raerino Ngāti Awa Te Arawa, K; Macmillan, Alex K; Jones Ngāti Kahungunu, Rhys G

2013-09-01

There is a growing body of research linking urban transport systems to inequities in health. However, there is a lack of research providing evidence of the effect of transport systems on indigenous family wellbeing. We examined the connections between urban transport and the health and wellbeing of Māori, the indigenous people of New Zealand. We provide an indigenous exploration of current urban transport systems, with a particular focus on the impacts of car dependence and the need for culturally relevant travel. We interviewed nineteen Māori participants utilising qualitative research techniques underpinned by an indigenous research methodology (Kaupapa Māori). The data highlighted the importance of accessing cultural activities and sites relevant to 'being Māori', and issues with affordability and safety of public transport. Understanding the relationship between indigenous wellbeing and transport systems that goes further than limited discourses of inequity is essential to improving transport for indigenous wellbeing. Providing an indigenous voice in transport decision-making will make it more likely that indigenous health and wellbeing is prioritised in transport planning. Copyright © 2013. Published by Elsevier Ltd.

Moving toward holistic wellness, empowerment and self-determination for Indigenous peoples in Canada: Can traditional Indigenous health care practices increase ownership over health and health care decisions?

Science.gov (United States)

Auger, Monique; Howell, Teresa; Gomes, Tonya

2016-12-27

This study aimed to understand the role that traditional Indigenous health care practices can play in increasing individual-level self-determination over health care and improving health outcomes for urban Indigenous peoples in Canada. This project took place in Vancouver, British Columbia and included the creation and delivery of holistic workshops to engage community members (n = 35) in learning about aspects of traditional health care practices. Short-term and intermediate outcomes were discussed through two gatherings involving focus groups and surveys. Data were transcribed, reviewed, thematically analyzed, and presented to the working group for validation. When participants compared their experiences with traditional health care to western health care, they described barriers to care that they had experienced in accessing medical doctors (e.g., racism, mistrust), as well as the benefits of traditional healing (e.g., based on relationships, holistic approach). All participants also noted that they had increased ownership over their choices around, and access to, health care, inclusive of both western and traditional options. They stressed that increased access to traditional health care is crucial within urban settings. Self-determination within Indigenous urban communities, and on a smaller scale, ownership for individuals, is a key determinant of health for Indigenous individuals and communities; this was made clear through the analysis of the research findings and is also supported within the literature. This research also demonstrates that access to traditional healing can enhance ownership for community members. These findings emphasize that there is a continued and growing need for support to aid urban Indigenous peoples in accessing traditional health care supports.

Can administrative data provide insights into the mental health of Indigenous Queenslanders?

Science.gov (United States)

Kisely, Steve; Pais, Joanne

2011-07-01

The Australian Government has provided $20 million to establish the Population Health Research Network (PHRN), with representation from all States and Territories to facilitate population health research through data linkage. Health LinQ is part of the Queensland node involving four Queensland universities, Queensland Health and the Australian e-Health Research Centre. This paper reviews the potential for using administrative databases to study the mental health experience of Indigenous Queenslanders. Researchers can define cohorts for study within the administrative data or link them to their own data. Robust protocols preserve confidentiality so that researchers only receive anonymized data. Indigenous status can be defined either through place of residence or through the recording of Indigenous status in datasets such as the Queensland Hospital Admitted Patient Data Collection. Available data include hospital morbidity, mental health data and mortality. Indigenous status is correctly identified in about 89% of cases with variation by definition used. Administrative data provide researchers and decision makers with accessible, cost-effective information without the intrusion and cost of additional data collection. These techniques are especially useful in studying regional, rural and remote populations where access may be difficult.

Synergy between indigenous knowledge systems, modern health ...

African Journals Online (AJOL)

... the people of this country should harness a synergy between indigenous health care systems, scientific research and modern health care methods. This article attempts to address the historical evolution of health care methods in South Africa, its effect on the community as well as challenges facing the health professions.

Family intervention in Indigenous communities: emergent issues in conducting outcome research.

Science.gov (United States)

Turner, Karen; Sanders, Matthew

2007-01-01

Indigenous children and youth are at greater risk of emotional and behavioural problems than non-Indigenous youth, with family life stresses and parenting style identified as common risk factors. There is substantial evidence that parenting programs can improve family relationships and improve child outcomes, however little research has focused on Indigenous communities. Our team is conducting research to evaluate a culturally sensitive adaptation of a mainstream intervention, the Group Triple P---Positive Parenting Program, for Indigenous families. This paper shares some of the insights into research and clinical issues gained as non-Indigenous researchers working with urban, rural and remote Indigenous communities. The experience of the research team and feedback from practitioners and parents have been drawn on for this discussion. Parenting programs need to be sensitive to the political and cultural context in which parenting takes place, flexibly incorporate cultural practices and expectations, and develop an evidence base of outcomes for families in diverse communities. As research is needed to evaluate the acceptability and effectiveness of these programs, culturally sensitive research practices are also necessary and the value of program evaluation and its benefit to the community must be clear. Community acceptance of the research process and the intervention itself is vital and may be influenced by community perceptions, current priorities, and local issues. If our overall aim is to increase the skilled health and mental health workforce in Indigenous communities and their use of evidence-based interventions, ongoing collaborative relationships between research institutions and service providers will serve to further this aim.

A clash of paradigms? Western and indigenous views on health research involving Aboriginal peoples.

Science.gov (United States)

Campbell, Theresa Diane

2014-07-01

To explore the issues of data management and data ownership with regard to health research conducted in aboriginal or indigenous populations in Canada. Research with aboriginal communities in Canada has often been conducted by researchers who had little or no understanding of the community in which the research was taking place. This led to 'helicopter' research, which benefitted the researcher but not the community. National aboriginal leadership developed the ownership, control, access, and possession (OCAP) principles, which outline how to manage research data regarding aboriginal people and to counteract disrespectful methodologies. However, these principles present their own set of challenges to those who would conduct research with aboriginal populations. Documents from the Assembly of First Nations, the Government of Canada, Aboriginal writers and researchers, and Nursing theorists and researchers. This is a methodology paper that reviews the issues of data ownership when conducting research with Aboriginal populations. The authors explore indigenous and Western views of knowledge development, outline and discuss the OCAP principles, and present the Canadian Institute of Health Research's guidelines for health research involving aboriginal people as a guide for those who want to carry out ethical and culturally competent research, do no harm and produce research that can benefit aboriginal peoples. There are special considerations associated with conducting research with Aboriginal populations. The Assembly of First Nations wants researchers to use the Ownership, Control, Access and Possession (OCAP) principles with First Nations data. These principles are restrictive and need to be discussed with stakeholders before research is undertaken. In Canada, it is imperative that researchers use the Canadian Institute of Health Research Guidelines for Health Research Involving Aboriginal People to ensure culturally sensitive and ethical conduct during the course of

Factors Influencing the Health Behaviour of Indigenous Australians: Perspectives from Support People.

Science.gov (United States)

Waterworth, Pippa; Pescud, Melanie; Braham, Rebecca; Dimmock, James; Rosenberg, Michael

2015-01-01

Disparities between the health of Indigenous and non-Indigenous populations continue to be prevalent within Australia. Research suggests that Indigenous people participate in health risk behaviour more often than their non-Indigenous counterparts, and that such behaviour has a substantial impact on health outcomes. Although this would indicate that reducing health risk behaviour may have positive effects on health outcomes, the factors that influence Indigenous health behaviour are still poorly understood. This study aimed to interview people who support Indigenous groups to gain an understanding of their views on the factors influencing health behaviour within Indigenous groups in Western Australia. Twenty nine people participated in the study. The emergent themes were mapped against the social ecological model. The results indicated that: (1) culture, social networks, history, racism, socioeconomic disadvantage, and the psychological distress associated with some of these factors interact to affect health behaviour in a complex manner; (2) the desire to retain cultural identity and distinctiveness may have both positive and negative influence on health risk behaviour; (3) strong social connections to family and kin that is intensified by cultural obligations, appears to affirm and disrupt positive health behaviour; (4) the separation between Indigenous and non-Indigenous social connection/networks that appeared to be fostered by marginalisation and racism may influence the effect of social networks on health behaviour; and (5) communication between Indigenous and non-Indigenous people may be interrupted by distrust between the groups, which reduces the influence of some non-Indigenous sources on the health behaviour of Indigenous people.

Factors Influencing the Health Behaviour of Indigenous Australians: Perspectives from Support People

Science.gov (United States)

Waterworth, Pippa; Pescud, Melanie; Braham, Rebecca; Dimmock, James; Rosenberg, Michael

2015-01-01

Disparities between the health of Indigenous and non-Indigenous populations continue to be prevalent within Australia. Research suggests that Indigenous people participate in health risk behaviour more often than their non-Indigenous counterparts, and that such behaviour has a substantial impact on health outcomes. Although this would indicate that reducing health risk behaviour may have positive effects on health outcomes, the factors that influence Indigenous health behaviour are still poorly understood. This study aimed to interview people who support Indigenous groups to gain an understanding of their views on the factors influencing health behaviour within Indigenous groups in Western Australia. Twenty nine people participated in the study. The emergent themes were mapped against the social ecological model. The results indicated that: (1) culture, social networks, history, racism, socioeconomic disadvantage, and the psychological distress associated with some of these factors interact to affect health behaviour in a complex manner; (2) the desire to retain cultural identity and distinctiveness may have both positive and negative influence on health risk behaviour; (3) strong social connections to family and kin that is intensified by cultural obligations, appears to affirm and disrupt positive health behaviour; (4) the separation between Indigenous and non-Indigenous social connection/networks that appeared to be fostered by marginalisation and racism may influence the effect of social networks on health behaviour; and (5) communication between Indigenous and non-Indigenous people may be interrupted by distrust between the groups, which reduces the influence of some non-Indigenous sources on the health behaviour of Indigenous people. PMID:26599437

The quality of Australian Indigenous primary health care research focusing on social and emotional wellbeing: a systematic review.

Science.gov (United States)

Farnbach, Sara; Eades, Anne-Maree; Fernando, Jamie K; Gwynn, Josephine D; Glozier, Nick; Hackett, Maree L

2017-10-11

Objectives and importance of the study: Primary health care research focused on Aboriginal and Torres Strait Islander (Indigenous) people is needed to ensure that key frontline services provide evidence based and culturally appropriate care. We systematically reviewed the published primary health care literature to identify research designs, processes and outcomes, and assess the scientific quality of research focused on social and emotional wellbeing. This will inform future research to improve evidence based, culturally appropriate primary health care. Systematic review in accordance with PRISMA and MOOSE guidelines. Four databases and one Indigenous-specific project website were searched for qualitative, quantitative and mixed-method published research. Studies that were conducted in primary health care services and focused on the social and emotional wellbeing of Indigenous people were included. Scientific quality was assessed using risk-of-bias assessment tools that were modified to meet our aims. We assessed community acceptance by identifying the involvement of community governance structures and representation during research development, conduct and reporting. Data were extracted using standard forms developed for this review. We included 32 articles, which reported on 25 studies. Qualitative and mixed methods were used in 18 studies. Twelve articles were judged as high or unclear risk of bias, four as moderate and five as low risk of bias. Another four studies were not able to be assessed as they did not align with the risk-of-bias tools. Of the five articles judged as low risk of bias, two also had high community acceptance and both of these were qualitative. One used a phenomenological approach and the other combined participatory action research with a social-ecological perspective and incorporated 'two-way learning' principles. Of the 16 studies where a primary outcome was identified, eight aimed to identify perceptions or experiences. The

Reducing the health disparities of Indigenous Australians: time to change focus

Directory of Open Access Journals (Sweden)

Durey Angela

2012-06-01

Full Text Available Abstract Background Indigenous peoples have worse health than non-Indigenous, are over-represented amongst the poor and disadvantaged, have lower life expectancies, and success in improving disparities is limited. To address this, research usually focuses on disadvantaged and marginalised groups, offering only partial understanding of influences underpinning slow progress. Critical analysis is also required of those with the power to perpetuate or improve health inequities. In this paper, using Australia as a case example, we explore the effects of ‘White’, Anglo-Australian cultural dominance in health service delivery to Indigenous Australians. We address the issue using race as an organising principle, underpinned by relations of power. Methods Interviews with non-Indigenous medical practitioners in Western Australia with extensive experience in Indigenous health encouraged reflection and articulation of their insights into factors promoting or impeding quality health care to Indigenous Australians. Interviews were audio-taped and transcribed. An inductive, exploratory analysis identified key themes that were reviewed and interrogated in light of existing literature on health care to Indigenous people, race and disadvantage. The researchers’ past experience, knowledge and understanding of health care and Indigenous health assisted with data interpretation. Informal discussions were also held with colleagues working professionally in Indigenous policy, practice and community settings. Results Racism emerged as a key issue, leading us to more deeply interrogate the role ‘Whiteness’ plays in Indigenous health care. While Whiteness can refer to skin colour, it also represents a racialized social structure where Indigenous knowledge, beliefs and values are subjugated to the dominant western biomedical model in policy and practice. Racism towards Indigenous patients in health services was institutional and interpersonal. Internalised

Climate Change and the Health of Indigenous Communities | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

Indigenous people are among the most directly affected by climate change. Yet, there is limited understanding of the health dimensions of climate change and opportunities for adaptation among indigenous populations. Researchers have tended to focus on other vulnerable regions or on populations as a whole.

Implications of land rights reform for Indigenous health.

Science.gov (United States)

Watson, Nicole L

2007-05-21

In August 2006, the Aboriginal Land Rights (Northern Territory) Amendment Bill 2006 (Cwlth) was passed into law, introducing, among other things, a system of 99-year leases over Indigenous townships. The leasing scheme will diminish the control that traditional owners previously exercised over their lands. This is at odds with research indicating that control over land is a positive influence on Indigenous health.

The quality of Australian Indigenous primary health care research focusing on social and emotional wellbeing: a systematic review

Directory of Open Access Journals (Sweden)

Sara Farnbach

2017-10-01

Full Text Available Objectives and importance of the study: Primary health care research focused on Aboriginal and Torres Strait Islander (Indigenous people is needed to ensure that key frontline services provide evidence based and culturally appropriate care. We systematically reviewed the published primary health care literature to identify research designs, processes and outcomes, and assess the scientific quality of research focused on social and emotional wellbeing. This will inform future research to improve evidence based, culturally appropriate primary health care. Study type: Systematic review in accordance with PRISMA and MOOSE guidelines. Methods: Four databases and one Indigenous-specific project website were searched for qualitative, quantitative and mixed-method published research. Studies that were conducted in primary health care services and focused on the social and emotional wellbeing of Indigenous people were included. Scientific quality was assessed using risk-of-bias assessment tools that were modified to meet our aims. We assessed community acceptance by identifying the involvement of community governance structures and representation during research development, conduct and reporting. Data were extracted using standard forms developed for this review. Results: We included 32 articles, which reported on 25 studies. Qualitative and mixed methods were used in 18 studies. Twelve articles were judged as high or unclear risk of bias, four as moderate and five as low risk of bias. Another four studies were not able to be assessed as they did not align with the risk-of-bias tools. Of the five articles judged as low risk of bias, two also had high community acceptance and both of these were qualitative. One used a phenomenological approach and the other combined participatory action research with a social–ecological perspective and incorporated ‘two-way learning’ principles. Of the 16 studies where a primary outcome was identified, eight aimed

Health and wellbeing of Indigenous adolescents in Australia: a systematic synthesis of population data.

Science.gov (United States)

Azzopardi, Peter S; Sawyer, Susan M; Carlin, John B; Degenhardt, Louisa; Brown, Ngiare; Brown, Alex D; Patton, George C

2018-02-24

Indigenous populations have high rates of disease and premature mortality. Most Indigenous communities are young, and adolescence (age 10-24 years) provides great opportunities for population health gain. However, the absence of a comprehensive account of Indigenous adolescents' health has been a barrier to effective policy. We aimed to report a national health profile for Indigenous adolescents in Australia. We undertook a systematic synthesis of population data to report the health and wellbeing of Indigenous adolescents in Australia. A reporting framework for Indigenous adolescent health in Australia was defined to measure health outcomes, health risks, and sociocultural determinants. Available data (primary data from national surveys and administrative datasets, and available published data) were mapped against the defined reporting framework, and the quality graded, with the highest quality data selected to report a health profile for Indigenous adolescents. Comparison with non-Indigenous adolescents was made where possible, and estimates (disaggregated by age, sex, and remoteness) were reported as relative risks. A national advisory group (six Indigenous young people, three Indigenous adult community members, three researchers, three policy makers, and two service providers, all aged ≥16 years) provided input about the reporting framework, interpretation of findings, and policy recommendations. Data were available for 184 (79%) of 234 elements of the reporting framework. All-cause mortality for Indigenous adolescents (70 per 100 000) was more than twice that of non-Indigenous adolescents, with about 60% of deaths due to intentional self-harm and road traffic injury. 80% of all deaths among Indigenous adolescents were considered as potentially avoidable in the current health system. Communicable diseases (particularly sexually transmitted infections) were leading contributors to morbidity. Almost a third of Indigenous adolescents aged 18-24 years reported

Ambivalent helpers and unhealthy choices: public health practitioners' narratives of Indigenous ill-health.

Science.gov (United States)

Kowal, Emma; Paradies, Yin

2005-03-01

Public health practitioners in Australian indigenous health work in a complex political environment. Public health training is limited in providing them with conceptual tools needed to unpack the postcolonial nexus of 'fourth-world' health. A workshop was designed by the authors to facilitate critical reflection on how the concepts of race and culture are used in constructions of indigenous ill-health. It was attended by researchers, students, clinicians and bureaucrats working in public health in northern Australia. A thematic analysis of the workshop minutes provided insight into public health practitioners' narratives of Indigenous ill-health. The major themes that emerged included tension between structure and agency and between sameness and difference, and ambivalence surrounding the 'helper' identity of public health practitioners. We suggest that these narratives can be understood as attempts to maintain the moral integrity of both Indigenous people and practitioners. This task is necessitated by the specter of cultural relativism intrinsic to contemporary liberal discourses of multiculturalism that attempt to reconcile the universal rights of the citizen with the special rights of minority groups. We argue that the concepts of self-determination and neocolonialism mark the spaces where universal and particular discourses overlap and clash. Practitioners who seek to escape neocolonialism must inhabit only the discursive space of public health congruent with self-determination, leaving them in a bind common to many postcolonial situations. They must relieve the ill-health of indigenous people without acting upon them; change them without declaring that change is required.

Indigenous health: effective and sustainable health services through continuous quality improvement.

Science.gov (United States)

Bailie, Ross S; Si, Damin; O'Donoghue, Lyn; Dowden, Michelle

2007-05-21

The Australian government's Healthy for Life program is supporting capacity development in Indigenous primary care using continuous quality improvement (CQI) techniques. An important influence on the Healthy for Life program has been the ABCD research project. The key features contributing to the success of the project are described. The ABCD research project: uses a CQI approach, with an ongoing cycle of gathering data on how well organisational systems are functioning, and developing and then implementing improvements; is guided by widely accepted principles of community-based research, which emphasise participation; and adheres to the principles and values of Indigenous health research and service delivery. The potential for improving health outcomes in Aboriginal and Torres Strait Islander communities using a CQI approach should be strengthened by clear clinical and managerial leadership, supporting service organisations at the community level, and applying participatory-action principles.

Indigenous Research on Chinese Management

DEFF Research Database (Denmark)

Li, Peter Ping; Leung, Kwok; Chen, Chao C.

2012-01-01

We attempt to provide a definition and a typology of indigenous research on Chinese management as well as outline the general methodological approaches for this type of research. We also present an integrative summary of the four articles included in this special issue and show how they illustrate...... our definition and typology of indigenous research on Chinese management, as well as the various methodological approaches we advocate. Further, we introduce a commentary on the four articles from the perspective of engaged scholarship, and also three additional articles included in this issue....... Finally, we conclude with our suggestions for future indigenous research....

Dadirri: Using a Philosophical Approach to Research to Build Trust between a Non-Indigenous Researcher and Indigenous Participants

Directory of Open Access Journals (Sweden)

Megan Marie Stronach

2014-09-01

Full Text Available Abstract: This article focuses on a philosophical approach employed in a PhD research project that set out to investigate sport career transition (SCT experiences of elite Indigenous Australian sportsmen. The research was necessary as little is known about the transition of this cohort to a life after sport, or their experiences of retirement. A key problem within the SCT paradigm is a presumption that an end to elite sport requires a process of adjustment that is common to all sportspeople—a rather narrow perspective that fails to acknowledge the situational complexity and socio-cultural diversity of elite athletes. With such a range of personal circumstances, it is reasonable to suppose that athletes from different cultural groups will have different individual SCT needs. The researcher is non-Indigenous and mature aged: she encountered a number of challenges in her efforts to understand Indigenous culture and its important sensitivities, and to build trust with the Indigenous male participants she interviewed. An Indigenous philosophy known as Dadirri, which emphasises deep and respectful listening, guided the development of the research design and methodology. Consistent with previous studies conducted by non-Indigenous researchers, an open-ended and conversational approach to interviewing Indigenous respondents was developed. The objective was for the voices of the athletes to be heard, allowing the collection of rich data based on the participants’ perspectives about SCT. An overview of the findings is presented, illustrating that Indigenous athletes experience SCT in complex and distinctive ways. The article provides a model for non-Indigenous researchers to conduct qualitative research with Indigenous people.

Development and Use of Health-Related Technologies in Indigenous Communities: Critical Review.

Science.gov (United States)

Jones, Louise; Jacklin, Kristen; O'Connell, Megan E

2017-07-20

Older Indigenous adults encounter multiple challenges as their age intersects with health inequities. Research suggests that a majority of older Indigenous adults prefer to age in place, and they will need culturally safe assistive technologies to do so. The aim of this critical review was to examine literature concerning use, adaptation, and development of assistive technologies for health purposes by Indigenous peoples. Working within Indigenous research methodologies and from a decolonizing approach, searches of peer-reviewed academic and gray literature dated to February 2016 were conducted using keywords related to assistive technology and Indigenous peoples. Sources were reviewed and coded thematically. Of the 34 sources captured, only 2 concerned technology specifically for older Indigenous adults. Studies detailing technology with Indigenous populations of all ages originated primarily from Canada (n=12), Australia (n=10), and the United States (n=9) and were coded to four themes: meaningful user involvement and community-based processes in development, the digital divide, Indigenous innovation in technology, and health technology needs as holistic and interdependent. A key finding is the necessity of meaningful user involvement in technology development, especially in communities struggling with the digital divide. In spite of, or perhaps because of this divide, Indigenous communities are enthusiastically adapting mobile technologies to suit their needs in creative, culturally specific ways. This enthusiasm and creativity, coupled with the extensive experience many Indigenous communities have with telehealth technologies, presents opportunity for meaningful, culturally safe development processes. ©Louise Jones, Kristen Jacklin, Megan E O'Connell. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 20.07.2017.

Improving forensic mental health care to Indigenous Australians: theorizing the intercultural space.

Science.gov (United States)

Durey, A; Wynaden, D; O'Kane, M

2014-05-01

This paper uses the 'intercultural space' as an educational strategy to prepare nurses to work respectfully with Indigenous patients in a forensic mental health context; offers an educational approach that introduces nurses to Indigenous knowledge, beliefs and values, examines power relations in colonized countries between the dominant white cultural group and the Indigenous population and encourages nurses to critically reflect on their health care practice; and explores the intercultural space as a shared space between cultures fostering open and robust inquiry where neither culture dominates and new positions, representations and understandings can emerge. Given the disproportionately high number of Indigenous people imprisoned in colonized countries, this paper responds to research from Western Australia on the need to prepare forensic mental health nurses to deliver care to Indigenous patients with mental health disorders. The paper highlights the nexus between theory, research and education that can inform the design and implementation of programmes to help nurses navigate the complex, layered and contested 'intercultural space' and deliver culturally safe care to Indigenous patients. Nurses are encouraged to critically reflect on how beliefs and values underpinning their cultural positioning impact on health care to Indigenous patients. The paper draws on intercultural theory to offer a pedagogical framework that acknowledges the negative impacts of colonization on Indigenous health and well-being, repositions and revalues Indigenous cultures and knowledges and fosters open and robust inquiry. This approach is seen as a step towards working more effectively in the intercultural space where ultimately binary oppositions that privilege one culture over another and inhibit robust inquiry are avoided, paving the way for new, more inclusive positions, representations and understandings to emerge. While the intercultural space can be a place of struggle, tension

Indigenous housing and health in the Canadian North

DEFF Research Database (Denmark)

Christensen, Julia

2016-01-01

In this article, I explore the relationship between housing, home and health amongst Indigenous homeless people living in the Canadian North. In particular, I examine the ways in which Indigenous homemaking practices conflict with housing policy, and exacerbate individual pathways to homelessness....... I argue that integral components in northern Indigenous conceptualizations of home and, in turn, health are not only unrecognized in housing policy, but actively discouraged. The potential for homemaking to inform health and housing policy speaks to the relevance of cultural safety not only...... to Indigenous health services, but also to a comprehensive framing of Indigenous health....

Study Protocol: establishing good relationships between patients and health care providers while providing cardiac care. Exploring how patient-clinician engagement contributes to health disparities between indigenous and non-indigenous Australians in South Australia

Directory of Open Access Journals (Sweden)

Roe Yvette L

2012-11-01

Full Text Available Abstract Background Studies that compare Indigenous Australian and non-Indigenous patients who experience a cardiac event or chest pain are inconclusive about the reasons for the differences in-hospital and survival rates. The advances in diagnostic accuracy, medication and specialised workforce has contributed to a lower case fatality and lengthen survival rates however this is not evident in the Indigenous Australian population. A possible driver contributing to this disparity may be the impact of patient-clinician interface during key interactions during the health care process. Methods/Design This study will apply an Indigenous framework to describe the interaction between Indigenous patients and clinicians during the continuum of cardiac health care, i.e. from acute admission, secondary and rehabilitative care. Adopting an Indigenous framework is more aligned with Indigenous realities, knowledge, intellects, histories and experiences. A triple layered designed focus group will be employed to discuss patient-clinician engagement. Focus groups will be arranged by geographic clusters i.e. metropolitan and a regional centre. Patient informants will be identified by Indigenous status (i.e. Indigenous and non-Indigenous and the focus groups will be convened separately. The health care provider focus groups will be convened on an organisational basis i.e. state health providers and Aboriginal Community Controlled Health Services. Yarning will be used as a research method to facilitate discussion. Yarning is in congruence with the oral traditions that are still a reality in day-to-day Indigenous lives. Discussion This study is nestled in a larger research program that explores the drivers to the disparity of care and health outcomes for Indigenous and non-Indigenous Australians who experience an acute cardiac admission. A focus on health status, risk factors and clinical interventions may camouflage critical issues within a patient

A transnational approach to understanding indicators of mental health, alcohol use and reproductive health among indigenous mexican migrants.

Science.gov (United States)

Zúñiga, María Luisa; Lewin Fischer, Pedro; Cornelius, Debra; Cornelius, Wayne; Goldenberg, Shira; Keyes, David

2014-06-01

The three studies presented in this Special Topics in Immigrant Health report findings from a novel transnational, mixed-methods study with indigenous Mayans in Yucatán, Mexico, and their satellite communities in Southern California. Indigenous migrants comprise the largest proportion of recent, first-time migrants from Mexico to the United States and are among the migrant populations most vulnerable to discrimination (e.g. work place) and health disparities. The studies presented focus on three topics: perceived discrimination and mental health among indigenous migrants and non-migrants, risky alcohol use behaviors associated with migration to the U.S. and within Mexico, and gendered power dynamics related to sexual health care access and utilization. This transnational research sheds new light on health issues and gender differences affecting indigenous Mexican migrant men, women and their families. Findings can serve to inform intervention research to improve migrant health in the U.S. and Mexico as well as transnational collaboration between countries.

Toward an Integrative Framework of Indigenous Research

DEFF Research Database (Denmark)

Li, Peter Ping

2012-01-01

It has long been recognized that indigenous research should be helpful, if not essential, for an adequate understanding of local phenomena. The indigenous approach is consistent with, but extends beyond, the repeated calls for contextualizing management and organization research. However, the cha......It has long been recognized that indigenous research should be helpful, if not essential, for an adequate understanding of local phenomena. The indigenous approach is consistent with, but extends beyond, the repeated calls for contextualizing management and organization research. However...

Characteristics of Indigenous primary health care service delivery models: a systematic scoping review.

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Harfield, Stephen G; Davy, Carol; McArthur, Alexa; Munn, Zachary; Brown, Alex; Brown, Ngiare

2018-01-25

Indigenous populations have poorer health outcomes compared to their non-Indigenous counterparts. The evolution of Indigenous primary health care services arose from mainstream health services being unable to adequately meet the needs of Indigenous communities and Indigenous peoples often being excluded and marginalised from mainstream health services. Part of the solution has been to establish Indigenous specific primary health care services, for and managed by Indigenous peoples. There are a number of reasons why Indigenous primary health care services are more likely than mainstream services to improve the health of Indigenous communities. Their success is partly due to the fact that they often provide comprehensive programs that incorporate treatment and management, prevention and health promotion, as well as addressing the social determinants of health. However, there are gaps in the evidence base including the characteristics that contribute to the success of Indigenous primary health care services in providing comprehensive primary health care. This systematic scoping review aims to identify the characteristics of Indigenous primary health care service delivery models. This systematic scoping review was led by an Aboriginal researcher, using the Joanna Briggs Institute Scoping Review Methodology. All published peer-reviewed and grey literature indexed in PubMed, EBSCO CINAHL, Embase, Informit, Mednar, and Trove databases from September 1978 to May 2015 were reviewed for inclusion. Studies were included if they describe the characteristics of service delivery models implemented within an Indigenous primary health care service. Sixty-two studies met the inclusion criteria. Data were extracted and then thematically analysed to identify the characteristics of Indigenous PHC service delivery models. Culture was the most prominent characteristic underpinning all of the other seven characteristics which were identified - accessible health services, community

Rowing upstream: Contextualising indigenous research processes ...

African Journals Online (AJOL)

The use of indigenous research ethics has a possibility of contextualising indigenous research. Orthodox research is guided by ethical principles which are meant to protect the institution or researcher and the participants. Despite the existence of the ethical pronouncements, literature has shown that research has proven to ...

Drinking water quality in Indigenous communities in Canada and health outcomes: a scoping review.

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Bradford, Lori E A; Okpalauwaekwe, Udoka; Waldner, Cheryl L; Bharadwaj, Lalita A

2016-01-01

Many Indigenous communities in Canada live with high-risk drinking water systems and drinking water advisories and experience health status and water quality below that of the general population. A scoping review of research examining drinking water quality and its relationship to Indigenous health was conducted. The study was undertaken to identify the extent of the literature, summarize current reports and identify research needs. A scoping review was designed to identify peer-reviewed literature that examined challenges related to drinking water and health in Indigenous communities in Canada. Key search terms were developed and mapped on five bibliographic databases (MEDLINE/PubMED, Web of Knowledge, SciVerse Scopus, Taylor and Francis online journal and Google Scholar). Online searches for grey literature using relevant government websites were completed. Sixteen articles (of 518; 156 bibliographic search engines, 362 grey literature) met criteria for inclusion (contained keywords; publication year 2000-2015; peer-reviewed and from Canada). Studies were quantitative (8), qualitative (5) or mixed (3) and included case, cohort, cross-sectional and participatory designs. In most articles, no definition of "health" was given (14/16), and the primary health issue described was gastrointestinal illness (12/16). Challenges to the study of health and well-being with respect to drinking water in Indigenous communities included irregular funding, remote locations, ethical approval processes, small sample sizes and missing data. Research on drinking water and health outcomes in Indigenous communities in Canada is limited and occurs on an opportunistic basis. There is a need for more research funding, and inquiry to inform policy decisions for improvements of water quality and health-related outcomes in Indigenous communities. A coordinated network looking at First Nations water and health outcomes, a database to store and create access to research findings, increased

Decolonizing Methodologies: Research and Indigenous Peoples.

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Smith, Linda Tuhiwai

From the vantage point of indigenous peoples, the term "research" is inextricably linked to European imperialism and colonialism. In this book, an indigenous researcher calls for the decolonization of research methods. The first part of the book critically examines the historical and philosophical bases of Western research; Western…

Drinking water quality in Indigenous communities in Canada and health outcomes: a scoping review

Directory of Open Access Journals (Sweden)

Lori E. A. Bradford

2016-07-01

Full Text Available Background: Many Indigenous communities in Canada live with high-risk drinking water systems and drinking water advisories and experience health status and water quality below that of the general population. A scoping review of research examining drinking water quality and its relationship to Indigenous health was conducted. Objective: The study was undertaken to identify the extent of the literature, summarize current reports and identify research needs. Design: A scoping review was designed to identify peer-reviewed literature that examined challenges related to drinking water and health in Indigenous communities in Canada. Key search terms were developed and mapped on five bibliographic databases (MEDLINE/PubMED, Web of Knowledge, SciVerse Scopus, Taylor and Francis online journal and Google Scholar. Online searches for grey literature using relevant government websites were completed. Results: Sixteen articles (of 518; 156 bibliographic search engines, 362 grey literature met criteria for inclusion (contained keywords; publication year 2000–2015; peer-reviewed and from Canada. Studies were quantitative (8, qualitative (5 or mixed (3 and included case, cohort, cross-sectional and participatory designs. In most articles, no definition of “health” was given (14/16, and the primary health issue described was gastrointestinal illness (12/16. Challenges to the study of health and well-being with respect to drinking water in Indigenous communities included irregular funding, remote locations, ethical approval processes, small sample sizes and missing data. Conclusions: Research on drinking water and health outcomes in Indigenous communities in Canada is limited and occurs on an opportunistic basis. There is a need for more research funding, and inquiry to inform policy decisions for improvements of water quality and health-related outcomes in Indigenous communities. A coordinated network looking at First Nations water and health outcomes, a

Partnering with Indigenous student co-researchers: improving research processes and outcomes.

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Genuis, Shelagh K; Willows, Noreen; Jardine, Cindy G

2015-01-01

To examine the contribution of student co-researchers to a community-based participatory Photovoice investigation of Indigenous children's food-related lived experience. We examine co-researchers' contributions to the research process, their role in knowledge co-generation and dissemination, and factors that fostered research partnership with the teenage co-researchers. High school students attending a First Nation community school in Canada were trained as research partners. They contributed to aspects of research design, conducted interviews with grades 3 and 4 Photovoice participants, and participated in data analysis and the development of a culturally relevant photobook. The study was initiated by the community's research committee. It is informed by critical consciousness theory and the positive youth development framework. Student co-researchers incorporated culturally appropriate strategies as they interviewed participants. Co-researchers adopted conversational approaches, built rapport by articulating personal and cultural connections, and engaged in mentoring and health promotion as they interviewed participants. They made critical contributions to dissemination by developing photobook content that promoted the importance of traditional foods and the vital role of family and community in healthy eating practices. Relationships and "dialogic" space were important to building partnership with and promoting capacity development among youth co-researchers. Partnership between university researchers and Indigenous student co-researchers holds great promise for health promotion in communities. Co-researchers developed research and leadership skills, gained understanding of health challenges facing their community, and initiated health and cultural promotion through the project's Photobook. This investigation supports the powerful potential of student co-researchers to meaningfully contribute to research processes and to build knowledge that is relevant and

Partnering with Indigenous student co-researchers: improving research processes and outcomes

Directory of Open Access Journals (Sweden)

Shelagh K. Genuis

2015-07-01

Full Text Available Objective: To examine the contribution of student co-researchers to a community-based participatory Photovoice investigation of Indigenous children's food-related lived experience. We examine co-researchers’ contributions to the research process, their role in knowledge co-generation and dissemination, and factors that fostered research partnership with the teenage co-researchers. Methods: High school students attending a First Nation community school in Canada were trained as research partners. They contributed to aspects of research design, conducted interviews with grades 3 and 4 Photovoice participants, and participated in data analysis and the development of a culturally relevant photobook. The study was initiated by the community's research committee. It is informed by critical consciousness theory and the positive youth development framework. Results: Student co-researchers incorporated culturally appropriate strategies as they interviewed participants. Co-researchers adopted conversational approaches, built rapport by articulating personal and cultural connections, and engaged in mentoring and health promotion as they interviewed participants. They made critical contributions to dissemination by developing photobook content that promoted the importance of traditional foods and the vital role of family and community in healthy eating practices. Relationships and “dialogic” space were important to building partnership with and promoting capacity development among youth co-researchers. Conclusions: Partnership between university researchers and Indigenous student co-researchers holds great promise for health promotion in communities. Co-researchers developed research and leadership skills, gained understanding of health challenges facing their community, and initiated health and cultural promotion through the project's Photobook. This investigation supports the powerful potential of student co-researchers to meaningfully contribute to

Insiders' Insight: Discrimination against Indigenous Peoples through the Eyes of Health Care Professionals.

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Wylie, Lloy; McConkey, Stephanie

2018-05-07

Discrimination in the health care system has a direct negative impact on health and wellbeing. Experiences of discrimination are considered a root cause for the health inequalities that exist among Indigenous peoples. Experiences of discrimination are commonplace, with patients noting abusive treatment, stereotyping, and a lack of quality in the care provided, which discourage Indigenous people from accessing care. This research project examined the perspectives of health care providers and decision-makers to identify what challenges they see facing Indigenous patients and families when accessing health services in a large city in southern Ontario. Discrimination against Indigenous people was identified as major challenges by respondents, noting that it is widespread. This paper discusses the three key discrimination subthemes that were identified, including an unwelcoming environment, stereotyping and stigma, and practice informed by racism. These findings point to the conclusion that in order to improve health care access for Indigenous peoples, we need to go beyond simply making health services more welcoming and inclusive. Practice norms shaped by biases informed by discrimination against Indigenous people are widespread and compromise standards of care. Therefore, the problem needs to be addressed throughout the health care system as part of a quality improvement strategy. This will require not only a significant shift in the attitudes, knowledge, and skills of health care providers, but also the establishment of accountabilities for health care organizations to ensure equitable health services for Indigenous peoples.

Cardiovascular disease medication health literacy among Indigenous peoples: design and protocol of an intervention trial in Indigenous primary care services.

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Crengle, Sue; Smylie, Janet; Kelaher, Margaret; Lambert, Michelle; Reid, Susan; Luke, Joanne; Anderson, Ian; Harré Hindmarsh, Jennie; Harwood, Matire

2014-07-12

populations. The study also illustrates the incorporation of Indigenous health research principles and processes in clinical trials and provides insights that may be useful in other contexts. Australian and New Zealand Clinical Trials Register (ACTRN12612001309875; date of registration 18/12/2012).

Review of Indigenous Health Curriculum in Nutrition and Dietetics at One Australian University: An Action Research Study

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Wilson, Annabelle M.; Mehta, Kaye; Miller, Jacqueline; Yaxley, Alison; Thomas, Jolene; Jackson, Kathryn; Wray, Amanda; Miller, Michelle D.

2015-01-01

This article describes a review undertaken in 2012-2013 by Nutrition and Dietetics, Flinders University, to assess the Indigenous health curriculum of the Bachelor of Nutrition and Dietetics (BND) and Masters of Nutrition and Dietetics (MND). An action research framework was used to guide and inform inquiry. This involved four stages, each of…

[The elderly care practices of indigenous-performance of health].

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Rissardo, Leidyani Karina; Alvim, Neide Aparecida Titonelli; Marcon, Sonia Silva; Carreira, Lígia

2014-01-01

This research aims to understand the care practices of health professionals who assist the elderly Kaingang. It is a qualitative study, supported in ethnography, conducted by ten professionals working in primary health care in the indigenous land of Faxinal, Paraná, Brazil. The data was collected from November 2010 to February 2012 by participant observation and interviews, and analyzed based on the Transcultural Care Theory. Was identified the preoccupation of the carers practices with the medication and immunization, as well as traditional medical care. To achieve these, care professionals had strategies that implemented maintenance of older people in care. We conclude that cultural values and integrate scientific need assistance to improve the health of elderly indigenous.

Yarning/Aboriginal storytelling: towards an understanding of an Indigenous perspective and its implications for research practice.

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Geia, Lynore K; Hayes, Barbara; Usher, Kim

2013-12-01

There is increasing recognition of Indigenous perspectives from various parts of the world in relation to storytelling, research and its effects on practice. The recent emergence of storytelling or yarning as a research method in Australian Aboriginal and Torres Strait Island studies and other Indigenous peoples of the world is gaining momentum. Narratives, stories, storytelling and yarning are emerging methods in research and has wide ranging potential to shape conventional research discourse making research more meaningful and accessible for researchers. In this paper we argue for the importance of Indigenous research methods and Indigenous method(ology), within collaborative respectful partnerships with non-Indigenous researchers. It is imperative to take these challenging steps together towards better outcomes for Indigenous people and their communities. In the Australian context we as researchers cannot afford to allow the gap between Aboriginal and Torres Strait Islanders and mainstream Australia health outcomes to grow even wider. One such pathway is the inclusion of Aboriginal storytelling or yarning from an Aboriginal and Torres Strait perspective within Indigenous and non-Indigenous research paradigms. Utilising Aboriginal storytelling or yarning will provide deeper understanding; complementing a two-way research paradigm for collaborative research. Furthermore, it has significant social implications for research and clinical practice amongst Indigenous populations; thus complementing the biomedical medical paradigm.

[Health and indigenous peoples in Brazil: reflections based on the First National Survey of Indigenous People's Health and Nutrition].

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Carlos, E A Coimbra

2014-04-01

The current configuration of indigenous peoples' health in Brazil results from a complex historical trajectory, responsible for major delays for this population segment in the countrywide social advances seen in recent decades, particularly in the fields of health, education, housing, and sanitation. The main focus of this contribution is to review synthetically a selection of the main results of the First National Survey of Indigenous People's Health and Nutrition, conducted in the period 2008-2009, which visited 113 villages across the Brazil and interviewed 6,692 women and 6,128 children. Among the results, emphasis is given to the observed poor sanitation conditions in villages, high prevalence of chronic malnutrition, anemia, diarrhea, and acute respiratory infections in children, and the emergence of non-communicable chronic diseases in women. The scenario depicted by this survey requires urgent critical review of indigenous health policy in order to better meet the health needs of Brazil's indigenous population.

The health of populations living in the indigenous minority settlements of northern Yakutia.

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Burtseva, Tatiana E; Uvarova, Tatiana E; Tomsky, Mikhail I; Odland, Jon Ø

2014-01-01

This monograph contains the results of a study carried out by the Yakutsk Research Center for Complex Medical Problems, "Evaluating the health of the indigenous minorities of the Sakha Republic (Yakutia) and optimizing medical assistance using innovative technologies and telemedicine in indigenous settlements." The child population was studied in 19 indigenous minority settlements, and the adult population was studied in 12 settlements.

A Global Assessment on Climate Research Engaging Indigenous Knowledge Systems and Recommendations for Quality Standards of Research Practice in Indigenous Communities

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Davíd-Chavez, D. M.; Gavin, M. C.

2017-12-01

Indigenous communities worldwide have maintained their own knowledge systems for millennia informed through careful observation of dynamics of environmental changes. Withstanding centuries of challenges to their rights to maintain and practice these knowledge systems, Indigenous peoples continually speak to a need for quality standards for research in their communities. Although, international and Indigenous peoples' working groups emphasize Indigenous knowledge systems and the communities who hold them as critical resources for understanding and adapting to climate change, there has yet to be a comprehensive, evidence based analysis into how diverse knowledge systems are integrated in scientific studies. Do current research practices challenge or support Indigenous communities in their efforts to maintain and appropriately apply their knowledge systems? This study addresses this question using a systematic literature review and meta-analysis assessing levels of Indigenous community participation and decision-making in all stages of the research process (initiation, design, implementation, analysis, dissemination). Assessment is based on reported quality indicators such as: outputs that serve the community, ethical guidelines in practice (free, prior, and informed consent and intellectual property rights), and community access to findings. These indicators serve to identify patterns between levels of community participation and quality standards in practice. Meta-analysis indicates most climate studies practice an extractive model in which Indigenous knowledge systems are co-opted with minimal participation or decision-making authority from communities who hold them. Few studies report outputs that directly serve Indigenous communities, ethical guidelines in practice, or community access to findings. Studies reporting the most quality indicators were initiated in mutual agreement between Indigenous communities and outside researchers or by communities themselves

[Forum: health and indigenous peoples in Brazil. Introduction].

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Welch, James R

2014-04-01

This Forum on Health and Indigenous Peoples in Brazil explores contemporary challenges to indigenous health and health politics in Brazil. The short collection of articles that follow are based on presentations, originally given at the Indigenous Health Working Group panel at the 10th Brazilian Public Health Conference in Rio Grande do Sul State, by professors Carlos E. A. Coimbra Jr. (Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz), Marina Denise Cardoso (Universidade Federal de São Carlos) and Eliana E. Diehl (Universidade Federal de Santa Catarina) with Marcos A. Pellegrini (Universidade Federal de Roraima). In this short Introduction, I introduce these contributions, taking as a point of reference a local example of healthcare inequity derived from a presentation at the same panel by Paulo F. Supretaprã, indigenous community leader from Etênhiritipá village, Mato Grosso State.

The forsaken mental health of the Indigenous Peoples - a moral case of outrageous exclusion in Latin America.

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Incayawar, Mario; Maldonado-Bouchard, Sioui

2009-10-29

Mental health is neglected in most parts of the world. For the Indigenous Peoples of Latin America, the plight is even more severe as there are no specific mental health services designed for them altogether. Given the high importance of mental health for general health, the status quo is unacceptable. Lack of research on the subject of Indigenous Peoples' mental health means that statistics are virtually unavailable. To illustrate their mental health status, one can nonetheless point to the high rates of poverty and extreme poverty in their communities, overcrowded housing, illiteracy, and lack of basic sanitary services such as water, electricity and sewage. At the dawn of the XXI century, they remain poor, powerless, and voiceless. They remain severely excluded from mainstream society despite being the first inhabitants of this continent and being an estimated of 48 million people. This paper comments, specifically, on the limited impact of the Pan American Health Organization's mental health initiative on the Indigenous Peoples of Latin America. The Pan American Health Organization's sponsored workshop "Programas y Servicios de Salud Mental en Communidades Indígenas" [Mental Health Programs and Services for the Indigenous Communities] in the city of Santa Cruz, Bolivia on July16 - 18, 1998, appeared promising. However, eleven years later, no specific mental health program has been designed nor developed for the Indigenous Peoples in Latin America. This paper makes four specific recommendations for improvements in the approach of the Pan American Health Organization: (1) focus activities on what can be done; (2) build partnerships with the Indigenous Peoples; (3) consider traditional healers as essential partners in any mental health effort; and (4) conduct basic research on the mental health status of the Indigenous Peoples prior to the programming of any mental health service. The persistent neglect of the Indigenous Peoples' mental health in Latin America

Adapting Western research methods to indigenous ways of knowing.

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Simonds, Vanessa W; Christopher, Suzanne

2013-12-01

Indigenous communities have long experienced exploitation by researchers and increasingly require participatory and decolonizing research processes. We present a case study of an intervention research project to exemplify a clash between Western research methodologies and Indigenous methodologies and how we attempted reconciliation. We then provide implications for future research based on lessons learned from Native American community partners who voiced concern over methods of Western deductive qualitative analysis. Decolonizing research requires constant reflective attention and action, and there is an absence of published guidance for this process. Continued exploration is needed for implementing Indigenous methods alone or in conjunction with appropriate Western methods when conducting research in Indigenous communities. Currently, examples of Indigenous methods and theories are not widely available in academic texts or published articles, and are often not perceived as valid.

Secondary analysis of data can inform care delivery for Indigenous women in an acute mental health inpatient unit.

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Bradley, Pat; Cunningham, Teresa; Lowell, Anne; Nagel, Tricia; Dunn, Sandra

2017-02-01

There is a paucity of research exploring Indigenous women's experiences in acute mental health inpatient services in Australia. Even less is known of Indigenous women's experience of seclusion events, as published data are rarely disaggregated by both indigeneity and gender. This research used secondary analysis of pre-existing datasets to identify any quantifiable difference in recorded experience between Indigenous and non-Indigenous women, and between Indigenous women and Indigenous men in an acute mental health inpatient unit. Standard separation data of age, length of stay, legal status, and discharge diagnosis were analysed, as were seclusion register data of age, seclusion grounds, and number of seclusion events. Descriptive statistics were used to summarize the data, and where warranted, inferential statistical methods used SPSS software to apply analysis of variance/multivariate analysis of variance testing. The results showed evidence that secondary analysis of existing datasets can provide a rich source of information to describe the experience of target groups, and to guide service planning and delivery of individualized, culturally-secure mental health care at a local level. The results are discussed, service and policy development implications are explored, and suggestions for further research are offered. © 2016 Australian College of Mental Health Nurses Inc.

Indigenous Geographies: Research as Reconciliation

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Cindy Smithers Graeme

2017-04-01

Full Text Available Employing a reflexive and co-constructed narrative analysis, this article explores our experiences as a non-Indigenous doctoral student and a First Nations research assistant working together within the context of a community-based participatory Indigenous geography research project. Our findings revealed that within the research process there were experiences of conflict, and opportunities to reflect upon our identity and create meaningful relationships. While these experiences contributed to an improved research process, at a broader level, we suggest that they also represented our personal stories of reconciliation. In this article, we share these stories, specifically as they relate to reconciliatory processes of re-education and cultural regeneration. We conclude by proposing several policy recommendations to support research as a pathway to reconciliation in Canada.

The World Indigenous Research Alliance (WIRA): Mediating and Mobilizing Indigenous Peoples' Educational Knowledge and Aspirations

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Whitinui, Paul; McIvor, Onowa; Robertson, Boni; Morcom, Lindsay; Cashman, Kimo; Arbon, Veronica

2015-01-01

There is an Indigenous resurgence in education occurring globally. For more than a century Euro-western approaches have controlled the provision and quality of education to, and for Indigenous peoples. The World Indigenous Research Alliance (WIRA) established in 2012, is a grass-roots movement of Indigenous scholars passionate about making a…

Culturally Safe Health Initiatives for Indigenous Peoples in Canada: A Scoping Review.

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Brooks-Cleator, Lauren; Phillipps, Breanna; Giles, Audrey

2018-01-01

Background Cultural safety has the potential to improve the health disparities between Indigenous and non-Indigenous Canadians, yet practical applications of the concept are lacking in the literature. Purpose This study aims to identify the key components of culturally safe health initiatives for the Indigenous population of Canada to refine its application in health-care settings. Methods We conducted a scoping review of the literature pertaining to culturally safe health promotion programs, initiatives, services, or care for the Indigenous population in Canada. Our initial search yielded 501 publications, but after full review of 44 publications, 30 were included in the review. After charting the data, we used thematic analysis to identify themes in the data. Results We identified six themes: collaboration/partnerships, power sharing, address the broader context of the patient's life, safe environment, organizational and individual level self-reflection, and training for health-care providers. Conclusion While it is important to recognize that the provision of culturally safe initiatives depend on the specific interaction between the health-care provider and the patient, having a common understanding of the components of cultural safety, such as those that we identified through this research, will help in the transition of cultural safety from theory into practice.

The forsaken mental health of the Indigenous Peoples - a moral case of outrageous exclusion in Latin America

Directory of Open Access Journals (Sweden)

Maldonado-Bouchard Sioui

2009-10-01

Full Text Available Abstract Background Mental health is neglected in most parts of the world. For the Indigenous Peoples of Latin America, the plight is even more severe as there are no specific mental health services designed for them altogether. Given the high importance of mental health for general health, the status quo is unacceptable. Lack of research on the subject of Indigenous Peoples' mental health means that statistics are virtually unavailable. To illustrate their mental health status, one can nonetheless point to the high rates of poverty and extreme poverty in their communities, overcrowded housing, illiteracy, and lack of basic sanitary services such as water, electricity and sewage. At the dawn of the XXI century, they remain poor, powerless, and voiceless. They remain severely excluded from mainstream society despite being the first inhabitants of this continent and being an estimated of 48 million people. This paper comments, specifically, on the limited impact of the Pan American Health Organization's mental health initiative on the Indigenous Peoples of Latin America. Discussion The Pan American Health Organization's sponsored workshop "Programas y Servicios de Salud Mental en Communidades Indígenas" [Mental Health Programs and Services for the Indigenous Communities] in the city of Santa Cruz, Bolivia on July16 - 18, 1998, appeared promising. However, eleven years later, no specific mental health program has been designed nor developed for the Indigenous Peoples in Latin America. This paper makes four specific recommendations for improvements in the approach of the Pan American Health Organization: (1 focus activities on what can be done; (2 build partnerships with the Indigenous Peoples; (3 consider traditional healers as essential partners in any mental health effort; and (4 conduct basic research on the mental health status of the Indigenous Peoples prior to the programming of any mental health service. Summary The persistent neglect of

Working with Indigenous Knowledge: A Guide for Researchers ...

International Development Research Centre (IDRC) Digital Library (Canada)

In the 1990s, indigenous knowledge has been fertile ground for research, and ... research and will appeal to both seasoned development professional as well as ... indigenous-knowledge issues with the University of Indonesia, the Institute of ...

Our land, our language: connecting dispossession and health equity in an indigenous context.

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Brown, Helen J; McPherson, Gladys; Peterson, Ruby; Newman, Vera; Cranmer, Barbara

2012-06-01

For contemporary Indigenous people, colonial relations (past and present) intersect with neoliberal policies and practices to create subtle forms of dispossession.These undermine the health of Indigenous peoples and create barriers restricting access to appropriate health services. Integrating insights from the critical geographer David Harvey, the authors demonstrate how the dispossession of land and language threaten health and well-being and worsen existing illness conditions. Drawing on the qualitative findings from a program of community-based research with the 'Namgis First Nation in the Canadian province of British Columbia, the authors argue for an account of how neoliberal mechanisms operate to further the "accumulation by dispossession" associated with historical and ongoing colonialism. Specifically, they show how neoliberal ideologies operate to sustain medical colonialism and health inequities for Indigenous peoples. The authors discuss the implications for nursing actions to achieve health equity in rural First Nations communities.

Access to primary health care services for Indigenous peoples: A framework synthesis.

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Davy, Carol; Harfield, Stephen; McArthur, Alexa; Munn, Zachary; Brown, Alex

2016-09-30

Indigenous peoples often find it difficult to access appropriate mainstream primary health care services. Securing access to primary health care services requires more than just services that are situated within easy reach. Ensuring the accessibility of health care for Indigenous peoples who are often faced with a vast array of additional barriers including experiences of discrimination and racism, can be complex. This framework synthesis aimed to identify issues that hindered Indigenous peoples from accessing primary health care and then explore how, if at all, these were addressed by Indigenous health care services. To be included in this framework synthesis papers must have presented findings focused on access to (factors relating to Indigenous peoples, their families and their communities) or accessibility of Indigenous primary health care services. Findings were imported into NVivo and a framework analysis undertaken whereby findings were coded to and then thematically analysed using Levesque and colleague's accessibility framework. Issues relating to the cultural and social determinants of health such as unemployment and low levels of education influenced whether Indigenous patients, their families and communities were able to access health care. Indigenous health care services addressed these issues in a number of ways including the provision of transport to and from appointments, a reduction in health care costs for people on low incomes and close consultation with, if not the direct involvement of, community members in identifying and then addressing health care needs. Indigenous health care services appear to be best placed to overcome both the social and cultural determinants of health which hamper Indigenous peoples from accessing health care. Findings of this synthesis also suggest that Levesque and colleague's accessibility framework should be broadened to include factors related to the health care system such as funding.

The Indigenous Experience of Work in a Health Research Organisation: Are There Wider Inferences?

Directory of Open Access Journals (Sweden)

Sharon Chirgwin

2017-08-01

Full Text Available The purpose of this study was to identify the factors that positively and negatively impacted on the employment experiences and trajectories of Indigenous Australians who are currently or were formerly employed by a research organisation in both remote and urban settings. The study design was an embedded mixed-methods approach. The first phase quantified staff uptake, continued employment, and attrition. Then interviews were conducted with 42 former and 51 current Indigenous staff members to obtain qualitative data. The results showed that the quality of supervision, the work flexibility to enable employees to respond to family and community priorities, and training and other forms of career support were all identified as important factors in the workplace. The most common reasons for leaving were that research projects ended, or to pursue a career change or further study. The authors use the findings to make recommendations pertinent to policy formation for both government and organisations seeking to attract and nurture Indigenous staff.

Social determinants of self-reported health for Canada's indigenous peoples: a public health approach.

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Bethune, R; Absher, N; Obiagwu, M; Qarmout, T; Steeves, M; Yaghoubi, M; Tikoo, R; Szafron, M; Dell, C; Farag, M

2018-04-14

In Canada, indigenous peoples suffer from a multitude of health disparities. To better understand these disparities, this study aims to examine the social determinants of self-reported health for indigenous peoples in Canada. This study uses data from Statistics Canada's Aboriginal Peoples Survey 2012. Multinomial logistic regression models were used to examine how selected social determinants of health are associated with self-reported health among off-reserve First Nations and Métis peoples in Canada. Our analysis shows that being older, female, and living in urban settings were significantly associated with negative ratings of self-reported health status among the indigenous respondents. Additionally, we found that higher income and levels of education were strongly and significantly associated with positive ratings of self-reported health status. Compared with indigenous peoples with an education level of grade 8 or lower, respondents with higher education were 10 times (5.35-22.48) more likely to report 'excellent' and 'very good' health. Respondents who earned more than $40,000 annually were three times (2.17-4.72) more likely to report 'excellent' and 'very good' health compared with those who earned less than $20,000 annually. When interacted with income, we also found that volunteering in the community is associated with better self-reported health. There are known protective determinants (income and education) and risk determinants (location of residence, gender, and age) which are associated with self-reported health status among off-reserve First Nations and Métis peoples. For indigenous-specific determinants, volunteering in the community appears to be associated with self-perceived health status. Thus, addressing these determinants will be necessary to achieve better health outcomes for indigenous peoples in Canada. Next steps include developing indigenous-specific social determinants of health indicators that adequately measure culture, connection

Beyond the Biomedical Paradigm: The Formation and Development of Indigenous Community-Controlled Health Organizations in Australia.

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Khoury, Peter

2015-01-01

This article describes the formation and development of Aboriginal Community-Controlled Health Services in Australia, with emphasis on the Redfern Aboriginal Medical Service in Sydney. These organizations were established in the 1970s by Indigenous Australians who were excluded from and denied access to mainstream health services. The aim of this research was to explore notions of Indigenous agency against a historical backdrop of dispossession, colonialism, and racism. Aboriginal Community-Controlled Health Services act as a primary source of healthcare for many Indigenous communities in rural and urban areas. This study examined their philosophy of healthcare, the range of services provided, their problems with state bureaucracies and government funding bodies, and the imposition of managerialist techniques and strategies on their governance. Essentially, these organizations transcend individualistic, biomedical, and bureaucratic paradigms of health services by conceptualizing and responding to Indigenous health needs at a grassroots level and in a broad social and political context. They are based on a social model of health. © SAGE Publications 2015.

Indigenous community health and climate change: integrating biophysical and social science indicators

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Donatuto, Jamie; Grossman, Eric E.; Konovsky, John; Grossman, Sarah; Campbell, Larry W.

2014-01-01

This article describes a pilot study evaluating the sensitivity of Indigenous community health to climate change impacts on Salish Sea shorelines (Washington State, United States and British Columbia, Canada). Current climate change assessments omit key community health concerns, which are vital to successful adaptation plans, particularly for Indigenous communities. Descriptive scaling techniques, employed in facilitated workshops with two Indigenous communities, tested the efficacy of ranking six key indicators of community health in relation to projected impacts to shellfish habitat and shoreline archaeological sites stemming from changes in the biophysical environment. Findings demonstrate that: when shellfish habitat and archaeological resources are impacted, so is Indigenous community health; not all community health indicators are equally impacted; and, the community health indicators of highest concern are not necessarily the same indicators most likely to be impacted. Based on the findings and feedback from community participants, exploratory trials were successful; Indigenous-specific health indicators may be useful to Indigenous communities who are assessing climate change sensitivities and creating adaptation plans.

Access to eye health services among indigenous Australians: an area level analysis

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Kelaher Margaret

2012-09-01

Full Text Available Abstract Background This project is a community-level study of equity of access to eye health services for Indigenous Australians. Methods The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey. The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, low = 1.1-3.0%, low medium = 3.1-6.0%, high medium = 6.1-10.0%, high = 10.1-20.0%, very high = 20 + %. The analysis of health service utilisation also took into account age, remoteness and the Socioeconomic Indices for Areas (SEIFA. Results The rate of eye exams provided in areas with very high Indigenous populations was two-thirds of the rate of eye exams for areas with very low indigenous populations. The cataract surgery rates in areas with high medium to very high Indigenous populations were less than half that reference areas. In over a third of communities with very high Indigenous populations the cataract surgery rate fell below the World Health Organization (WHO guidelines compared to a cataract surgery rate of 3% in areas with very low Indigenous populations. Conclusions There remain serious disparities in access to eye health service in areas with high Indigenous populations. Addressing disparities requires a co-ordinated approach to improving Indigenous people’s access to eye health services. More extensive take-up of existing Medicare provisions is an important step in this process. Along with improving access to health services, community education concerning the importance of eye health and the effectiveness of treatment might reduce reluctance to seek help.

Assessing Health Care Access and Use among Indigenous Peoples in Alberta: a Systematic Review.

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Nader, Forouz; Kolahdooz, Fariba; Sharma, Sangita

2017-01-01

Alberta's Indigenous population is growing, yet health care access may be limited. This paper presents a comprehensive review on health care access among Indigenous populations in Alberta with a focus on the health care services use and barriers to health care access. Scientific databases (PubMed, EMBASE, CINAHL, and PsycINFO) and online search engines were systematically searched for studies and grey literature published in English between 2000 and 2013 examining health care services access, use and barriers to access among Indigenous populations in Alberta. Information on health care services use and barriers to use or access was synthesized based on the MOOSE guidelines. Overall, compared to non-Indigenous populations, health care use rates for hospital/emergency room services were higher and health care services use of outpatient specialists was lower among Indigenous peoples. Inadequate numbers of Indigenous health care professionals; a lack of cross-cultural training; fear of foreign environments; and distance from family and friends were barriers to health care use and access. Inequity in social determinants of health among Indigenous peoples and inadequate "health services with prevention approaches," may contribute to present health disparities between Indigenous and non-Indigenous populations in the province.

Beyond Recovery: Colonization, Health and Healing for Indigenous People in Canada

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Lavallee, Lynn F.; Poole, Jennifer M.

2010-01-01

How do we limit our focus to mental health when Indigenous teaching demands a much wider lens? How do we respond to mental health recovery when Indigenous experience speaks to a very different approach to healing, and how can we take up the health of Indigenous people in Canada without a discussion of identity and colonization? We cannot, for the…

Ethical genetic research in Indigenous communities: challenges and successful approaches.

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McWhirter, Rebekah E; Mununggirritj, Djapirri; Marika, Dipililnga; Dickinson, Joanne L; Condon, John R

2012-12-01

Indigenous populations, in common with all populations, stand to benefit from the potential of genetic research to lead to improvements in diagnostic and therapeutic tools for a wide range of complex diseases. However, many Indigenous communities, especially ones that are isolated, are not included in genetic research efforts. This situation is largely a consequence of the challenges of ethically conducting genetic research in Indigenous communities and compounded by Indigenous peoples' negative past experiences with genetic issues. To examine ways of addressing these challenges, we review one investigation of a cancer cluster in remote Aboriginal communities in Arnhem Land, Australia. Our experiences demonstrate that genetic research can be both ethically and successfully conducted with Indigenous communities by respecting the authority of the community, involving community members, and including regular community review throughout the research process. Copyright © 2012 Elsevier Ltd. All rights reserved.

Priority Setting in Indigenous Health: Why We Need an Explicit Decision Making Approach

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Michael E. Otim

2015-06-01

Full Text Available Indigenous Australians have significantly poorer health outcomes than the non-Indigenous population worldwide. The Australian government has increased its investment in Indigenous health through the "Closing the Health Gap" initiative. Deciding where to invest scarce resources so as to maximize health outcomes for Indigenous peoples may require improved priority setting processes. Current government practice involves a mix of implicit and explicit processes to varying degrees at the macro and meso decision making levels. In this article, we argue that explicit priority setting should be emphasized in Indigenous health, as it can ensure that the decision making process is accountable, systematic, and transparent. Following a review of the literature, we outline four key issues that need to be considered for explicit priority setting: developing an Indigenous health "constitution," strengthening the evidence base, selecting mechanisms for priority setting, and establishing appropriate incentives and institutional structure. We then summarize our findings into a checklist that can help a decision makers ensure that explicit priority setting is undertaken in Indigenous health. By addressing these key issues, the benefits of an explicit approach, which include increased efficiency, equity, and use of evidence, can be realized, thereby maximizing Indigenous health outcomes.

Our games our health: a cultural asset for promoting health in indigenous communities.

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Parker, Elizabeth; Meiklejohn, Beryl; Patterson, Carla; Edwards, Ken; Preece, Cilia; Shuter, Patricia; Gould, Trish

2006-08-01

Indigenous Australians have higher morbidity and mortality rates than non-Indigenous Australians. Until recently, few health promotion interventions have had more than limited success in Indigenous populations. This community-based health promotion initiative introduced traditional Indigenous games into schools and community groups in Cherbourg and Stradbroke Island (Queensland, Australia). A joint community forum managed the project, and the Indigenous community-based project officers co-ordinated training in traditional games and undertook community asset audits and evaluations. The games have been included in the activities of a range of community organisations in Cherbourg and Stradbroke Island. Several other organisations and communities in Australia have included them in their projects. A games video and manual were produced to facilitate the initiative's transferability and sustainability. Conventional approaches to health promotion generally focus on individual risk factors and often ignore a more holistic perspective. This project adopted a culturally appropriate, holistic approach, embracing a paradigm that concentrated on the communities' cultural assets and contributed to sustainable and transferable outcomes. There is a need for appropriate evaluation tools for time-limited community engagement projects.

Indigenous and tribal peoples' health (The Lancet-Lowitja Institute Global Collaboration): a population study.

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Anderson, Ian; Robson, Bridget; Connolly, Michele; Al-Yaman, Fadwa; Bjertness, Espen; King, Alexandra; Tynan, Michael; Madden, Richard; Bang, Abhay; Coimbra, Carlos E A; Pesantes, Maria Amalia; Amigo, Hugo; Andronov, Sergei; Armien, Blas; Obando, Daniel Ayala; Axelsson, Per; Bhatti, Zaid Shakoor; Bhutta, Zulfiqar Ahmed; Bjerregaard, Peter; Bjertness, Marius B; Briceno-Leon, Roberto; Broderstad, Ann Ragnhild; Bustos, Patricia; Chongsuvivatwong, Virasakdi; Chu, Jiayou; Deji; Gouda, Jitendra; Harikumar, Rachakulla; Htay, Thein Thein; Htet, Aung Soe; Izugbara, Chimaraoke; Kamaka, Martina; King, Malcolm; Kodavanti, Mallikharjuna Rao; Lara, Macarena; Laxmaiah, Avula; Lema, Claudia; Taborda, Ana María León; Liabsuetrakul, Tippawan; Lobanov, Andrey; Melhus, Marita; Meshram, Indrapal; Miranda, J Jaime; Mu, Thet Thet; Nagalla, Balkrishna; Nimmathota, Arlappa; Popov, Andrey Ivanovich; Poveda, Ana María Peñuela; Ram, Faujdar; Reich, Hannah; Santos, Ricardo V; Sein, Aye Aye; Shekhar, Chander; Sherpa, Lhamo Y; Skold, Peter; Tano, Sofia; Tanywe, Asahngwa; Ugwu, Chidi; Ugwu, Fabian; Vapattanawong, Patama; Wan, Xia; Welch, James R; Yang, Gonghuan; Yang, Zhaoqing; Yap, Leslie

2016-07-09

International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populations, but have been restricted in their coverage of countries or the range of health indicators. Our objective is to describe the health and social status of Indigenous and tribal peoples relative to benchmark populations from a sample of countries. Collaborators with expertise in Indigenous health data systems were identified for each country. Data were obtained for population, life expectancy at birth, infant mortality, low and high birthweight, maternal mortality, nutritional status, educational attainment, and economic status. Data sources consisted of governmental data, data from non-governmental organisations such as UNICEF, and other research. Absolute and relative differences were calculated. Our data (23 countries, 28 populations) provide evidence of poorer health and social outcomes for Indigenous peoples than for non-Indigenous populations. However, this is not uniformly the case, and the size of the rate difference varies. We document poorer outcomes for Indigenous populations for: life expectancy at birth for 16 of 18 populations with a difference greater than 1 year in 15 populations; infant mortality rate for 18 of 19 populations with a rate difference greater than one per 1000 livebirths in 16 populations; maternal mortality in ten populations; low birthweight with the rate difference greater than 2% in three populations; high birthweight with the rate difference greater than 2% in one population; child malnutrition for ten of 16 populations with a difference greater than 10% in five populations; child obesity for eight of 12 populations with a difference greater than 5% in four populations; adult obesity for seven of 13 populations with a difference greater than 10% in

Health and indigenous people: intercultural health as a new paradigm toward the reduction of cultural and social marginalization?

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Torri, Maria Costanza

2010-01-01

The precarious socio-economic and health conditions of indigenous populations legitimize claims of marginalization and attest to the inherent inequality that indigenous groups suffer. In the last few years, advocates have urged the use of traditional indigenous health practices as more culturally fitting for most indigenous populations. An intercultural health program can reduce the conditions of social and cultural marginalization in an indigenous population. However, accepting and integrating indigenous medicine into a westernized health system presents a major challenge to intercultural healthcare in Latin America. The objective of this paper is to analyze the case of Makewe hospital, one of the first and few examples of intercultural health initiatives in Chile. The paper will examine the implementation of this initiative and the main challenges in creating an effective intercultural health program.

Spaces of hope? Youth perspectives on health and wellness in indigenous communities.

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Wood, Lydia; Kamper, David; Swanson, Kate

2018-03-01

This article addresses an apparent paradox between academic and policy depictions of American Indian reservations as "broken" and "unhealthy" places, and Indigenous youth perceptions of reservations as spaces of "health" and "wellness." Public health literature often frames reservations as damaged, health-denying places, chronicling the extraordinarily high rates of suicide, substance abuse, as well as vast health disparities. Despite these dire statistics, our research with Native youth in San Diego County found that young people chose to primarily emphasize their positive experiences with, and attachments to, their reservations. In this article, we share strength- and desire-based narratives to explore how reservations can serve as spaces of wellness for Indigenous youth, despite ongoing settler colonial harm. We seek to expand the discussion on the unintended consequences of deficit-centered scholarship by arguing that health research should also engage with the narratives of hope and desire that are reflective of the way many Native youth feel about their communities. In this article, we urge scholars and practitioners to rethink how we conduct health research to include methodologies that listen to the narratives and experiences of those who, day in and day out, navigate settler colonial landscapes, while continuing to create spaces of hope and healing. Copyright © 2018 Elsevier Ltd. All rights reserved.

Indigenous Research and Academic Freedom: A View from Political Scientists

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Christopher Alcantara

2017-04-01

Full Text Available Over the last several decades, scholars working on Indigenous topics have faced increasing pressure to engage in research that promotes social justice and results in formal partnerships with Indigenous communities. In this article, we argue that non-community-based research, in which the researcher exercises academic autonomy over the project, still has a role to play in Indigenous-focused research, depending on the research question, topic, and situation at hand. We explore this argument from the perspective of political scientists who study Indigenous–settler political relations in Canada.

Cultural and social determinants of health among indigenous Mexican migrants in the United States.

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Lee, Junghee; Donlan, William; Cardoso, Edgar Ezequiel Orea; Paz, Juan Jesus

2013-01-01

Despite growing numbers, indigenous Mexican migrants are relatively invisible to health practitioners who group them with nonindigenous, mestizo Mexican-origin populations. Associations between indigenous and mestizo cultural identifications with psychosocial characteristics and health indicators among indigenous Mexican migrants were examined. Results revealed gender differences in cultural identifications, perceived discrimination, self-esteem, self-efficacy, and various health indicators including depression severity, culture-bound syndromes, and self-rated health. Multivariate regression and structural equation path modeling demonstrated how indigenous cultural identification and perceived discrimination affects health. Findings suggest that interventions should utilize indigenous community-based activities designed to promote self-esteem and the value of indigenous culture, with a focus on females.

X-Integrationism for Chinese Indigenous Management Research

DEFF Research Database (Denmark)

Li, Xin

2015-01-01

Regarding philosophical foundation of Chinese indigenous management research, Prof. Kwang Kuo Hwang of Taiwan University and Prof. Peter P. Li of Copenhagen Business School have contradictory judgments. Their opinions represent two opposite poles. This paper tries to offer a middle route between ...... rooted in China and the West, such as, Chinese Yin Yang thinking, Daoism, Confucianism, Bohr’s complementarity principle, and Hegel’s dialectic logic, this paper tries to construct the daoliology, epistemology and methodology of Chinese indigenous management research....

Indigenous and tribal peoples' health (The Lancet-Lowitja Institute Global Collaboration)

DEFF Research Database (Denmark)

Anderson, Ian; Robson, Bridget; Connolly, Michele

2016-01-01

BACKGROUND: International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populat...

Reclaiming Our Spirits: Development and Pilot Testing of a Health Promotion Intervention for Indigenous Women Who Have Experienced Intimate Partner Violence.

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Varcoe, Colleen; Browne, Annette J; Ford-Gilboe, Marilyn; Dion Stout, Madeleine; McKenzie, Holly; Price, Roberta; Bungay, Victoria; Smye, Victoria; Inyallie, Jane; Day, Linda; Khan, Koushambhi; Heino, Angela; Merritt-Gray, Marilyn

2017-06-01

Indigenous women are subjected to high rates of multiple forms of violence, including intimate partner violence (IPV), in the context of ongoing colonization and neo-colonization. Health promotion interventions for women who experience violence have not been tailored specifically for Indigenous women. Reclaiming Our Spirits (ROS) is a health promotion intervention designed for Indigenous women living in an urban context in Canada. In this paper, we describe the development of the intervention, results of a pilot study, and the revised subsequent intervention. Building on a theory-based health promotion intervention (iHEAL) showing promising results in feasibility studies, ROS was developed using a series of related approaches including (a) guidance from Indigenous women with research expertise specific to IPV and Indigenous women's experiences; (b) articulation of an Indigenous lens, including using Cree (one of the largest Indigenous language groups in North America) concepts to identify key aspects; and (c) interviews with Elders (n = 10) living in the study setting. Offered over 6-8 months, ROS consists of a Circle, led by an Indigenous Elder, and 1:1 visits with a Registered Nurse, focused on six areas for health promotion derived from previous research. Pilot testing with Indigenous women (n = 21) produced signs of improvement in most measures of health from pre- to post-intervention. Women found the pilot intervention acceptable and helpful but also offered valuable suggestions for improvement. A revised intervention, with greater structure within the Circle and nurses with stronger knowledge of Indigenous women's experience and community health, is currently undergoing testing. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Approaching Etuaptmumk – introducing a consensus-based mixed method for health services research

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Susan Chatwood

2015-05-01

Full Text Available With the recognized need for health systems’ improvements in the circumpolar and indigenous context, there has been a call to expand the research agenda across all sectors influencing wellness and to recognize academic and indigenous knowledge through the research process. Despite being recognized as a distinct body of knowledge in international forums and across indigenous groups, examples of methods and theories based on indigenous knowledge are not well documented in academic texts or peer-reviewed literature on health systems. This paper describes the use of a consensus-based, mixed method with indigenous knowledge by an experienced group of researchers and indigenous knowledge holders who collaborated on a study that explored indigenous values underlying health systems stewardship. The method is built on the principles of Etuaptmumk or two-eyed seeing, which aim to respond to and resolve the inherent conflicts between indigenous ways of knowing and the scientific inquiry that informs the evidence base in health care. Mixed methods’ frameworks appear to provide a framing suitable for research questions that require data from indigenous knowledge sources and western knowledge. The nominal consensus method, as a western paradigm, was found to be responsive to embedding of indigenous knowledge and allowed space to express multiple perspectives and reach consensus on the question at hand. Further utilization and critical evaluation of this mixed methodology with indigenous knowledge are required.

Approaching Etuaptmumk – introducing a consensus-based mixed method for health services research

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Chatwood, Susan; Paulette, Francois; Baker, Ross; Eriksen, Astrid; Hansen, Ketil Lenert; Eriksen, Heidi; Hiratsuka, Vanessa; Lavoie, Josée; Lou, Wendy; Mauro, Ian; Orbinski, James; Pabrum, Nathalie; Retallack, Hanna; Brown, Adalsteinn

2015-01-01

With the recognized need for health systems’ improvements in the circumpolar and indigenous context, there has been a call to expand the research agenda across all sectors influencing wellness and to recognize academic and indigenous knowledge through the research process. Despite being recognized as a distinct body of knowledge in international forums and across indigenous groups, examples of methods and theories based on indigenous knowledge are not well documented in academic texts or peer-reviewed literature on health systems. This paper describes the use of a consensus-based, mixed method with indigenous knowledge by an experienced group of researchers and indigenous knowledge holders who collaborated on a study that explored indigenous values underlying health systems stewardship. The method is built on the principles of Etuaptmumk or two-eyed seeing, which aim to respond to and resolve the inherent conflicts between indigenous ways of knowing and the scientific inquiry that informs the evidence base in health care. Mixed methods’ frameworks appear to provide a framing suitable for research questions that require data from indigenous knowledge sources and western knowledge. The nominal consensus method, as a western paradigm, was found to be responsive to embedding of indigenous knowledge and allowed space to express multiple perspectives and reach consensus on the question at hand. Further utilization and critical evaluation of this mixed methodology with indigenous knowledge are required. PMID:26004427

Health service utilization by indigenous cancer patients in Queensland: a descriptive study

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Bernardes Christina M

2012-10-01

Full Text Available Abstract Introduction Indigenous Australians experience more aggressive cancers and higher cancer mortality rates than other Australians. Cancer patients undergoing treatment are likely to access health services (e.g. social worker, cancer helpline, pain management services. To date Indigenous cancer patients’ use of these services is limited. This paper describes the use of health services by Indigenous cancer patients. Methods Indigenous cancer patients receiving treatment were recruited at four major Queensland public hospitals (Royal Brisbane Women’s Hospital, Princess Alexandra, Cairns Base Hospital and Townsville Hospital. Participants were invited to complete a structured questionnaire during a face-to-face interview which sought information about their use of community and allied health services. Results Of the 157 patients interviewed most were women (54.1%, of Aboriginal descent (73.9%, lived outer regional areas (40.1% and had a mean age of 52.2 years. The most frequent cancer types were breast cancer (22.3%, blood related (14.0%, lung (12.1% and gastroenterological (10.8%. More than half of the participants reported using at least one of the ‘Indigenous Health Worker/Services’ (76.4%, ‘Allied Health Workers/Services’ (72.6% and ‘Information Sources’ (70.7%. Younger participants 19–39 years were more likely to use information sources (81.0% than older participants who more commonly used community services (48.8%. The cancer patients used a median of three health services groups while receiving cancer treatment. Conclusions Indigenous cancer patients used a range of health services whilst receiving treatment. Indigenous Health Workers/Services and Allied Health Workers/Services were the most commonly used services. However, there is a need for further systematic investigation into the health service utilization by Indigenous cancer patients.

Abuse and discrimination towards indigenous people in public health care facilities: experiences from rural Guatemala.

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Cerón, Alejandro; Ruano, Ana Lorena; Sánchez, Silvia; Chew, Aiken S; Díaz, Diego; Hernández, Alison; Flores, Walter

2016-05-13

Health inequalities disproportionally affect indigenous people in Guatemala. Previous studies have noted that the disadvantageous situation of indigenous people is the result of complex and structural elements such as social exclusion, racism and discrimination. These elements need to be addressed in order to tackle the social determinants of health. This research was part of a larger participatory collaboration between Centro de Estudios para la Equidad y Gobernanza en los Servicios de Salud (CEGSS) and community based organizations aiming to implement social accountability in rural indigenous municipalities of Guatemala. Discrimination while seeking health care services in public facilities was ranked among the top three problems by communities and that should be addressed in the social accountability intervention. This study aimed to understand and categorize the episodes of discrimination as reported by indigenous communities. A participatory approach was used, involving CEGSS's researchers and field staff and community leaders. One focus group in one rural village of 13 different municipalities was implemented. Focus groups were aimed at identifying instances of mistreatment in health care services and documenting the account of those who were affected or who witnessed them. All of the 132 obtained episodes were transcribed and scrutinized using a thematic analysis. Episodes described by participants ranged from indifference to violence (psychological, symbolic, and physical), including coercion, mockery, deception and racism. Different expressions of discrimination and mistreatment associated to poverty, language barriers, gender, ethnicity and social class were narrated by participants. Addressing mistreatment in public health settings will involve tackling the prevalent forms of discrimination, including racism. This will likely require profound, complex and sustained interventions at the programmatic and policy levels beyond the strict realm of public

Synergy between indigenous knowledge systems, modern health care system and scientific research – a vision for the 21st century

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Fhumulani Mavis Mulaudzi

2001-11-01

Full Text Available Research already conducted in African countries indicates that the majority of patients still seek help from the traditional indigenous health care systems. Opsomming Navorsing wat reeds in Afrika-lande onderneem is, dui aan dat die meerderheid pasiënte steeds hulp soek vanaf die tradisioneel inheemse gesondheidsorgsisteme. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

Marginalization and health service coverage among indigenous, rural, and urban populations: a public health problem in Mexico.

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Roldán, José; Álvarez, Marsela; Carrasco, María; Guarneros, Noé; Ledesma, José; Cuchillo-Hilario, Mario; Chávez, Adolfo

2017-12-01

  Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on Indigenous, rural and urban populations. The objective of this study was to understand Mexico’s public health problem across three population areas, Indigenous, rural and urban, in relation to degree of marginalization and health service coverage.   The sampling universe of the study consisted of 107 458 geographic locations in the country. The study was retrospective, comparative and confirmatory. The study applied analysis of variance, parametric and non-parametric, correlation and correspondence analyses.   Significant differences were identified between the Indigenous, rural and urban populations with respect to their level of marginalization and access to health services. The most affected area was Indigenous, followed by rural areas. The sector that was least affected was urban.   Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where Indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the Indigenous and rural populations throws the gravity of the public health problem into relief.

Indigenous Values and Health Systems Stewardship in Circumpolar Countries

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Susan Chatwood

2017-11-01

Full Text Available Circumpolar regions, and the nations within which they reside, have recently gained international attention because of shared and pressing public policy issues such as climate change, resource development, endangered wildlife and sovereignty disputes. In a call for national and circumpolar action on shared areas of concern, the Arctic states health ministers recently met and signed a declaration that identified shared priorities for international cooperation. Among the areas for collaboration raised, the declaration highlighted the importance of enhancing intercultural understanding, promoting culturally appropriate health care delivery and strengthening circumpolar collaboration in culturally appropriate health care delivery. This paper responds to the opportunity for further study to fully understand indigenous values and contexts, and presents these as they may apply to a framework that will support international comparisons and systems improvements within circumpolar regions. We explored the value base of indigenous peoples and provide considerations on how these values might interface with national values, health systems values and value bases between indigenous nations particularly in the context of health system policy-making that is inevitably shared between indigenous communities and jurisdictional or federal governments. Through a mixed methods nominal consensus process, nine values were identified and described: humanity, cultural responsiveness, teaching, nourishment, community voice, kinship, respect, holism and empowerment.

Use of telehealth for health care of Indigenous peoples with chronic conditions: a systematic review.

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Fraser, Sarah; Mackean, Tamara; Grant, Julian; Hunter, Kate; Towers, Kurt; Ivers, Rebecca

2017-01-01

Telehealth may be a cost effective modality in healthcare delivery, but how well used or how appropriate it is for the care of Indigenous peoples is unclear. This review examines the evidence for telehealth in facilitating chronic conditions management with Indigenous peoples. Databases were systematically searched for qualitative or quantitative primary research studies that investigated telehealth use for chronic conditions management with Indigenous peoples worldwide. Evidence of effectiveness was by consumer health outcomes, evidence of acceptability was through consumer and user perception, and health service feasibility was evident by service impact. Data were assessed for quality and data extracted using pre-defined tools. Articles (n=32) examined effectiveness (n=11), critiqued telehealth from the perspectives of the client (n=10) and healthcare professionals (n=8), and examined feasibility (n=12). Studies reported Indigenous people tend to be satisfied with telehealth, but are sceptical about its cultural safety. Evidence for the effectiveness of telehealth from a western biomedical perspective was found. Telehealth is promising; however, a lack of robust studies in this review make tangible conclusions difficult. A better overall understanding of telehealth use with Indigenous peoples, including delivery of culturally competent health care, true consultation and cultural competency of the professionals involved, would be helpful. Telehealth may have the potential to improve health care for Indigenous people, however the modality needs to be culturally competent and the care received must be culturally safe.

Linking Indigenous Peoplesr Health-Related Decision Making to Information Communication Technology: Insights from an Emerging Economy

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Md. Jahir Uddin Palas

2017-04-01

Full Text Available Indigenous peoples are being marginalised globally from a socioeconomic perspective and are often excluded from mainstream communities for social and/or geographic reasons. Historically, they tend to have lower living standards, including poor health conditions as compared to the rest of the population. Literature suggests that information and communication technologies (ICTs have the potential to improve awareness about how to improve health and wellbeing. In order to both deepen and broaden the understanding of how ICTs can influence Indigenous peoplesr health-related decision-making, this study has developed a conceptual framework based on the capability approach, focusing on the five dimensions of freedoms suggested by Amartya Sen. Data collected from a sample of members of an Indigenous community in Bangladesh, using a purposive sampling method, were analysed through qualitative techniques to identify ways in which a mobile-based health system have influenced the lives of indigenous people. The findings revealed that the mobile healthcare system explored in this study addressed a number of factors pertaining to indigenous peoplesr quality of life. These findings are useful for policy formulation related to the design and implementation of healthcare strategies in Bangladesh. The conceptual framework, following further validation, could serve as a platform for the advancement of research towards understanding how mobile healthcare systems can improve the wellbeing of individuals in indigenous communities.

Engaging with complexity to improve the health of indigenous people: a call for the use of systems thinking to tackle health inequity.

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Hernández, Alison; Ruano, Ana Lorena; Marchal, Bruno; San Sebastián, Miguel; Flores, Walter

2017-02-21

The 400 million indigenous people worldwide represent a wealth of linguistic and cultural diversity, as well as traditional knowledge and sustainable practices that are invaluable resources for human development. However, indigenous people remain on the margins of society in high, middle and low-income countries, and they bear a disproportionate burden of poverty, disease, and mortality compared to the general population. These inequalities have persisted, and in some countries have even worsened, despite the overall improvements in health indicators in relation to the 15-year push to meet the Millennium Development Goals. As we enter the Sustainable Development Goals (SDGs) era, there is growing consensus that efforts to achieve Universal Health Coverage (UHC) and promote sustainable development should be guided by the moral imperative to improve equity. To achieve this, we need to move beyond the reductionist tendency to frame indigenous health as a problem of poor health indicators to be solved through targeted service delivery tactics and move towards holistic, integrated approaches that address the causes of inequalities both inside and outside the health sector. To meet the challenge of engaging with the conditions underlying inequalities and promoting transformational change, equity-oriented research and practice in the field of indigenous health requires: engaging power, context-adapted strategies to improve service delivery, and mobilizing networks of collective action. The application of systems thinking approaches offers a pathway for the evolution of equity-oriented research and practice in collaborative, politically informed and mutually enhancing efforts to understand and transform the systems that generate and reproduce inequities in indigenous health. These approaches hold the potential to strengthen practice through the development of more nuanced, context-sensitive strategies for redressing power imbalances, reshaping the service delivery

A review of protective factors and causal mechanisms that enhance the mental health of Indigenous Circumpolar youth

OpenAIRE

Petrasek MacDonald, Joanna; Ford, James D.; Cunsolo Willox, Ashlee; Ross, Nancy A.

2013-01-01

Objectives To review the protective factors and causal mechanisms which promote and enhance Indigenous youth mental health in the Circumpolar North. Study design A systematic literature review of peer-reviewed English-language research was conducted to systematically examine the protective factors and causal mechanisms which promote and enhance Indigenous youth mental health in the Circumpolar North. Methods This review followed the Preferred Reporting Items for Systematic Reviews and Meta-An...

[Indigenous peoples' access to health services in Cuiabá, Mato Grosso State, Brazil].

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Gomes, Silvana Cardoso; Esperidião, Monique Azevedo

2017-06-12

This study aimed to evaluate indigenous peoples' access to medium and high-complexity health services in the municipality of Cuiabá, Mato Grosso State, Brazil, through the Casa de Saúde Indígena or Indigenous Peoples' Clinic (CASAI Cuiabá). A single case study with a qualitative approach was conducted at CASAI Cuiabá. Data were obtained from observation of the work routines at CASAI Cuiabá, semi-structured interviews with health professionals and administrators from the Cuiabá Special Indigenous Health District (DSEI) and CASAI Cuiabá, and document analysis. Data analysis used a matrix derived from the theoretical and logical model of accessibility, validated by the Delphi method with a group of experts on indigenous peoples' health. Despite advances achieved by CASAI in improving indigenous peoples' access, there are persistent social, organizational, cultural, and geographic barriers in access to medium and high-complexity health services in Cuiabá. The study highlights the need for specific strategies to improve access to health services by indigenous peoples in Mato Grosso State.

Factors Affecting the Retention of Indigenous Australians in the Health Workforce: A Systematic Review

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Genevieve C. Lai

2018-05-01

Full Text Available Indigenous Australians are under-represented in the health workforce. The shortfall in the Indigenous health workforce compounds the health disparities experienced by Indigenous Australians and places pressure on Indigenous health professionals. This systematic review aims to identify enablers and barriers to the retention of Indigenous Australians within the health workforce and to describe strategies to assist with development and retention of Indigenous health professionals after qualification. Four electronic databases were systematically searched in August 2017. Supplementary searches of relevant websites were also undertaken. Articles were screened for inclusion using pre-defined criteria and assessed for quality using the Mixed Methods Assessment Tool. Fifteen articles met the criteria for inclusion. Important factors affecting the retention of Indigenous health professionals included work environment, heavy workloads, poorly documented/understood roles and responsibilities, low salary and a perception of salary disparity, and the influence of community as both a strong personal motivator and source of stress when work/life boundaries could not be maintained. Evidence suggests that retention of Indigenous health professionals will be improved through building supportive and culturally safe workplaces; clearly documenting and communicating roles, scope of practice and responsibilities; and ensuring that employees are appropriately supported and remunerated. The absence of intervention studies highlights the need for deliberative interventions that rigorously evaluate all aspects of implementation of relevant workforce, health service policy, and practice change.

Indigenous Child Health in Brazil: The Evaluation of Impacts as a Human Rights Issue.

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Coates, Anna R; Del Pino Marchito, Sandra; Vitoy, Bernardino

2016-06-01

Improving the health status of indigenous children is a long-standing challenge. Several United Nations committees have identified the health of indigenous peoples as a human rights concern. Addressing the health of indigenous children cannot be separated from their social, cultural, and historic contexts, and any related health program must offer culturally appropriate services and a community perspective broad enough to address the needs of children and the local worlds in which they live. Evaluations of programs must, therefore, address process as well as impacts. This paper assesses interventions addressing indigenous children's health in Brazil, ranging from those explicitly targeting indigenous children's health, such as the targeted immunization program for indigenous peoples, as well as more generalized programs, including a focus upon indigenous children, such as the Integrated Management of Childhood Illness. The paper discusses the tensions and complexities of ethnically targeted health interventions as well as the conceptual and methodological challenge of measuring the processes employed and their impact. The lessons learned, especially the need for countries to more systematically collect data and evaluate impacts using ethnicity as an analytical category, are drawn out with respect to ensuring human rights for all within health sector responses.

Indigenous Health and Human Rights: A Reflection on Law and Culture

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Mazel, Odette

2018-01-01

In Australia, Aboriginal and Torres Strait Islander peoples bear a greater burden of disease and have lower life expectancy than their non-Indigenous counterparts. These combined indicators are evidence of an entrenched health crisis in the Indigenous population that is linked to systemic disadvantage over many decades. In an effort to improve life expectancy and lessen the burden of disease, a number of strategies and national frameworks now embed a human rights-based approach to achieving health equality. This paper explores the application of human rights to Indigenous health and examines the inherent tensions that exist in engaging a system of law based on universal assumptions of the Enlightenment to advance Indigenous rights. What becomes apparent through this exploration is that the strategic approach of Indigenous peoples’ use of human rights, despite its genesis in a system of law that justified colonisation, has opened up opportunities to reframe fixed ideas of law and culture. PMID:29670026

Indigenous Health and Human Rights: A Reflection on Law and Culture.

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Mazel, Odette

2018-04-18

In Australia, Aboriginal and Torres Strait Islander peoples bear a greater burden of disease and have lower life expectancy than their non-Indigenous counterparts. These combined indicators are evidence of an entrenched health crisis in the Indigenous population that is linked to systemic disadvantage over many decades. In an effort to improve life expectancy and lessen the burden of disease, a number of strategies and national frameworks now embed a human rights-based approach to achieving health equality. This paper explores the application of human rights to Indigenous health and examines the inherent tensions that exist in engaging a system of law based on universal assumptions of the Enlightenment to advance Indigenous rights. What becomes apparent through this exploration is that the strategic approach of Indigenous peoples’ use of human rights, despite its genesis in a system of law that justified colonisation, has opened up opportunities to reframe fixed ideas of law and culture.

Socioeconomic disparities in the mental health of Indigenous children in Western Australia

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Shepherd Carrington CJ

2012-09-01

Full Text Available Abstract Background The burden of mental health problems among Aboriginal and Torres Strait Islander children is a major public health problem in Australia. While socioeconomic factors are implicated as important determinants of mental health problems in mainstream populations, their bearing on the mental health of Indigenous Australians remains largely uncharted across all age groups. Methods We examined the relationship between the risk of clinically significant emotional or behavioural difficulties (CSEBD and a range of socioeconomic measures for 3993 Indigenous children aged 4–17 years in Western Australia, using a representative survey conducted in 2000–02. Analysis was conducted using multivariate logistic regression within a multilevel framework. Results Almost one quarter (24% of Indigenous children were classified as being at high risk of CSEBD. Our findings generally indicate that higher socioeconomic status is associated with a reduced risk of mental health problems in Indigenous children. Housing quality and tenure and neighbourhood-level disadvantage all have a strong direct effect on child mental health. Further, the circumstances of families with Indigenous children (parenting quality, stress, family composition, overcrowding, household mobility, racism and family functioning emerged as an important explanatory mechanism underpinning the relationship between child mental health and measures of material wellbeing such as carer employment status and family financial circumstances. Conclusions Our results provide incremental evidence of a social gradient in the mental health of Aboriginal and Torres Strait Islander children. Improving the social, economic and psychological conditions of families with Indigenous children has considerable potential to reduce the mental health inequalities within Indigenous populations and, in turn, to close the substantial racial gap in mental health. Interventions that target housing quality, home

How Indigenous values shaped a successful multi-year Soil Health program in Aotearoa-New Zealand (presented from both indigenous Māori and western science perspectives)

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Stevenson, B.; Harmsworth, G.; Kalaugher, E.

2017-12-01

New Zealand is a multicultural society, founded on the Treaty of Waitangi which when enshrined into various legislation and national policy, provides incentive to incorporate indigenous Māori world views into nationally funded science and research programmes. Here we discuss how the integration of indigenous world views and western science were combined in a research proposal that resulted in successful funding for a 5 year collaborative science programme. The programme strives to develop an expanded national soil health framework for New Zealand that will be used by policy makers, local government, indigenous Māori, industry, and primary sector groups to maintain the natural capital and productivity of soils within environmental constraints. Soil health is fundamental to economic, social, and human wellbeing, and provides a myriad of ecosystem and environmental services, such as those sustaining food and fibre production. Typically soil health is defined by "dynamic" soil characteristics that are susceptible to changes in land use or land management over relatively short time frames (years to decades). Soil resilience, however, is a much longer-term concept that is not well captured in current soil health thinking. The Māori world view encapsulates such long term thinking through interconnected Māori values and inter-generational concepts (e.g., whakapapa, rangatiratanga, manawhenua, kaitiakitanga, mauri) that provide the basis for indigenous resource management in Aotearoa-New Zealand. These values and recognition of the Treaty of Waitangi provide authority and rights to manage resources according to tikanga (customs, principles). Māori environmental concepts and knowledge combined with science concepts for understanding soil health and resilience, served as a powerful central theme for the design and implementation of this science program. Māori involvement and capability development are integral to this research effort and we believe the synthesis of M�

Indigenous Methodology in Understanding Indigenous Nurse Graduate Transition to Practice

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Donna L. M. Kurtz

2017-10-01

Full Text Available Increasing Indigenous health care professional presence in health care aims to reduce health inequities of Indigenous Peoples in Canada. Nurses are the largest health professional group and nurse graduates the main source of recruitment. The quality of graduate transition to practice is evident in the literature; however, little is reported about Indigenous new graduates. We describe using Indigenous methodology and two-eyed seeing (Indigenous and Western perspectives in exploring Indigenous transition experiences. Talking circles provided a safe environment for nurses, nurse educators and students, health managers, and policy makers to discuss Indigenous new graduate case scenarios. The methodology was critical in identifying challenges faced, recommendations for change, and a new collective commitment for cultural safety education, and ethical and respectful relationships within education, practice, and policy.

"Health divide" between indigenous and non-indigenous populations in Kerala, India: population based study.

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Haddad, Slim; Mohindra, Katia Sarla; Siekmans, Kendra; Màk, Geneviève; Narayana, Delampady

2012-05-29

The objective of this study is to investigate the magnitude and nature of health inequalities between indigenous (Scheduled Tribes) and non-indigenous populations, as well as between different indigenous groups, in a rural district of Kerala State, India. A health survey was carried out in a rural community (N = 1660 men and women, 18-96 years). Age- and sex-standardised prevalence of underweight (BMI populations. Multi-level weighted logistic regression models were used to estimate the predicted prevalence of morbidity for each age and social group. A Blinder-Oaxaca decomposition was used to further explore the health gap between tribes and non-tribes, and between subgroups of tribes. Social stratification remains a strong determinant of health in the progressive social policy environment of Kerala. The tribal groups are bearing a higher burden of underweight (46.1 vs. 24.3%), anaemia (9.9 vs. 3.5%) and goitre (8.5 vs. 3.6%) compared to non-tribes, but have similar levels of tuberculosis (21.4 vs. 20.4%) and hypertension (23.5 vs. 20.1%). Significant health inequalities also exist within tribal populations; the Paniya have higher levels of underweight (54.8 vs. 40.7%) and anaemia (17.2 vs. 5.7%) than other Scheduled Tribes. The social gradient in health is evident in each age group, with the exception of hypertension. The predicted prevalence of underweight is 31 and 13 percentage points higher for Paniya and other Scheduled Tribe members, respectively, compared to Forward Caste members 18-30 y (27.1%). Higher hypertension is only evident among Paniya adults 18-30 y (10 percentage points higher than Forward Caste adults of the same age group (5.4%)). The decomposition analysis shows that poverty and other determinants of health only explain 51% and 42% of the health gap between tribes and non-tribes for underweight and goitre, respectively. Policies and programmes designed to benefit the Scheduled Tribes need to promote their well-being in general but

Enhancing health care equity with Indigenous populations: evidence-based strategies from an ethnographic study.

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Browne, Annette J; Varcoe, Colleen; Lavoie, Josée; Smye, Victoria; Wong, Sabrina T; Krause, Murry; Tu, David; Godwin, Olive; Khan, Koushambhi; Fridkin, Alycia

2016-10-04

Structural violence shapes the health of Indigenous peoples globally, and is deeply embedded in history, individual and institutional racism, and inequitable social policies and practices. Many Indigenous communities have flourished, however, the impact of colonialism continues to have profound health effects for Indigenous peoples in Canada and internationally. Despite increasing evidence of health status inequities affecting Indigenous populations, health services often fail to address health and social inequities as routine aspects of health care delivery. In this paper, we discuss an evidence-based framework and specific strategies for promoting health care equity for Indigenous populations. Using an ethnographic design and mixed methods, this study was conducted at two Urban Aboriginal Health Centres located in two inner cities in Canada, which serve a combined patient population of 5,500. Data collection included in-depth interviews with a total of 114 patients and staff (n = 73 patients; n = 41 staff), and over 900 h of participant observation focused on staff members' interactions and patterns of relating with patients. Four key dimensions of equity-oriented health services are foundational to supporting the health and well-being of Indigenous peoples: inequity-responsive care, culturally safe care, trauma- and violence-informed care, and contextually tailored care. Partnerships with Indigenous leaders, agencies, and communities are required to operationalize and tailor these key dimensions to local contexts. We discuss 10 strategies that intersect to optimize effectiveness of health care services for Indigenous peoples, and provide examples of how they can be implemented in a variety of health care settings. While the key dimensions of equity-oriented care and 10 strategies may be most optimally operationalized in the context of interdisciplinary teamwork, they also serve as health equity guidelines for organizations and providers working in

Indigenous peoples of North America: environmental exposures and reproductive justice.

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Hoover, Elizabeth; Cook, Katsi; Plain, Ron; Sanchez, Kathy; Waghiyi, Vi; Miller, Pamela; Dufault, Renee; Sislin, Caitlin; Carpenter, David O

2012-12-01

Indigenous American communities face disproportionate health burdens and environmental health risks compared with the average North American population. These health impacts are issues of both environmental and reproductive justice. In this commentary, we review five indigenous communities in various stages of environmental health research and discuss the intersection of environmental health and reproductive justice issues in these communities as well as the limitations of legal recourse. The health disparities impacting life expectancy and reproductive capabilities in indigenous communities are due to a combination of social, economic, and environmental factors. The system of federal environmental and Indian law is insufficient to protect indigenous communities from environmental contamination. Many communities are interested in developing appropriate research partnerships in order to discern the full impact of environmental contamination and prevent further damage. Continued research involving collaborative partnerships among scientific researchers, community members, and health care providers is needed to determine the impacts of this contamination and to develop approaches for remediation and policy interventions.

Indigenous perspectives on active living in remote Australia: a qualitative exploration of the socio-cultural link between health, the environment and economics.

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Thompson, Sharon L; Chenhall, Richard D; Brimblecombe, Julie K

2013-05-15

The burden of chronic disease in Indigenous Australia is more than double that of non-Indigenous populations and even higher in remote Northern Territory (NT) communities. Sufficient levels of physical activity are known to reduce the risk of chronic disease and improve the health of those already suffering from chronic disease. It has been identified that effective promotion of physical activity in Indigenous settings requires the diverse cultural perspectives and participation of Indigenous people. However, Indigenous concepts of physical activity are not represented in the public health literature and examples of Indigenous involvement in physical activity promotion are scarce. This study aimed to explore and describe local perspectives, experiences and meanings of physical activity in two remote NT Indigenous communities. Qualitative research methods guided by ethnographic and participatory action research principles were used. Semi-structured interviews conducted with 23 purposively selected community members were the main source of data, augmented by five commissioned paintings by community-based artists and observations recorded in a journal by the first author. The findings reveal that in this cultural context the meaning of physical activity is embedded in socially significant and economically necessary physical engagement with the environment. Participants described physical activities associated with Indigenous natural and cultural resource management, customary spaces, seasonal timing and traditional education as creating and protecting health. These activities were viewed not only as culturally appropriate physical activities that contribute to health but as legitimate, physically active forms of social organisation, education and employment that help to build and maintain relationships, wealth, resources and the environment. This different construction of physical activity in remote Indigenous communities highlights the importance of involving

Does evidence influence policy? Resource allocation and the Indigenous Burden of Disease study.

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Doran, Christopher M; Ling, Rod; Searles, Andrew; Hill, Peter

2016-01-01

Objective The Indigenous Burden of Disease (IBoD) report is the most comprehensive assessment of Indigenous disease burden in Australia. The aim of the present study was to investigate the potential effect of the IBoD report on Australian Indigenous health policy, service expenditure and research funding. Findings have significance for understanding factors that may influence Indigenous health policy. Methods The potential effect of the IBoD report was considered by: (1) conducting a text search of pertinent documents published by the federal government, Council of Australian Governments and the National Health and Medical Research Council of Australia (NHMRC) and observing the quantity and quality of references to IBoD; (2) examining data on government Indigenous healthcare expenditure for trends consistent with the findings and policy implications of the IBoD report; and (3) examining NHMRC Indigenous grant allocation trends consistent with the findings and policy implications of the IBoD report. Results Of 110 government and NHMRC documents found, IBoD was cited in 27. Immediately after publication of the IBoD report, federal and state governments increased Indigenous health spending (relative to non-Indigenous), notably for community health and public health at the state level. Expenditure on Indigenous hospital separations for chronic diseases also increased. These changes are broadly consistent with the findings of the IBoD report on the significance of chronic disease and the need to address certain risk factors. However, there is no evidence that such changes had a causal connection with the IBoD study. After publication of the IBoD report, changes in NHMRC Indigenous research funding showed little consistency with the findings of the IBoD report. Conclusions The present study found only indirect and inconsistent correlational evidence of the potential influence of the IBoD report on Indigenous health expenditure and research funding. Further assessment of

Can digital stories go where palliative care research has never gone before? A descriptive qualitative study exploring the application of an emerging public health research method in an indigenous palliative care context.

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Williams, Lisa; Gott, Merryn; Moeke-Maxwell, Tess; Black, Stella; Kothari, Shuchi; Pearson, Sarina; Morgan, Tessa; Wharemate, Matua Rawiri; Hansen, Whaea Whio

2017-09-04

The World Health Organization (WHO) has called for global approaches to palliative care development. Yet it is questionable whether one-size-fits-all solutions can accommodate international disparities in palliative care need. More flexible research methods are called for in order to understand diverse priorities at local levels. This is especially imperative for Indigenous populations and other groups underrepresented in the palliative care evidence-base. Digital storytelling (DST) offers the potential to be one such method. Digital stories are short first-person videos that tell a story of great significance to the creator. The method has already found a place within public health research and has been described as a useful, emergent method for community-based participatory research. The aim of this study was to explore Māori participants' views on DST's usefulness, from an Indigenous perspective, as a research method within the discipline of palliative care. The digital storytelling method was adapted to include Māori cultural protocols. Data capturing participant experience of the study were collected using participant observation and anonymous questionnaires. Eight participants, seven women and one man, took part. Field notes and questionnaire data were analysed using critical thematic analysis. Two main themes were identified during analyses: 1) issues that facilitated digital storytelling's usefulness as a research method for Māori reporting on end of life caregiving; and 2) issues that hindered this process. All subthemes identified: recruitment, the pōwhiri process, (Māori formal welcome of visitors) and technology, related to both main themes and are presented in this way. Digital storytelling is an emerging method useful for exploring Indigenous palliative care issues. In line with a Health Promoting Palliative Care approach that centres research in communities, it helps meet the need for diverse approaches to involve underrepresented groups.

Indigenous Engagement in Tropical River Research in Australia: The TRaCK Program

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Sue E. Jackson

2015-05-01

Full Text Available The literature on scientific-Indigenous ecological knowledge collaborations rarely analyses programmatic efforts undertaken by multi-disciplinary research groups over very large geographic scales. The TRaCK (Tropical Rivers and Coastal Knowledge research program was established to provide the science and knowledge needed by governments, industries, and communities to sustainably manage northern Australia’s rivers and estuaries. A number of policies and procedures were developed to ensure that the needs of Indigenous people of the multi-jurisdictional region were addressed and to enhance the benefits they might derive from participating in the research. An overarching Indigenous Engagement Strategy undergirded the program’s engagement activities, providing guidance on matters relating to the protection of intellectual property, negotiation of research agreements, remuneration for Indigenous expertise, and communications standards. This article reviews the achievements and shortcomings of the TRaCK experience of Indigenous engagement and highlights lessons for researchers and research organisations contemplating applied environmental science initiatives of this scale and scope.

Intimate partner violence and mental ill health among global populations of Indigenous women: a systematic review.

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Chmielowska, Marta; Fuhr, Daniela C

2017-06-01

Intimate partner violence (IPV) has been recognised as a major obstacle to the achievement of gender equality and human development. Its adverse physical and mental health consequences have been reported to affect women of all ages and backgrounds. Although Indigenous women seem to experience higher rates of partner abuse than non-Indigenous women, mental health consequences of IPV among this population are not yet clearly established in the literature. This study systematically reviewed the global literature on mental health outcomes and risk factors for mental ill health among Indigenous women who experienced IPV. Primary quantitative and mixed methods studies that reported about mental health and IPV among Indigenous women (aged 14+) were included. 21 bibliographic databases were searched until January 2017. Quality of included studies was assessed through the Newcastle-Ottawa Scale. Findings are reported according to PRISMA-P 2015. 13 studies were identified. The majority of studies reported very high rates of IPV and high prevalence of mental disorders. The most frequently identified types of IPV were physical and/or sexual violence, verbal aggression, and emotional abuse. The strongest predictor of poor mental health was physical violence. The most commonly reported mental health outcomes were depression and posttraumatic stress disorder. Despite the small number of studies identified, the available evidence suggests that experiences of IPV and mental disorders among Indigenous women are linked and exacerbated by poverty, discrimination, and substance abuse. More research is needed to better understand distributions and presentations of IPV-related mental illness in this population.

It Matters Who You Are: Indigenous Knowledge Research and Researchers

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Keane, Moyra; Khupe, Constance; Muza, Blessings

2016-01-01

It is common for researchers in Indigenous Knowledge (IK) in science education research to draw on aspects of the scientific paradigm from their science training. The consequent research seeks to be objective. This paradigm is not necessarily appropriate for IK research. While there have been calls for IK-aligned methodologies (Chilisa 2012; Keane…

Social media and mobile apps for health promotion in Australian Indigenous populations: scoping review.

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Brusse, Carl; Gardner, Karen; McAullay, Daniel; Dowden, Michelle

2014-12-10

Health promotion organizations are increasingly embracing social media technologies to engage end users in a more interactive way and to widely disseminate their messages with the aim of improving health outcomes. However, such technologies are still in their early stages of development and, thus, evidence of their efficacy is limited. The study aimed to provide a current overview of the evidence surrounding consumer-use social media and mobile software apps for health promotion interventions, with a particular focus on the Australian context and on health promotion targeted toward an Indigenous audience. Specifically, our research questions were: (1) What is the peer-reviewed evidence of benefit for social media and mobile technologies used in health promotion, intervention, self-management, and health service delivery, with regard to smoking cessation, sexual health, and otitis media? and (2) What social media and mobile software have been used in Indigenous-focused health promotion interventions in Australia with respect to smoking cessation, sexual health, or otitis media, and what is the evidence of their effectiveness and benefit? We conducted a scoping study of peer-reviewed evidence for the effectiveness of social media and mobile technologies in health promotion (globally) with respect to smoking cessation, sexual health, and otitis media. A scoping review was also conducted for Australian uses of social media to reach Indigenous Australians and mobile apps produced by Australian health bodies, again with respect to these three areas. The review identified 17 intervention studies and seven systematic reviews that met inclusion criteria, which showed limited evidence of benefit from these interventions. We also found five Australian projects with significant social media health components targeting the Indigenous Australian population for health promotion purposes, and four mobile software apps that met inclusion criteria. No evidence of benefit was found

Food system sustainability for health and well-being of Indigenous Peoples.

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Kuhnlein, Harriet V

2015-09-01

To describe how Indigenous Peoples understand how to enhance use of their food systems to promote sustainability, as demonstrated in several food-based interventions. Comments contributed by partners from case studies of Indigenous Peoples and their food systems attending an international meeting were implemented with public health interventions at the community level in nine countries. The Rockefeller Foundation Bellagio Conference Center in Bellagio, Italy, where experiences from case studies of Indigenous Peoples were considered and then conducted in their home communities in rural areas. Leaders of the Indigenous Peoples' case studies, their communities and their academic partners. Reported strategies on how to improve use of local food systems in case study communities of Indigenous Peoples. Indigenous Peoples' reflections on their local food systems should be encouraged and acted upon to protect and promote sustainability of the cultures and ecosystems that derive their food systems. Promoting use of local traditional food biodiversity is an essential driver of food system sustainability for Indigenous Peoples, and contributes to global consciousness for protecting food biodiversity and food system sustainability more broadly. Key lessons learned, key messages and good practices for nutrition and public health practitioners and policy makers are given.

Allostatic load mediates the impact of stress and trauma on physical and mental health in Indigenous Australians.

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Sarnyai, Zoltán; Berger, Maximus; Jawan, Isabella

2016-02-01

A considerable gap exists in health and social emotional well-being between Indigenous people and non-Indigenous Australians. Recent research in stress neurobiology highlights biological pathways that link early adversity and traumas as well as life stresses to ill health. We argue that the neurobiological stress response and its maladaptive changes, termed allostatic load, provide a useful framework to understand how adversity leads to physical and mental illness in Indigenous people. In this paper we review the biology of allostatic load and make links between stress-induced systemic hormonal, metabolic and immunological changes and physical and mental illnesses. Exposure to chronic stress throughout life results in an increased allostatic load that may contribute to a number of metabolic, cardiovascular and mental disorders that shorten life expectancy in Indigenous Australians. © The Royal Australian and New Zealand College of Psychiatrists 2015.

What works in Indigenous tobacco control? The perceptions of remote Indigenous community members and health staff.

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Johnston, Vanessa; Thomas, David P

2010-04-01

To explore the perceptions of remote Indigenous community members and health staff regarding the acceptability and effectiveness of different tobacco control health promotion interventions. Qualitative methods were used for this exploratory study, including interviews with remote Indigenous community members and health staff, as well as observations of the delivery of different tobacco control activities in three remote communities in the Northern Territory (NT). Several tobacco control interventions for which there is strong evidence in other settings were generally perceived as acceptable and efficacious in the remote Indigenous setting. Primary care interventions, such as brief advice and pharmaceutical quitting aids, when available and accessible, were perceived as important and effective strategies to help people quit, as were the promotion of smokefree areas. By contrast unmodified Quit programs were perceived to have questionable application in this context and there were conflicting findings regarding taxation increases on tobacco and social marketing campaigns. Several evidence-based 'mainstream' activities are perceived to be acceptable to this population, but we may also need to address the concerns raised by health staff and community members about the acceptability of some unmodified activities. Additionally, organisational barriers within the health system may be contributing to the reduced effectiveness of tobacco control in this setting.

What Is Indigenous Research in Philosophy of Education? And What Is PESA, from an Indigenous Perspective?

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Mika, Carl; Stewart, Georgina; Watson, Ka'imi; Silva, Keola; Martin, Brian; Matapo, Jacoba; Galuvao, Akata

2018-01-01

In this commentary, various expert authors offer their ideas on indigenous research in the philosophy of education and PESA's role from an indigenous perspective. Georgiana Stewart is the first author to step forward and explain that education is based on knowledge, and so education is centrally concerned with literacy and identity. Stewart goes…

Mixed Methods in Indigenous Research: Building Relationships for Sustainable Intervention Outcomes

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Chilisa, Bagele; Tsheko, Gaelebale N.

2014-01-01

Indigenous communities raise concerns that they are overresearched and tired of research always asking the same questions and reproducing the same answers, thus pressuring researchers to open the discourse on mixed methods research so as to enable new debates and approaches to emerge. A postcolonial indigenous paradigm provides a theoretical…

Neoliberalism and indigenous knowledge: Māori health research and the cultural politics of New Zealand's "National Science Challenges".

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Prussing, Erica; Newbury, Elizabeth

2016-02-01

In 2012-13 the Ministry of Business, Innovation and Employment (MBIE) in New Zealand rapidly implemented a major restructuring of national scientific research funding. The "National Science Challenges" (NSC) initiative aims to promote greater commercial applications of scientific knowledge, reflecting ongoing neoliberal reforms in New Zealand. Using the example of health research, we examine the NSC as a key moment in ongoing indigenous Māori advocacy against neoliberalization. NSC rhetoric and practice through 2013 moved to marginalize participation by Māori researchers, in part through constructing "Māori" and "science" as essentially separate arenas-yet at the same time appeared to recognize and value culturally distinctive forms of Māori knowledge. To contest this "neoliberal multiculturalism," Māori health researchers reasserted the validity of culturally distinctive knowledge, strategically appropriated NSC rhetoric, and marshalled political resources to protect Māori research infrastructure. By foregrounding scientific knowledge production as an arena of contestation over neoliberal values and priorities, and attending closely to how neoliberalizing tactics can include moves to acknowledge cultural diversity, this analysis poses new questions for social scientific study of global trends toward reconfiguring the production of knowledge about health. Study findings are drawn from textual analysis of MBIE documents about the NSC from 2012 to 2014, materials circulated by Māori researchers in the blogosphere in 2014, and ethnographic interviews conducted in 2013 with 17 Māori health researchers working at 7 sites that included university-based research centers, government agencies, and independent consultancies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Listening to Indigenous Health Workers: Helping to Explain the Disconnect between Policy and Practice in Oral Health Role Development in Remote Australia

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Walker, David; Tennant, Marc; Short, Stephanie D.

2011-01-01

Objective: This research was undertaken to explore factors operating at the level of the clinic and the community which influence the development of the oral health role of Indigenous Health Workers. The research is a significant aspect of a wider study of the disconnect between the strong national policy support for the development of the oral…

Characteristics of Indigenous primary health care models of service delivery: a scoping review protocol.

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Harfield, Stephen; Davy, Carol; Kite, Elaine; McArthur, Alexa; Munn, Zachary; Brown, Ngiare; Brown, Alex

2015-11-01

The objective of the scoping review is to identify and describe within the existing literature the characteristics (values, principles, components and suggest practical applications) of primary health care models of service delivery for Indigenous people. More specifically, the review question is:What are the characteristics (values, principles, components and suggested practical applications) of primary health care models of service delivery for Indigenous people?Findings from this scoping review will inform two systematic reviews. One of these will explore the acceptability and the other the effectiveness of identified characteristics. The scoping review will follow the JBI Scoping Review methodology as outlined in the 2015 Joanna Briggs Institute Reviewers' Manual. Indigenous populations in colonized countries experience worse health outcomes relative to their non-Indigenous counterparts. In Australia, in the period 2010 to 2012 the estimated gap in life expectancy between Aboriginal and Torres Strait Islander Australians compared to non-Indigenous Australians was 10 years Similar gaps in life expectancy between Indigenous and non-Indigenous have been demonstrated in other countries, such as New Zealand, Canada and the United StatesThe gap in life expectancy and the health disadvantage experienced by Indigenous people is in part the result of mainstream health services not adequately meeting the health needs of Indigenous people and Indigenous people's inability to access mainstream services Part of the solution has been the establishment of primary health care services for and in many cases run by Indigenous people. Indigenous primary health services have been developed to provide culturally appropriate services that meet the needs of local Indigenous communities.In Australia, the first Aboriginal medical service was established in 1971 in Redfern, New South Wales, by "community activists in response to ongoing discrimination against Aboriginal people within

Innovation in Indigenous Health and Medical Education: The Leaders in Indigenous Medical Education (LIME) Network as a Community of Practice.

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Mazel, Odette; Ewen, Shaun

2015-01-01

The Leaders in Indigenous Medical Education (LIME) Network aims to improve the quality and effectiveness of Indigenous health in medical education as well as best practice in the recruitment, retention, and graduation of Indigenous medical students. In this article we explore the utility of Etienne Wenger's "communities of practice" (CoP) concept in providing a theoretical framework to better understand the LIME Network as a form of social infrastructure to further knowledge and innovation in this important area of health care education reform. The Network operates across all medical schools in Australia and New Zealand. Utilizing a model of evaluation of communities of practice developed by Fung-Kee-Fung et al., we seek to analyze the outcomes of the LIME Network as a CoP and assess its approach and contribution to improving the implementation of Indigenous health in the medical curriculum and the graduation of Indigenous medical students. By reflecting on the Network through a community of practice lens, this article highlights the synthesis between the LIME Network and Wenger's theory and provides a framework with which to measure Network outputs. It also posits an opportunity to better capture the impact of Network activities into the future to ensure that it remains a relevant and sustainable entity.

An explanatory analysis of economic and health inequality changes among Mexican indigenous people, 2000-2010

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2014-01-01

Introduction Mexico faces important problems concerning income and health inequity. Mexico’s national public agenda prioritizes remedying current inequities between its indigenous and non-indigenous population groups. This study explores the changes in social inequalities among Mexico’s indigenous and non-indigenous populations for the time period 2000 to 2010 using routinely collected poverty, welfare and health indicator data. Methods We described changes in socioeconomic indicators (housing condition), poverty (Foster-Greer-Thorbecke and Sen-Shorrocks-Sen indexes), health indicators (childhood stunting and infant mortality) using diverse sources of nationally representative data. Results This analysis provides consistent evidence of disparities in the Mexican indigenous population regarding both basic and crucial developmental indicators. Although developmental indicators have improved among the indigenous population, when we compare indigenous and non-indigenous people, the gap in socio-economic and developmental indicators persists. Conclusions Despite a decade of efforts to promote public programs, poverty persists and is a particular burden for indigenous populations within Mexican society. In light of the results, it would be advisable to review public policy and to specifically target future policy to the needs of the indigenous population. PMID:24576113

“Health divide” between indigenous and non-indigenous populations in Kerala, India: Population based study

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Haddad Slim

2012-05-01

Full Text Available Abstract Background The objective of this study is to investigate the magnitude and nature of health inequalities between indigenous (Scheduled Tribes and non-indigenous populations, as well as between different indigenous groups, in a rural district of Kerala State, India. Methods A health survey was carried out in a rural community (N = 1660 men and women, 18–96 years. Age- and sex-standardised prevalence of underweight (BMI 2, anaemia, goitre, suspected tuberculosis and hypertension was compared across forward castes, other backward classes and tribal populations. Multi-level weighted logistic regression models were used to estimate the predicted prevalence of morbidity for each age and social group. A Blinder-Oaxaca decomposition was used to further explore the health gap between tribes and non-tribes, and between subgroups of tribes. Results Social stratification remains a strong determinant of health in the progressive social policy environment of Kerala. The tribal groups are bearing a higher burden of underweight (46.1 vs. 24.3%, anaemia (9.9 vs. 3.5% and goitre (8.5 vs. 3.6% compared to non-tribes, but have similar levels of tuberculosis (21.4 vs. 20.4% and hypertension (23.5 vs. 20.1%. Significant health inequalities also exist within tribal populations; the Paniya have higher levels of underweight (54.8 vs. 40.7% and anaemia (17.2 vs. 5.7% than other Scheduled Tribes. The social gradient in health is evident in each age group, with the exception of hypertension. The predicted prevalence of underweight is 31 and 13 percentage points higher for Paniya and other Scheduled Tribe members, respectively, compared to Forward Caste members 18–30 y (27.1%. Higher hypertension is only evident among Paniya adults 18–30 y (10 percentage points higher than Forward Caste adults of the same age group (5.4%. The decomposition analysis shows that poverty and other determinants of health only explain 51% and 42% of the health gap

A holistic model for the selection of environmental assessment indicators to assess the impact of industrialization on indigenous health.

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Kryzanowski, Julie A; McIntyre, Lynn

2011-01-01

Mainstream environmental assessment (EA) methodologies often inadequately address health, social and cultural impacts of concern for Canadian indigenous communities affected by industrialization. Our objective is to present a holistic, culturally-appropriate framework for the selection of indigenous health indicators for baseline health assessment, impact prediction, or monitoring of impacts over time. We used a critical population health approach to explore the determinants of health and health inequities in indigenous communities and conceptualize the pathways by which industrialization affects these determinants. We integrated and extended key elements from three indigenous health frameworks into a new holistic model for the selection of indigenous EA indicators. The holistic model conceptualizes individual and community determinants of health within external social, economic and political contexts and thus provides a comprehensive framework for selecting indicators of indigenous health. Indigenous health is the product of interactions among multiple determinants of health and contexts. Potential applications are discussed using case study examples involving indigenous communities affected by industrialization. Industrialization can worsen indigenous health inequities by perpetuating the health, social and cultural impacts of historic environmental dispossession. To mitigate impacts, EA should explicitly recognize linkages between environmental dispossession and the determinants of health and health inequities and meaningfully involve indigenous communities in the process.

Proposing a health promotion framework to address gambling problems in Australian Indigenous communities.

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Fogarty, Marisa; Coalter, Nicola; Gordon, Ashley; Breen, Helen

2018-02-01

Gambling impacts affect Australian Indigenous families and communities in diverse and complex ways. Indigenous people throughout Australia engage in a broad range of regulated and unregulated gambling activities. Challenges in this area include the complexities that come with delivering services and programmes between the most remote regions, to highly populated towns and cities of Australia. There is little knowledge transfer between states and territories in Australia and no conceptual understanding or analysis of what constitutes 'best practice' in gambling service delivery for Indigenous people, families and communities. This article reviews health promotion approaches used in Australia, with a particular focus on Indigenous and gambling-based initiatives. Contributing to this review is an examination of health promotion strategies used in Indigenous gambling service delivery in the Northern Territory, New South Wales and Western Australia, demonstrating diversity and innovation in approaches. The article concludes by emphasizing the potential value of adopting health promotion strategies to underpin programme and service delivery for addressing gambling problems in Australian Indigenous communities. However, success is contingent on robust, evidence-based programme design, implementation and evaluation that adhere to health promotion principles. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The interface of mental health and human rights in Indigenous peoples: triple jeopardy and triple opportunity.

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Tarantola, Daniel

2007-01-01

Insufficient understanding of the reciprocal interactions between health and human rights, mental health and human rights and the realization of all human rights by Indigenous peoples constitute a triple jeopardy in how these topics are currently being addressed and/or openly antagonized. This paper will attempt to show how a combined health and human rights approach to mental health in Indigenous peoples can transform a triple jeopardy into a triple opportunity. The vast and growing body of literature on mental health, health as a whole, and human rights as these relate to health and to Indigenous peoples will be used to frame the discussion. Attention to the complex interactions of health and human rights can guide policy formulation and action by offering a method of analysis, a process of participatory decision and a framework for accountability. In addition, mental health can find its rightful place in the health and human rights discourse through efforts to help policymakers and practitioners broaden their vision of mental illness to holistically encompass aspects of physical, social, emotional and cultural wellbeing. Finally, connecting the role that rights realization plays in determining health and wellbeing will add power to the rightful claims by Indigenous peoples to the promotion and protection of all their human rights--civil, political, economic, social and cultural. Broadening the research agenda by applying systematically a health and human rights analytical framework to the understanding of social determinants of health would minimize the risk of assigning health outcome merely to behaviours, practices and lifestyles, uncovering structural determinants of holistic health entrenched in policies and governmental conduct. Building the evidence of the negative impact of human rights violation on health and the negative impact of ill-health on the fulfilment of other human rights can help in designing comprehensive interventions, building on the

How seasonality and weather affect perinatal health: Comparing the experiences of indigenous and non-indigenous mothers in Kanungu District, Uganda.

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MacVicar, Sarah; Berrang-Ford, Lea; Harper, Sherilee; Steele, Vivienne; Lwasa, Shuaib; Bambaiha, Didacus Namanya; Twesigomwe, Sabastien; Asaasira, Grace; Ross, Nancy

2017-08-01

Maternal and newborn health disparities and the health impacts of climate change present grand challenges for global health equity, and there remain knowledge gaps in our understanding of how these challenges intersect. This study examines the pathways through which mothers are affected by seasonal and meteorological factors in sub-Saharan Africa in general, and Kanungu District (Uganda), in particular. We conducted a community-based study consisting of focus group discussions with mothers and interviews with health care workers in Kanungu District. Using a priori and a posteriori coding, we found a diversity of perspectives on the impacts of seasonal and weather exposures, with reporting of more food available in the rainy season. The rainy season was also identified as the period in which women performed physical labour for longer time periods, while work conditions in the dry season were reported to be more difficult due to heat. The causal pathways through which weather and seasonality may be affecting size at birth as reported by Kanungu mothers were consistent with those most frequently reported in the literature elsewhere, including maternal energy balance (nutritional intake and physical exertion output) and seasonal illness. While both Indigenous and non-Indigenous mothers described similar pathways, however, the severity of these experiences differed. Non-Indigenous mothers frequently relied on livestock assets or opportunities for less taxing physical work than Indigenous women, who had fewer options when facing food shortages or transport costs. Findings point to specific entry points for intervention including increased nutritional support in dry season periods of food scarcity, increased diversification of wage labour opportunities, and increased access to contraception. Interventions should be particularly targeted towards Indigenous mothers as they face greater food insecurity, may have fewer sources of income, and face greater overall deprivation

Bridging the divide between genomic science and indigenous peoples.

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Jacobs, Bette; Roffenbender, Jason; Collmann, Jeff; Cherry, Kate; Bitsói, LeManuel Lee; Bassett, Kim; Evans, Charles H

2010-01-01

The new science of genomics endeavors to chart the genomes of individuals around the world, with the dual goals of understanding the role genetic factors play in human health and solving problems of disease and disability. From the perspective of indigenous peoples and developing countries, the promises and perils of genomic science appear against a backdrop of global health disparity and political vulnerability. These conditions pose a dilemma for many communities when attempting to decide about participating in genomic research or any other biomedical research. Genomic research offers the possibility of improved technologies for managing the acute and chronic diseases that plague their members. Yet, the history of particularly biomedical research among people in indigenous and developing nations offers salient examples of unethical practice, misuse of data, and failed promises. This dilemma creates risks for communities who decide either to participate or not to participate in genomic science research. Some argue that the history of poor scientific practice justifies refusal to join genomic research projects. Others argue that disease poses such great threats to the well-being of people in indigenous communities and developing nations that not participating in genomic research risks irrevocable harm. Thus, some communities particularly among indigenous peoples have declined to participate as subjects in genomic research. At the same time, some communities have begun developing new guidelines, procedures, and practices for engaging with the scientific community that offer opportunities to bridge the gap between genomic science and indigenous and/or developing communities. Four new approaches warrant special attention and further support: consulting with local communities; negotiating the complexities of consent; training members of local communities in science and health care; and training scientists to work with indigenous communities. Implicit is a new

Interview with the Hon. Ken Wyatt: improving Indigenous health outcomes from a political viewpoint

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Ken Wyatt

2017-10-01

Full Text Available In 2017, Australia celebrates 50 years since the 1967 referendum, when more than 90% of Australians voted to amend the constitution to allow the national government to create laws for Indigenous people and include them in the census. We spoke with the Honourable Ken Wyatt, the Minister for Indigenous Health and the Minister for Aged Care, about what has occurred over the past 50 years in Indigenous health from a political perspective, and what we have learnt to improve health outcomes in the future.

[Health and indigenous peoples in Brazil: notes on some current policy mistakes].

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Cardoso, Marina Denise

2014-04-01

This article aims to analyze health policies for indigenous peoples in Brazil with reference to the 1988 National Constitution and its consequences for their healthcare. Three components are central to this analysis: the management model, based on the concepts of "autonomy" and "social control", but essentially expressing the forms of indigenous representation and participation in public policies; the concept of "differential care" for establishing an inclusive (but operationally normative) healthcare model; and the relationship between the management model for indigenous healthcare and indigenous therapeutic practices.

Association between environmental contaminants and health outcomes in indigenous populations of the Circumpolar North.

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Singh, Kavita; Bjerregaard, Peter; Chan, Hing Man

2014-01-01

Since the 1990s, research has been carried out to monitor environmental contaminants and their effects on human health in the Arctic. Although evidence shows that Arctic indigenous peoples are exposed to higher levels of contaminants and do worse on several dimensions of health compared with other populations, the contribution of such exposures on adverse outcomes is unclear. The purpose of this review is to provide a synopsis of the published epidemiological literature that has examined association between environmental contaminants and health outcomes in Arctic indigenous populations. A literature search was conducted in OVID Medline (1946-January 2014) using search terms that combined concepts of contaminant and indigenous populations in the Arctic. No language or date restrictions were applied. The reference lists of review articles were hand-searched. Of 559 citations, 60 studies were relevant. The studies fell under the following categories: paediatric (n=18), reproductive health (n=18), obstetrics and gynaecology (n=9), cardiology (n=7), bone health (n=2), oncology (n=2), endocrinology (n=2) and other (n=2). All studies, except one from Arctic Finland, were either from Nunavik or Greenland. Most studies assessed polychlorinated biphenyls (n=43) and organochlorine pesticides (n=29). Fewer studies examined heavy metals, perfluorinated compounds, or polybrominated diphenyl ethers. Details of study results for each health category are provided. It is difficult to make conclusive statements about the effects of environmental contaminants on health due to mixed results, small number of studies and studies being restricted to a small number of regions. Meta-analytical synthesis of the evidence should be considered for priority contaminants and health outcomes. The following research gaps should be addressed in future studies: association of contaminants and health in other Arctic regions (i.e. Inuvialuit Settlement Region, Nunavut, Nunatsiavut, Alaska, European

Relational Accountability in Indigenizing Visual Research for Participatory Communication

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Verena Thomas

2016-02-01

Full Text Available This article argues that an indigenous approach to communication research allows us to re-think academic approaches of engaging in and evaluating participatory communication research. It takes as its case study the Komuniti Tok Piksa project undertaken in the Highlands of Papua New Guinea. The project explores ways in which visual methods when paired with a community action approach embedded within an indigenous framework can be used to facilitate social change through meaningful participation. It involves communities to narrate their experiences in regard to HIV and AIDS and assists them in designing and recording their own messages. Local researchers are trained in using visual tools to facilitate this engagement with the communities.

[The Sanumá-Yanomami medical system and indigenous peoples' health policy in Brazil].

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Guimarães, Sílvia Maria Ferreira

2015-10-01

The purpose of this study is to discuss how the Sanumá indigenous people, a subgroup of the Yanomami linguistic family, located in northern Roraima State, Brazil, interacts with and relates to the public policy for indigenous people's health. Missionaries and Brazilian government and non-governmental organization employees are the agents with whom the Sanumá had to deal during the implementation of a healthcare policy. The ethnography of this interrelationship, permeated by moments of epidemic outbreaks, clashes, and attempts at collaboration, raises questions on the implementation of health services in indigenous territories.

The Indigenous Red Ribbon Storytelling Study: What does it mean for Indigenous peoples living with HIV and a substance use disorder to access antiretroviral therapy in Saskatchewan?

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Nowgesic, Earl; Meili, Ryan; Stack, Sandra; Myers, Ted

2015-01-01

Indigenous peoples living with HIV are less likely than non-Indigenous peoples living with HIV to access antiretroviral therapy; however, there is not enough contextual information surrounding this issue. The Indigenous Red Ribbon Storytelling Study was conducted in part to examine how Indigenous peoples living with HIV construct and understand their experiences accessing antiretroviral therapy. Our study design was critical Indigenous qualitative research, using the Behavioral Model of Health Services Use and community-based participatory research approaches. The study was conducted in partnership with Indigenous and non-Indigenous organizations. Study participants were adults from two Canadian cities. The study methods included 20 individual and two Indigenous sharing circle interviews, six participant observation sessions, a short survey and thematic analysis. Accessing antiretroviral therapy within the context of living with a substance use disorder was an overarching theme. Indigenous peoples living with HIV felt they had to choose between living with their active substance use disorder and accessing antiretroviral therapy. They felt misunderstood as a person living with a substance use disorder and often felt coerced into using antiretroviral therapy. Despite these challenges, they persevered as Indigenous peoples living with HIV and a substance use disorder. Further research on antiretroviral therapy access among Indigenous peoples living with HIV and a substance use disorder, particularly from the perspective of health service providers, is needed.

Heart failure among Indigenous Australians: a systematic review

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Woods John A

2012-11-01

Full Text Available Abstract Background Cardiovascular diseases contribute substantially to the poor health and reduced life expectancy of Indigenous Australians. Heart failure is a common, disabling, progressive and costly complication of these disorders. The epidemiology of heart failure and the adequacy of relevant health service provision in Indigenous Australians are not well delineated. Methods A systematic search of the electronic databases PubMed, Embase, Web of Science, Cinahl Plus, Informit and Google Scholar was undertaken in April 2012 for peer-reviewed journal articles relevant to the topic of heart failure in Indigenous Australians. Additionally, a website search was done to identify other pertinent publications, particularly government reports. Results There was a paucity of relevant peer-reviewed research, and government reports dominated the results. Ten journal articles, 1 published conference abstract and 10 reports were eligible for inclusion. Indigenous Australians reportedly have higher morbidity and mortality from heart failure than their non-Indigenous counterparts (age-standardised prevalence ratio 1.7; age-standardised hospital separation ratio ≥3; crude per capita hospital expenditure ratio 1.58; age-adjusted mortality ratio >2. Despite the evident disproportionate burden of heart failure in Indigenous Australians, the accuracy of estimation from administrative data is limited by poor indigenous identification, inadequate case ascertainment and exclusion of younger subjects from mortality statistics. A recent journal article specifically documented a high prevalence of heart failure in Central Australian Aboriginal adults (5.3%, noting frequent undiagnosed disease. One study examined barriers to health service provision for Indigenous Australians in the context of heart failure. Conclusions Despite the shortcomings of available published data, it is clear that Indigenous Australians have an excess burden of heart failure. Emerging data

"Working Together": An Intercultural Academic Leadership Programme to Build Health Science Educators' Capacity to Teach Indigenous Health and Culture

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Durey, Angela; Taylor, Kate; Bessarab, Dawn; Kickett, Marion; Jones, Sue; Hoffman, Julie; Flavell, Helen; Scott, Kim

2017-01-01

Progress has been slow in improving health disparities between Aboriginal and Torres Strait Islander (Indigenous) Australians and other Australians. While reasons for this are complex, delivering healthcare respectful of cultural differences is one approach to improving Indigenous health outcomes. This paper presents and evaluates an intercultural…

Reclaiming Indigenous identities: Culture as strength against suicide among Indigenous youth in Canada.

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Barker, Brittany; Goodman, Ashley; DeBeck, Kora

2017-06-16

In Canada, Indigenous youth suicide represents one of several health disparities burdening Indigenous populations, and like many other of these disparities, can be understood as an expression of societal, historical, cultural and familial trauma. As the number of Indigenous youth who take their own lives every year in Canada continues to far exceed national averages, it appears that conventional suicide prevention efforts remain ineffective among this population. A growing body of research argues that conventional interventions, largely rooted in Western individual-level behavioural change frameworks, are culturally discordant with Indigenous paradigms. In response, some Indigenous communities are turning to cultural revitalization as a holistic community-driven response to suicide prevention and treatment. The following commentary explores the emerging evidence base for "culture as treatment" - a novel approach to suicide that emphasizes the significance of interconnectedness in healing, alongside the revitalization of traditional values to reclaim community wellness. In doing so, we seek to contribute to a changing discourse surrounding Indigenous youth suicide by acknowledging culture as strength against this national crisis.

Out of a digital chrysalis: NIHNMF (pronounced nymph--the National Indigenous Health and New Media Forum).

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Cattoni, Jan; Gamble, Lucinda; Gibson, Julie; Hunter, Ernest; Jones, Anita; Mitchell, Sarah; Pelham, Steven; Smith, Rakana; Travers, Helen

2009-08-01

In conjunction with the Creating Futures conference, the inaugural meeting of the National Indigenous Health and New Media Forum (NIHNMF--pronounced as 'nymph') was held at the Tanks Gallery in Cairns, Queensland, Australia. This paper describes the background to this innovative meeting of media minds. It also explores an emerging vision for addressing Indigenous health disparities through digital inclusion to overcome the 'digital divide' between mainstream and Indigenous Australians that constrains the delivery of appropriate health promotion to this health priority population.

The Global and the Local: Health in Latin American Indigenous Women.

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Valeggia, Claudia

2016-01-01

All over Latin America, indigenous populations are rapidly changing their lifestyle. This work elaborates on the complex experience of indigenous people in transition. Poverty, discrimination, marginalization, and endurance are defining characteristics of their everyday life. Global health programs represent excellent opportunities for addressing these issues. These initiatives, however, are at risk of being short-sighted, ethnocentric, and paradigmcentric. Global health programs would be increasingly more successful if they break disciplinary boundaries and invite actors with different perspectives to a dialogue that does not emphasize biology over culture or academic over community expertise.

[Health and indigenous peoples in Brazil: the challenge of professional training and continuing education of workers in intercultural contexts].

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Diehl, Eliana Elisabeth; Pellegrini, Marcos Antonio

2014-04-01

This article discusses training and continuing medical education for indigenous health workers and health professionals in indigenous health under the guidelines of the Brazilian National Healthcare Policy for Indigenous Peoples, which is currently behind schedule and incomplete as part of the official government agenda. Based on inter-sector proposals for health training by the Ministries of Health and Education, the article highlights the case of indigenous healthcare, emphasizing that government initiatives in this area still need to incorporate the concept of continuing education, a powerful tool for fostering intercultural dialogue and orienting health practices.

Maternal health and health-seeking behaviors among indigenous Mam mothers from Quetzaltenango, Guatemala

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Anne Marie Chomat

2014-02-01

Full Text Available OBJECTIVE: To obtain background information about maternal health and health-seeking behaviors among indigenous mothers living in rural Mam-Mayan communities of Quetzaltenango, Guatemala. METHODS: A cross-sectional analysis of 100 pregnant and breastfeeding women in four communities was performed to determine prevalence and determinants of service utilization. RESULTS: Extreme poverty, poor education, and poor access to basic resources were prevalent. Out of 100 women 14-41 years old, 33% did not use the formal health care sector for antenatal care; the majority consulted a traditional birth attendant. Only 13% delivered in a hospital. Lower socioeconomic status, lack of fluency in Spanish, and no ownership of a motorized vehicle were associated with the highest likelihood of poor utilization of services. CONCLUSIONS: A variety of factors affect utilization of maternal health services by indigenous women in rural Quetzaltenango. These include socioeconomic disparities, ethnic and linguistic differences, and poor access to basic resources. The current reproductive needs of women should be addressed to improve their health and increase their chance of having healthy children.

Cultural barriers to effective communication between Indigenous communities and health care providers in Northern Argentina: an anthropological contribution to Chagas disease prevention and control.

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Dell'Arciprete, Ana; Braunstein, José; Touris, Cecilia; Dinardi, Graciela; Llovet, Ignacio; Sosa-Estani, Sergio

2014-01-29

Ninety percent of the aboriginal communities of Argentina are located in areas of endemic vectorial transmission of Chagas disease. Control activities in these communities have not been effective. The goal of this research was to explore the role played by beliefs, habits, and practices of Pilaga and Wichi indigenous communities in their interaction with the local health system in the province of Formosa. This article contributes to the understanding of the cultural barriers that affect the communication process between indigenous peoples and their health care providers. Twenty-nine open ended interviews were carried out with members of four indigenous communities (Pilaga and Wichi) located in central Formosa. These interviews were used to describe and compare these communities' approach to health and disease as they pertain to Chagas as well as their perceptions of Western medicine and its incarnation in local health practice. Five key findings are presented: 1) members of these communities tend to see disease as caused by other people or by the person's violation of taboos instead of as a biological process; 2) while the Pilaga are more inclined to accept Western medicine, the Wichi often favour the indigenous approach to health care over the Western approach; 3) members of these communities do not associate the vector with the transmission of the disease and they have little awareness of the need for vector control activities; 4) indigenous individuals who undergo diagnostic tests and accept treatment often do so without full information and knowledge; 5) the clinical encounter is rife with conflict between the expectations of health care providers and those of members of these communities. Our analysis suggests that there is a need to consider the role of the cultural patterning of health and disease when developing interventions to prevent and control Chagas disease among indigenous communities in Northern Argentina. This is especially important when

Women-Centered and Culturally Responsive Heart Health Promotion Among Indigenous Women in Canada.

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Ziabakhsh, Shabnam; Pederson, Ann; Prodan-Bhalla, Natasha; Middagh, Diane; Jinkerson-Brass, Sharon

2016-11-01

Most women in Canada confront a combination of bio-psychosocial factors that put them at risk for cardiovascular disease. The challenge for health planners is to address these factors while contextualizing interventions that meet the specific needs of particular social and cultural groupings. The article will discuss a women-centered, group-based heart health pilot initiative designed to engage with indigenous approaches to healing. The nurse practitioners co-led the group with a representative from the indigenous community to balance women-centered practices with more traditional and culturally appropriate ones. In particular, indigenous processes, such as a Talking Circle, combined with indigenous knowledge/content were integrated into the pilot program. The project was evaluated to investigate its outcomes (how the intervention impacted the participants) and processes (how participants perceived the intervention). Evaluation involved analysis of the Talking Circle's content, a focus group, field observations, and self-completed surveys. Most women made changes regarding their diet, some began physical activities, and others focused on better managing their emotional health. Women viewed the group as successful because it embraced both women-centered and culturally appropriate health promotion practices. The intervention created a culturally safe space for learning and transformation. The findings confirm the need for employing culturally relevant, gender-specific approaches to heart health promotion that are situated in and responsive to community needs. © 2016 Society for Public Health Education.

Social representations of the health care of the Mbyá-Guarani indigenous population by health workers 1

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Falkenberg, Mirian Benites; Shimizu, Helena Eri; Bermudez, Ximena Pamela Díaz

2017-01-01

ABSTRACT Objective: to analyze the social representations of health care of the Mbyá-Guarani ethnic group by multidisciplinary teams from the Special Indigenous Health District in the south coast of Rio Grande do Sul state (Distrito Sanitário Especial Indígena Litoral Sul do Rio Grande do Sul), Brazil. Method: a qualitative method based on the theory of social representations was used. Data were collected via semi-structured interviews with 20 health workers and by participant observation. The interviews were analyzed with ALCESTE software, which conducts a lexical content analysis using quantitative techniques for the treatment of textual data. Results: there were disagreements in the health care concepts and practices between traditional medicine and biomedicine; however, some progress has been achieved in the area of intermedicality. The ethnic boundaries established between health workers and indigenous peoples based on their representations of culture and family, together with the lack of infrastructure and organization of health actions, are perceived as factors that hinder health care in an intercultural context. Conclusion: a new basis for the process of indigenous health care needs to be established by understanding the needs identified and by agreement among individuals, groups, and health professionals via intercultural exchange. PMID:28177056

Mobile health interventions in Indigenous populations

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Valerie Onyinyechi Umaefulam

2017-06-01

Full Text Available Humans are social beings and communication is vital and necessary for every cultural group which may be the primary motivator, why many populations worldwide have taken up mobile phones (1. Communication via mobile has significant cultural and identity implications for Indigenous people worldwide particularly those living in rural and hard to reach communities because due to globalization, a number of people now live away from their local communities for trade, employment, education, etc. Thus, mobile phones are devices for social networking and communication; and enables cultural connection and identification with family and friends. Its affordability, versatility of features, and portability create an opportunity for utilizing mobile technology to positively impact the health via health education, promotion, and provision of remote health services among others.

The Community-First Land-Centred Theoretical Framework: Bringing a "Good Mind" to Indigenous Education Research?

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Styres, Sandra D.; Zinga, Dawn M.

2013-01-01

This article introduces an emergent research theoretical framework, the community-first Land-centred research framework. Carefully examining the literature within Indigenous educational research, we noted the limited approaches for engaging in culturally aligned and relevant research within Indigenous communities. The community-first Land-centred…

Overseas-trained doctors in Indigenous rural health services: negotiating professional relationships across cultural domains.

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Durey, Angela; Hill, Peter; Arkles, Rachelle; Gilles, Marisa; Peterson, Katia; Wearne, Susan; Canuto, Condy; Pulver, Lisa Jackson

2008-12-01

To examine how OTDs and staff in rural and remote Indigenous health contexts communicate and negotiate identity and relationships, and consider how this may influence OTDs' transition, integration and retention. Ten case studies were conducted in rural and remote settings across Australia, each of an OTD providing primary care in a substantially Indigenous practice population, his/her partner, co-workers and Indigenous board members associated with the health service. Cases were purposefully sampled to ensure diversity in gender, location and country of origin. Identity as 'fluid' emerged as a key theme in effective communication and building good relationships between OTDs and Indigenous staff. OTDs enter a social space where their own cultural and professional beliefs and practices intersect with the expectations of culturally safe practice shaped by the Australian Indigenous context. These are negotiated through differences in language, role expectation, practice, status and identification with locus with uncertain outcomes. Limited professional and cultural support often impeded this process. The reconstruction of OTDs' identities and mediating beyond predictable barriers to cultural engagement contributes significantly not only to OTDs' integration and, to a lesser extent, their retention, but also to maximising effective communication across cultural domains. Retention of OTDs working in Indigenous health contexts rests on a combination of OTDs' capacity to adapt culturally and professionally to this complex environment, and of effective strategies to support them.

Working together to make Indigenous health care curricula everybody's business: a graduate attribute teaching innovation report.

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Virdun, Claudia; Gray, Joanne; Sherwood, Juanita; Power, Tamara; Phillips, Angela; Parker, Nicola; Jackson, Debra

2013-12-01

Previously there has been commitment to the idea that Indigenous curricula should be taught by Indigenous academic staff, whereas now there is increasing recognition of the need for all academic staff to have confidence in enabling Indigenous cultural competency for nursing and other health professional students. In this way, Indigenous content can be threaded throughout a curriculum and raised in many teaching and learning situations, rather than being siloed into particular subjects and with particular staff. There are many sensitivities around this change, with potential implications for Indigenous and non-Indigenous students and staff, and for the quality of teaching and learning experiences. This paper reports on a collaborative process that was used to reconceptualise how Indigenous health care curricula would be positioned throughout a programme and who would or could work with students in this area. Effective leadership, establishing a truly collaborative environment, acknowledging fears and perceived inadequacies, and creating safe spaces for sharing and learning were crucial in effecting this change.

An analysis of two indigenous reproductive health illnesses in a Nahua community in Veracruz, Mexico

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Smith-Oka Vania

2012-08-01

Full Text Available Abstract Background This article describes the local concepts indigenous Nahua women hold regarding their reproduction. Specifically it provides a description of two indigenous illnesses—isihuayo and necaxantle, it discusses their etiology, symptoms, and treatments, and it analyzes them within the local ethnomedical framework and sociopolitical context. A perception of female vulnerability is shown to be an underlying shaper of women’s experiences of these illnesses. Methods This research took place in a small Nahua village in Mexico. Qualitative data on local perceptions of these illnesses were collected by a combination of participant observation and interviews. Ethnobotanical data was obtained through interviews, and medicinal plants were collected in home gardens, fields, stream banks, and forested areas. The total study population consisted of traditional birth attendants (N = 5, clinicians (N = 8, and laywomen (N = 48. Results Results showed that 20% of the village women had suffered from one or both of these illnesses. The article includes a detailed description of the etiology, symptoms, and treatments of these illnesses. Data shows that they were caused by mechanical, physical, and social factors related to a woman’s weakness and/or lack of support. Traditional birth attendants often treated women’s illnesses. Five medicinal plants were salient in the treatment of these illnesses: Ocimum basilicum L., Mentzelia aspera L., Pedilanthus tithymaloides (L. Poit., and Piper umbellatum L. were used for isihuayo, while Solanum wendlandii Hook f. was used for necaxantle. Conclusions The research on these two ethnomedical conditions is a useful case study to understanding how indigenous women experience reproductive health. Reproductive health is not simply about clinically-based medicine but is also about how biomedicine intersects with the local bodily concepts. By describing and analyzing indigenous women’s ill health, one can focus

Educational content related to postcolonialism and indigenous health inequities recommended for all rehabilitation students in Canada: a qualitative study.

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Hojjati, Ala; Beavis, Allana S W; Kassam, Aly; Choudhury, Daniel; Fraser, Michelle; Masching, Renée; Nixon, Stephanie A

2017-10-02

Postcolonial analysis can help rehabilitation providers understand how colonization and racialization create and sustain health inequities faced by indigenous peoples. However, there is little guidance in the literature regarding inclusion of postcolonialism within rehabilitation educational curricula. Therefore, this study explored perspectives regarding educational content related to postcolonialism and indigenous health that rehabilitation students in Canada should learn to increase health equity. This qualitative study involved in-depth, semi-structured interviews with 19 individuals with insight into postcolonialism and health in Canada. Data were analyzed collaboratively to identify, code, and translate themes according to a structured six-phase method. Four themes emerged regarding educational content for rehabilitation students: (1) the historic trauma of colonization and its ongoing impacts on rehabilitation for indigenous peoples; (2) disproportionate health burden and inequitable access to health services; (3) how rehabilitation is related to Indigenous ways of knowing; and (4) why rehabilitation is well-positioned to address health inequities with Indigenous Peoples. Results call for reflection on assumptions underpinning the rehabilitation professions that may unintentionally reinforce health inequities. A postcolonial lens can help rehabilitation educators promote culturally safe services for people whose ill health and disability are linked to the effects of colonization. Implications for Rehabilitation Given the powerful, ongoing effects of colonization and racialization on health and disability, recommendation #24 from the Truth and Reconciliation Commission of Canada calls for the education of health professionals related to Indigenous history, rights, and anti-racism. However, there is little curricula on these areas in the education of rehabilitation professional students or in continuing education programs for practicing clinicians. This is the

Back to the basics: Identifying and addressing underlying challenges in achieving high quality and relevant health statistics for indigenous populations in Canada.

Science.gov (United States)

Smylie, Janet; Firestone, Michelle

Canada is known internationally for excellence in both the quality and public policy relevance of its health and social statistics. There is a double standard however with respect to the relevance and quality of statistics for Indigenous populations in Canada. Indigenous specific health and social statistics gathering is informed by unique ethical, rights-based, policy and practice imperatives regarding the need for Indigenous participation and leadership in Indigenous data processes throughout the spectrum of indicator development, data collection, management, analysis and use. We demonstrate how current Indigenous data quality challenges including misclassification errors and non-response bias systematically contribute to a significant underestimate of inequities in health determinants, health status, and health care access between Indigenous and non-Indigenous people in Canada. The major quality challenge underlying these errors and biases is the lack of Indigenous specific identifiers that are consistent and relevant in major health and social data sources. The recent removal of an Indigenous identity question from the Canadian census has resulted in further deterioration of an already suboptimal system. A revision of core health data sources to include relevant, consistent, and inclusive Indigenous self-identification is urgently required. These changes need to be carried out in partnership with Indigenous peoples and their representative and governing organizations.

Research integrity and rights of indigenous peoples: appropriating Foucault's critique of knowledge/power.

Science.gov (United States)

Swazo, Norman K

2005-09-01

In this paper I appropriate the philosophical critique of Michel Foucault as it applies to the engagement of Western science and indigenous peoples in the context of biomedical research. The science of population genetics, specifically as pursued in the Human Genome Diversity Project, is the obvious example to illustrate (a) the contraposition of modern science and 'indigenous science', (b) the tendency to depreciate and marginalize indigenous knowledge systems, and (c) the subsumption of indigenous moral preferences in the juridical armature of international human rights law. I suggest that international bioethicists may learn from Foucault's critique, specifically of the need for vigilance about the knowledge/power relation expressed by the contraposition of modern science and 'indigeneity'.

Association between environmental contaminants and health outcomes in indigenous populations of the Circumpolar North

DEFF Research Database (Denmark)

Singh, Kavita; Bjerregaard, Peter; Chan, Hing Man

2014-01-01

populations. DESIGN: A literature search was conducted in OVID Medline (1946-January 2014) using search terms that combined concepts of contaminant and indigenous populations in the Arctic. No language or date restrictions were applied. The reference lists of review articles were hand-searched. RESULTS...... and health outcomes. The following research gaps should be addressed in future studies: association of contaminants and health in other Arctic regions (i.e. Inuvialuit Settlement Region, Nunavut, Nunatsiavut, Alaska, European North and Russian North); assessment of contaminants on chronic diseases; inclusion...

Bridging the triple divide: performance and innovative multimedia in the service of behavioural health change in remote Indigenous settings.

Science.gov (United States)

Hunter, Ernest; Travers, Helen; Gibson, Julie; Campion, Jonathan

2007-01-01

The use of innovative information technology is now well established in health. However, while the gap in health status between Indigenous and other Australians is both significant and unchanging, there is limited application of these new approaches to addressing this national health priority. This may in part reflect the 'digital divide', which is another facet of Indigenous disadvantage. This paper describes an approach to address both issues in remote Indigenous settings. The Health Interactive Technology Network began as a proof-of-concept study of touchscreen technology in two Indigenous health settings. It has subsequently expanded to a number of remote Indigenous communities and developed new platforms and applications to respond to emerging health issues. In creating narrative, interactive approaches to address choices in relation to health behaviours, the community development and engagement effects of the creative process have been highlighted. These findings suggest that these approaches will be suited to further expansion in the area of mental health.

Indigenous obesity in the news: a media analysis of news representation of obesity in Australia's Indigenous population.

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Islam, Salwa; Fitzgerald, Lisa

2016-01-01

High rates of obesity are a significant issue amongst Indigenous populations in many countries around the world. Media framing of issues can play a critical role in shaping public opinion and government policy. A broad range of media analyses have been conducted on various aspects of obesity, however media representation of Indigenous obesity remains unexplored. In this study we investigate how obesity in Australia's Indigenous population is represented in newsprint media coverage. Media articles published between 2007 and 2014 were analysed for the distribution and extent of coverage over time and across Indigenous and mainstream media sources using quantitative content analysis. Representation of the causes and solutions of Indigenous obesity and framing in text and image content was examined using qualitative framing analysis. Media coverage of Indigenous obesity was very limited with no clear trends in reporting over time or across sources. The single Indigenous media source was the second largest contributor to the media discourse of this issue. Structural causes/origins were most often cited and individual solutions were comparatively overrepresented. A range of frames were employed across the media sources. All images reinforced textual framing except for one article where the image depicted individual factors whereas the text referred to structural determinants. This study provides a starting point for an important area of research that needs further investigation. The findings highlight the importance of alternative news media outlets, such as The Koori Mail, and that these should be developed to enhance the quality and diversity of media coverage. Media organisations can actively contribute to improving Indigenous health through raising awareness, evidence-based balanced reporting, and development of closer ties with Indigenous health workers.

Elder women's perceptions around optimal perinatal health: a constructivist grounded-theory study with an Indigenous community in southern Ontario.

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Kandasamy, Sujane; Vanstone, Meredith; Oremus, Mark; Hill, Trista; Wahi, Gita; Wilson, Julie; Davis, A Darlene; Jacobs, Ruby; Anglin, Rebecca; Anand, Sonia Savitri

2017-05-18

Women play important roles in translating health knowledge, particularly around pregnancy and birth, in Indigenous societies. We investigated elder Indigenous women's perceptions around optimal perinatal health. Using a methodological framework that integrated a constructivist grounded-theory approach with an Indigenous epistemology, we conducted and analyzed in-depth interviews and focus groups with women from the Six Nations community in southern Ontario who self-identified as grandmothers. Our purposive sampling strategy was guided by a Six Nations advisory group and included researcher participation in a variety of local gatherings as well as personalized invitations to specific women, either face-to-face or via telephone. Three focus groups and 7 individual interviews were conducted with 18 grandmothers. The participants' experiences converged on 3 primary beliefs: pregnancy is a natural phase, pregnancy is a sacred period for the woman and the unborn child, and the requirements of immunity, security (trust), comfort, social development and parental responsibility are necessary for optimal postnatal health. Participants also identified 6 communal responsibilities necessary for families to raise healthy children: access to healthy and safe food, assurance of strong social support networks for mothers, access to resources for postnatal support, increased opportunities for children to participate in physical activity, more teachings around the impact of maternal behaviours during pregnancy and more teachings around spirituality/positive thinking. We also worked with the Six Nations community on several integrated knowledge-translation elements, including collaboration with an Indigenous artist to develop a digital story (short film). Elder women are a trusted and knowledgeable group who are able to understand and incorporate multiple sources of knowledge and deliver it in culturally meaningful ways. Thus, tailoring public health programming to include elder women

Climate change and indigenous peoples: A synthesis of current impacts and experiences

Science.gov (United States)

Norton-Smith, Kathryn; Lynn, Kathy; Chief, Karletta; Cozetto, Karen; Donatuto, Jamie; Hiza, Margaret; Kruger, Linda; Maldonado, Julie; Viles, Carson; Whyte, Kyle P.

2016-01-01

A growing body of literature examines the vulnerability, risk, resilience, and adaptation of indigenous peoples to climate change. This synthesis of literature brings together research pertaining to the impacts of climate change on sovereignty, culture, health, and economies that are currently being experienced by Alaska Native and American Indian tribes and other indigenous communities in the United States. The knowledge and science of how climate change impacts are affecting indigenous peoples contributes to the development of policies, plans, and programs for adapting to climate change and reducing greenhouse gas emissions. This report defines and describes the key frameworks that inform indigenous understandings of climate change impacts and pathways for adaptation and mitigation, namely, tribal sovereignty and self-determination, culture and cultural identity, and indigenous community health indicators. It also provides a comprehensive synthesis of climate knowledge, science, and strategies that indigenous communities are exploring, as well as an understanding of the gaps in research on these issues. This literature synthesis is intended to make a contribution to future efforts such as the 4th National Climate Assessment, while serving as a resource for future research, tribal and agency climate initiatives, and policy development.

Promoting fit bodies, healthy eating and physical activity among Indigenous Australian men: a study protocol

Directory of Open Access Journals (Sweden)

Ricciardelli Lina A

2012-01-01

Full Text Available Abstract Background Overall the physical health of Indigenous men is among the worst in Australia. Research has indicated that modifiable lifestyle factors, such as poor nutrition and physical inactivity, appear to contribute strongly to these poor health conditions. To effectively develop and implement strategies to improve the health of Australia's Indigenous peoples, a greater understanding is needed of how Indigenous men perceive health, and how they view and care for their bodies. Further, a more systematic understanding of how sociocultural factors affect their health attitudes and behaviours is needed. This article presents the study protocol of a community-based investigation into the factors surrounding the health and body image of Indigenous Australian men. Methods and design The study will be conducted in a collaborative manner with Indigenous Australian men using a participatory action research framework. Men will be recruited from three locations around Australia (metropolitan, regional, and rural and interviewed to understand their experiences and perspectives on a number of issues related to health and health behaviour. The information that is collected will be analysed using modified grounded theory and thematic analysis. The results will then be used to develop and implement community events in each location to provide feedback on the findings to the community, promote health enhancing strategies, and determine future action and collaboration. Discussion This study will explore both risk and protective factors that affect the health of Indigenous Australian men. This knowledge will be disseminated to the wider Indigenous community and can be used to inform future health promotion strategies. The expected outcome of this study is therefore an increased understanding of health and health change in Indigenous Australian men, the development of strategies that promote healthy eating and positive patterns of physical activity and, in

Indigenous Health Workforce Development: challenges and successes of the Vision 20:20 programme.

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Curtis, Elana; Reid, Papaarangi

2013-01-01

There are significant health workforce inequities that exist internationally. The shortage of indigenous health professionals within Australia and New Zealand requires action across multiple sectors, including health and education. This article outlines the successes and challenges of the University of Auckland's Vision 20:20 programme, which aims to improve indigenous Māori and Pacific health workforce development via recruitment, bridging/foundation and tertiary retention support interventions within the Faculty of Medical and Health Sciences (FMHS). Seven years of student data (2005-2011) are presented for undergraduate Student Pass Rate (SPR) by ethnicity and Certificate in Health Sciences (CertHSc) SPR, enrolments and completions by ethnicity. Four key areas of development are described: (i) student selection and pathway planning; (ii) foundation programme refinement; (iii) academic/pastoral support; and (iv) re-development of the indigenous recruitment model. Key programme developments have had a positive impact on basic student data outcomes. The FMHS undergraduate SPR increased from 89% in 2005 to 94% in 2011 for Māori and from 81% in 2005 to 87% in 2011 for Pacific. The CertHSc SPR increased from 52% in 2005 to 92% in 2011 with a greater proportion of Māori and Pacific enrolments achieving completion over time (18-76% for Māori and 29-74% for Pacific). Tertiary institutions have the potential to make an important contribution to indigenous health workforce development. Key challenges remain including secondary school feeder issues, equity funding, programme evaluation, post-tertiary specialist workforce development and retention in Aotearoa, New Zealand. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Indigenous mothers face more than three delays: The challenges of multiculturalism in health

Directory of Open Access Journals (Sweden)

Roosta-G., Manigeh

2015-08-01

Full Text Available Although the maternal mortality ratio has descended in Bolivia from 416 (1989 to 229 deaths (DHS 2003 per one hundred thousand live births, it is one of the highest in the region. As a national average, the ratio conceals the rural-urban, socio-economics differences and the reality of the indigenous population. Maternal mortality is one of the major challenges at national level. Reduction of maternal mortality, in addition of technical-medical measures offering health services, requires to focus on socio-cultural aspects that hamper the access to health services. This article examines challenges faced by indigenous mothers accessing the health services. In addition to the geographic, economic and administrative barriers that generate delays in access to the health services, there are others that are presented in the context of multiculturalism resulting from discriminatory attitudes exercised in health centers. The testimonies of indigenous mothers show delays faced in health centers because of prejudice and discrimination suffered, threatening the lives of mothers and their babies. The study also suggests the need to deepen the concept of multiculturalism as a successful strategy in health, in order to promote equity and social justice on the horizon of more inclusive societies.

Bridging cultural and social divides for indigenous health in Peru ...

International Development Research Centre (IDRC) Digital Library (Canada)

2017-02-01

Feb 1, 2017 ... English · Français ... The training also emphasized respect for indigenous medical knowledge and practices; dialogue with the community and its ... The lack of incentives for intercultural health illustrates this disconnect.

Agroecology and Health: Lessons from Indigenous Populations.

Science.gov (United States)

Suárez-Torres, José; Suárez-López, José Ricardo; López-Paredes, Dolores; Morocho, Hilario; Cachiguango-Cachiguango, Luis Enrique; Dellai, William

2017-06-01

The article aims to systematize and disseminate the main contributions of indigenous ancestral wisdom in the agroecological production of food, especially in Latin America. For this purpose, it is necessary to ask whether such knowledge can be accepted by academia research groups and international forums as a valid alternative that could contribute to overcome the world's nutritional problems. Although no new findings are being made, the validity of ancestral knowledge and agroecology is recognized by scientific research, and by international forums organized by agencies of the United Nations. These recommend that governments should implement them in their policies of development, and in the allocation of funds to support these initiatives. Agroecology and ancestral knowledge are being adopted by a growing number of organizations, indigenous peoples and social groups in various parts of the world, as development alternatives that respond to local needs and worldviews. Its productive potential is progressively being recognized at an international level as a model that contributes to improve the condition of people regarding nutritional food.

"Only your blood can tell the story"--a qualitative research study using semi-structured interviews to explore the hepatitis B related knowledge, perceptions and experiences of remote dwelling Indigenous Australians and their health care providers in northern Australia.

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Davies, Jane; Bukulatjpi, Sarah; Sharma, Suresh; Davis, Joshua; Johnston, Vanessa

2014-11-28

Hepatitis B is endemic in the Indigenous communities of the Northern Territory of Australia and significantly contributes to liver-related morbidity and mortality. It is recognised that low health literacy levels, different worldviews and English as a second language all contribute to the difficulties health workers often have in explaining biomedical health concepts, relevant to hepatitis B infection, to patients. The aim of this research project was to explore the knowledge, perceptions and experiences of remote dwelling Indigenous adults and their health care providers relating to hepatitis B infection with a view to using this as the evidence base to develop a culturally appropriate educational tool. The impetus for this project came from health clinic staff at a remote community in Arnhem Land in the Northern Territory, in partnership with a visiting specialist liver clinic from the Royal Darwin Hospital. Participants were clinic patients with hepatitis B (n = 12), community members (n = 9) and key informants (n = 13); 25 were Indigenous individuals.A participatory action research project design was used with purposive sampling to identify participants. Semi-structured interviews were undertaken to explore: current understanding of hepatitis B, desire for knowledge, and perspectives on how people could acquire the information needed. All individuals were offered the use of an interpreter. The data were examined using deductive and inductive thematic analysis. Low levels of biomedical knowledge about Hepatitis B, negative perceptions of Hepatitis B, communication (particularly language) and culture were the major themes that emerged from the data. Accurate concepts grounded in Indigenous culture such as "only your blood can tell the story" were present but accompanied by a feeling of disempowerment due to perceived lack of "medical" understanding, and informed partnerships between caregiver and patient. Culturally appropriate discussions in a

[Interventions to improve access to health services by indigenous peoples in the Americas].

Science.gov (United States)

Araujo, Miguel; Moraga, Cecilia; Chapman, Evelina; Barreto, Jorge; Illanes, Eduardo

2016-11-01

Synthesize evidence on effectiveness of interventions designed to improve access to health services by indigenous populations. Review of systematic reviews published as of July 2015, selecting and analyzing only studies in the Region of the Americas. The bibliographic search encompassed MEDLINE, Lilacs, SciELO, EMBASE, DARE, HTA, The Cochrane Library, and organization websites. Two independent reviewers selected studies and analyzed their methodological quality. A narrative summary of the results was produced. Twenty-two reviews met the inclusion criteria. All selected studies were conducted in Canada and the United States of America. The majority of the interventions were preventive, to surmount geographical barriers, increase use of effective measures, develop human resources, and improve people's skills or willingness to seek care. Topics included pregnancy, cardiovascular risk factors, diabetes, substance abuse, child development, cancer, mental health, oral health, and injuries. Some interventions showed effectiveness with moderate or high quality studies: educational strategies to prevent depression, interventions to prevent childhood caries, and multicomponent programs to promote use of child safety seats. In general, results for chronic non-communicable diseases were negative or inconsistent. Interventions do exist that have potential for producing positive effects on access to health services by indigenous populations in the Americas, but available studies are limited to Canada and the U.S. There is a significant research gap on the topic in Latin America and the Caribbean.

[Health and nutrition of indigenous and nonindigenous children in the Peruvian Amazon].

Science.gov (United States)

Díaz, Adrián; Arana, Ana; Vargas-Machuca, Rocío; Antiporta, Daniel

2015-07-01

Evaluate the nutritional status of indigenous and nonindigenous children under 5 in two provinces in the Peruvian Amazon. . Descriptive cross-sectional representative study of families with children under 5 in the provinces of Bagua and Condorcanqui in Peru. The study consisted of an interview with the child's or children's mother or caregiver, anthropometric assessment, capillary hemoglobin measurement, screening for intestinal parasites in children under 5, access to health services, history of acute respiratory infections and acute diarrheal diseases, socioeconomic status, and intake of inadequately iodized salt. Using generalized linear methods, the determinants of chronic malnutrition and anemia in children were identified in each study population. . A total of 986 families and 1 372 children were assessed. The prevalence of chronic malnutrition was higher in the indigenous population than in the nonindigenous population (56.2% versus 21.9%); likewise for anemia (51.3% versus 40.9%). The determinants of chronic malnutrition in the two populations differed. In the indigenous population, the main determinants were an age of more than 36 months (OR 2.21; CI95% 1.61-3.04) and substandard housing (OR 2.9; CI95% 1.19-7.11), while in the non-indigenous population, they were extreme poverty (OR 2.31; IC95% 1.50-3.55) and institutional birth (OR 3.1; IC95% 2.00-4.83). There are marked gaps between the indigenous population and the nonindigenous population in terms of living conditions, access to health services, and the nutritional status of children under 5. Particular attention should be paid to the indigenous population to improve the way state programs and services are delivered in these contexts.

Cultivating Native American scientists: an application of an Indigenous model to an undergraduate research experience

Science.gov (United States)

McMahon, Tracey R.; Griese, Emily R.; Kenyon, DenYelle Baete

2018-03-01

With growing evidence demonstrating the impact of undergraduate research experiences on educational persistence, efforts are currently being made to expand these opportunities within universities and research institutions throughout the United States. Recruiting underrepresented students into these programs has become an increasingly popular method of promoting diversity in science. Given the low matriculation into postsecondary education and completion rates among Native Americans, there is a great need for Native American undergraduate research internships. Although research has shown that Western education models tend to be less effective with Native populations, the implementation of indigenous epistemologies and pedagogies within higher education, including research experiences, is rare. This study explores the applicability of a cognitive apprenticeship merged with an indigenous approach, the Circle of Courage, to build a scientific learning environment and enhance the academic and professional development of Native students engaged in an undergraduate research experience in the health sciences. Data were drawn from focus groups with 20 students who participated in this program in 2012-2014. Questions explored the extent to which relational bonds between students and mentors were cultivated as well as the impact of this experience on the development of research skills, intellectual growth, academic and professional self-determination, and the attachment of meaning to their research experiences. Data were analyzed via deductive content analysis, allowing for an assessment of how the theoretical constructs inherent to this model (belonging, mastery, independence, and generosity) impacted students. Findings suggest that engaging Native students in research experiences that prioritize the needs of belonging, mastery, independence, and generosity can be a successful means of fostering a positive learning environment, in which students felt like significant members

Research methods in indigenous mathematical Knowledge: An ...

African Journals Online (AJOL)

Indigenous games are an integral component of indigenous knowledge systems. ... and national activities; mathematical concepts associated with the games; possibilities and implications for general classroom ... AJOL African Journals Online.

Development and preliminary validation of the 'Caring for Country' questionnaire: measurement of an Indigenous Australian health determinant

Directory of Open Access Journals (Sweden)

Gunthorpe Wendy

2008-12-01

Full Text Available Abstract Background 'Caring for Country' is defined as Indigenous participation in interrelated activities with the objective of promoting ecological and human health. Ecological services on Indigenous-owned lands are belatedly attracting some institutional investment. However, the health outcomes associated with Indigenous participation in 'caring for country' activities have never been investigated. The aims of this study were to pilot and validate a questionnaire measuring caring for country as an Indigenous health determinant and to relate it to an external reference, obesity. Methods Purposively sampled participants were 301 Indigenous adults aged 15 to 54 years, recruited during a cross-sectional program of preventive health checks in a remote Australian community. Questionnaire validation was undertaken with psychometric tests of internal consistency, reliability, exploratory factor analysis and confirmatory one-factor congeneric modelling. Accurate item weightings were derived from the model and used to create a single weighted composite score for caring for country. Multiple linear regression modelling was used to test associations between the caring for country score and body mass index adjusting for socio-demographic factors and health behaviours. Results The questionnaire demonstrated adequate internal consistency, test-retest validity and proxy-respondent validity. Exploratory factor analysis of the 'caring for country' items produced a single factor solution that was confirmed via one-factor congeneric modelling. A significant and substantial association between greater participation in caring for country activities and lower body mass index was demonstrated. Adjusting for socio-demographic factors and health behaviours, an inter-quartile range rise in caring for country scores was associated with 6.1 Kg and 5.3 Kg less body weight for non-pregnant women and men respectively. Conclusion This study indicates preliminary support for

Motivation Matters: Profiling Indigenous and Non-Indigenous Students' Motivational Goals

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Magson, Natasha R.; Craven, Rhonda G.; Nelson, Genevieve F.; Yeung, Alexander S.; Bodkin-Andrews, Gawaian H.; McInerney, Dennis M.

2014-01-01

This research explored gender and cross-cultural similarities and differences in the motivational profiles of Indigenous Papua New Guinean (PNG) and Indigenous and non-Indigenous Australians. Secondary students (N = 1,792) completed self-report motivational measures. Invariance testing demonstrated that the Inventory of School Motivation…

Epidemiology of sexually transmitted infections in global indigenous populations: data availability and gaps.

Science.gov (United States)

Minichiello, Victor; Rahman, Saifur; Hussain, Rafat

2013-10-01

Socioeconomic and health disadvantage is widespread within and across indigenous communities in the world, leading to differentials in morbidity and mortality between indigenous and non-indigenous populations. Sexually transmitted infections (STIs), including HIV/AIDS, among indigenous populations are an emerging public health concern. The focus of this paper is on examining the STI epidemiology in indigenous communities in various parts of the world utilizing a range of data sources. Most of the STI research on global indigenous communities has concentrated on developed countries, neglecting more than half the world's indigenous people in the developing countries. This has resulted in major gaps in data at global level for STIs and HIV/AIDS among indigenous populations. Available data show that the prevalence of STIs is increasing among the indigenous communities and in several instances, the rates of these infections are higher than among non-indigenous populations. However, HIV still remains low when compared with the rates of other STIs. The paper argues that there is an urgent need to collect more comprehensive and reliable data at the global level across various indigenous communities. There is also an opportunity to reverse current trends in STIs through innovative, evidence-based and culturally appropriate targeted sexual health programmes.

Rehabilitation and indigenous peoples: the Māori experience.

Science.gov (United States)

Harwood, Matire

2010-01-01

Indigenous peoples often have the worst health status in comparison to non-indigenous people in their own nations; urgent action to address the health inequities for indigenous people is required. The role of rehabilitation in addressing health and disability inequities is particularly important due to the health need of indigenous peoples; the unequal distribution of health determinants; and disparities in access to, quality of care through and outcomes following rehabilitation. This article will present a perspective for Māori, the indigenous peoples of New Zealand, on a framework for improving rehabilitation services for Māori and ultimately their health and wellbeing.

Approaches to dog health education programs in Australian rural and remote Indigenous communities: four case studies.

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Constable, S E; Dixon, R M; Dixon, R J; Toribio, J-A

2013-09-01

Dog health in rural and remote Australian Indigenous communities is below urban averages in numerous respects. Many Indigenous communities have called for knowledge sharing in this area. However, dog health education programs are in their infancy, and lack data on effective practices. Without this core knowledge, health promotion efforts cannot progress effectively. This paper discusses a strategy that draws from successful approaches in human health and indigenous education, such as dadirri, and culturally respectful community engagement and development. Negotiating an appropriate education program is explored in its practical application through four case studies. Though each case was unique, the comparison of the four illustrated the importance of listening (community consultation), developing and maintaining relationships, community involvement and employment. The most successful case studies were those that could fully implement all four areas. Outcomes included improved local dog health capacity, local employment and engagement with the program and significantly improved dog health.

Engaging indigenous and academic knowledge on bees in the Amazon: implications for environmental management and transdisciplinary research.

Science.gov (United States)

Athayde, Simone; Stepp, John Richard; Ballester, Wemerson C

2016-06-20

This paper contributes to the development of theoretical and methodological approaches that aim to engage indigenous, technical and academic knowledge for environmental management. We present an exploratory analysis of a transdisciplinary project carried out to identify and contrast indigenous and academic perspectives on the relationship between the Africanized honey bee and stingless bee species in the Brazilian Amazon. The project was developed by practitioners and researchers of the Instituto Socioambiental (ISA, a Brazilian NGO), responding to a concern raised by a funding agency, regarding the potential impact of apiculture development by indigenous peoples, on the diversity of stingless bee species in the Xingu Park, southern Brazilian Amazon. Research and educational activities were carried out among four indigenous peoples: Kawaiwete or Kaiabi, Yudja or Juruna, Kīsêdjê or Suyá and Ikpeng or Txicão. A constructivist qualitative approach was developed, which included academic literature review, conduction of semi-structured interviews with elders and leaders, community focus groups, field walks and workshops in schools in four villages. Semi-structured interviews and on-line surveys were carried out among academic experts and practitioners. We found that in both indigenous and scientific perspectives, diversity is a key aspect in keeping exotic and native species in balance and thus avoiding heightened competition and extinction. The Africanized honey bee was compared to the non-indigenous westerners who colonized the Americas, with whom indigenous peoples had to learn to coexist. We identify challenges and opportunities for engagement of indigenous and scientific knowledge for research and management of bee species in the Amazon. A combination of small-scale apiculture and meliponiculture is viewed as an approach that might help to maintain biological and cultural diversity in Amazonian landscapes. The articulation of knowledge from non-indigenous

[ETHICAL CONDUCT FOR RESEARCH INVOLVING INDIGENOUS PEOPLE IN FRANCE: A COMMENT OF THE CNRS ETHICS COMMITTEE OPINION ON THE IMPERATIVE OF FAIRNESS IN THE RELATIONSHIP BETWEEN RESEARCHERS AND INDIGENOUS PEOPLES].

Science.gov (United States)

Burelli, Thomas; Bambridge, Tamatoa

2015-12-01

Historically, scientific research and colonization process have maintained very close ties. In order to frame research involving indigenous peoples and to avoid situations of abuse, some States have developed very detailed ethicalframeworks. In France, there are no ethicalframework comparable to those observed in particular in Anglo-Saxon countries like Canada. Extensive discussions were conducted by the Ethics Committee of the CNRS leading to the adoption of an opinion of a high quality but which appears largely unknown and under-exploited. This opinion deals with "the delicate question of the rights of local and indigenous populations during the research projected conducted with their support in developed and developing countries (DCs)". In this paper, we propose to analyze how this opinion can be considered remarkable because it recognizes the current challenges of research projects involving indigenous people, but also because of his recommendations. We still see that the scope of its recommendations is however limited so far although some encouraging experiences like the recent adoption of the CRIOBE centre code of ethics in French Polynesia can be observed.

Indigenous health beliefs, attitudes and practices among VhaVenda: A challenge to the promotion of HIV/AIDS prevention strategies

Directory of Open Access Journals (Sweden)

F.M. Mulaudzi

2007-09-01

Full Text Available Currently, the syndromic management of HIV/AIDS is based on a biomedical model that focuses on the ABC (Abstain, Be faithful, Condomise model. The ABC model overlooks the issue of indigenous cultural practices, sexual behaviours, knowledge and attitudes of the society. A grounded theory study was used for the research. The population for the research on which this article is reporting, was selected from the Vhavenda ethnic group using purposive sampling. In-depth interviews were held at the participants’ own homes. The outcome of the study on which this article is reporting, may assist in identifying indigenous health beliefs, attitudes and practices that will assist in curbing the spread of HIV/AIDS. The findings revealed that cultural practices, such as premarital counselling, polygamy and widow inheritance, are believed to be influential in making women more susceptible to sexually transmitted diseases, including HIV/AIDS. The practice of abstinence, as emphasised at initiation schools, should be incorporated into current policies and preventative practices. The findings further demonstrate that policy-makers who formulated the HIV/AIDS strategy have limited knowledge of the health beliefs, attitudes and practices of the people they serve. They thus find it difficult to draw up promotion and prevention strategies that meet the needs of the community. It is therefore imperative that our health-care training curriculum be reviewed to make provision for the incorporation of sound and effective indigenous practices to reduce the spread of HIV/AIDS and to eliminate or refine practices that are harmful and detrimental to people’s health. The cultural practices that were proved reliable and effective will be recommended for integration into health education.

The DRUID study: racism and self-assessed health status in an indigenous population

Science.gov (United States)

2012-01-01

Background There is now considerable evidence from around the world that racism is associated with both mental and physical ill-health. However, little is known about the mediating factors between racism and ill-health. This paper investigates relationships between racism and self-assessed mental and physical health among Indigenous Australians as well as potential mediators of these relationships. Methods A total of 164 adults in the Darwin Region Urban Indigenous Diabetes (DRUID) study completed a validated instrument assessing interpersonal racism and a separate item on discrimination-related stress. Self-assessed health status was measured using the SF-12. Stress, optimism, lack of control, social connections, cultural identity and reactions/responses to interpersonal racism were considered as mediators and moderators of the relationship between racism/discrimination and self-assessed health status. Results After adjusting for socio-demographic factors, interpersonal racism was significantly associated with the SF-12 mental (but not the physical) health component. Stress, lack of control and feeling powerless as a reaction to racism emerged as significant mediators of the relationship between racism and general mental health. Similar findings emerged for discrimination-related stress. Conclusions Racism/discrimination is significantly associated with poor general mental health among this indigenous population. The mediating factors between racism and mental health identified in this study suggest new approaches to ameliorating the detrimental effects of racism on health. In particular, the importance of reducing racism-related stress, enhancing general levels of mastery, and minimising negative social connections in order to ameliorate the negative consequences of racism. PMID:22333047

Acculturation and self-rated health among Arctic indigenous peoples: a population-based cross-sectional study.

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Eliassen, Bent-Martin; Braaten, Tonje; Melhus, Marita; Hansen, Ketil Lenert; Broderstad, Ann Ragnhild

2012-11-05

Acculturation is for indigenous peoples related to the process of colonisation over centuries as well as the on-going social transition experienced in the Arctic today. Changing living conditions and lifestyle affect health in numerous ways in Arctic indigenous populations. Self-rated health (SRH) is a relevant variable in primary health care and in general public health assessments and monitoring. Exploring the relationship between acculturation and SRH in indigenous populations having experienced great societal and cultural change is thus of great importance. The principal method in the Survey of Living Conditions in the Arctic (SLiCA) was standardised face-to-face interviews using a questionnaire. Very high overall participation rates of 83% were obtained in Greenland and Alaska, whilst a more conventional rate of 57% was achieved in Norway. Acculturation was conceptualised as certain traditional subsistence activities being of lesser importance for people's ethnic identity, and poorer spoken indigenous language ability (SILA). Acculturation was included in six separate gender- and country-specific ordinal logistic regressions to assess qualitative effects on SRH. Multivariable analyses showed that acculturation significantly predicted poorer SRH in Greenland. An increased subsistence score gave an OR of 2.32 (Pcultural differences in the conceptualisation of SRH, and confounding effects of health care use, SES and discrimination, make it difficult to appropriately assess how strong this effect is though.

Experiences of chronic stress and mental health concerns among urban Indigenous women.

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Benoit, Anita C; Cotnam, Jasmine; Raboud, Janet; Greene, Saara; Beaver, Kerrigan; Zoccole, Art; O'Brien-Teengs, Doe; Balfour, Louise; Wu, Wei; Loutfy, Mona

2016-10-01

We measured stress, depression and post-traumatic stress disorder (PTSD) levels of urban Indigenous women living with and without HIV in Ontario, Canada, and identified correlates of depression. We recruited 30 Indigenous women living with HIV and 60 without HIV aged 18 years or older who completed socio-demographic and health questionnaires and validated scales assessing stress, depression and PTSD. Descriptive statistics were conducted to summarize variables and linear regression to identify correlates of depression. 85.6 % of Indigenous women self-identified as First Nation. Co-morbidities other than HIV were self-reported by 82.2 % (n = 74) of the sample. High levels of perceived stress were reported by 57.8 % (n = 52) of the sample and 84.2 % (n = 75) had moderate to high levels of urban stress. High median levels of race-related (51/88, IQR 42-68.5) and parental-related stress (40.5/90, IQR 35-49) scores were reported. 82.2 % (n = 74) reported severe depressive symptoms and 83.2 % (n = 74) severe PTSD. High levels of perceived stress was correlated with high depressive symptoms (estimate 1.28 (95 % CI 0.97-1.58), p stress and physical and mental health concerns. Interventions cutting across diverse health care settings are required for improving and preventing adverse health outcomes.

Interventions to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA: a systematic review.

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Clifford, Anton; McCalman, Janya; Bainbridge, Roxanne; Tsey, Komla

2015-04-01

This article describes the characteristics and reviews the methodological quality of interventions designed to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA. A total of 17 electronic databases and 13 websites for the period of 2002-13. Studies were included if they evaluated an intervention strategy designed to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, the USA or Canada. Information on the characteristics and methodological quality of included studies was extracted using standardized assessment tools. Sixteen published evaluations of interventions to improve cultural competency in health care for Indigenous peoples were identified: 11 for Indigenous peoples of the USA and 5 for Indigenous Australians. The main types of intervention strategies were education and training of the health workforce, culturally specific health programs and recruitment of an Indigenous health workforce. Main positive outcomes reported were improvements in health professionals' confidence, and patients' satisfaction with and access to health care. The methodological quality of evaluations and the reporting of key methodological criteria were variable. Particular problems included weak study designs, low or no reporting of consent rates, confounding and non-validated measurement instruments. There is a lack of evidence from rigorous evaluations on the effectiveness of interventions for improving cultural competency in health care for Indigenous peoples. Future evaluations should employ more rigorous study designs and extend their measurement of outcomes beyond those relating to health professionals, to those relating to the health of Indigenous peoples. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Accidents involving Brazilian indigenous treated at urgent and emergency services of the Unified Health System.

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Souza, Edinilsa Ramos de; Njaine, Kathie; Mascarenhas, Márcio Dênis Medeiros; Oliveira, Maria Conceição de

2016-12-01

Abstract We analyzed the accidents with Brazilian indigenous treated at urgent and emergency services of the Unified Health System (SUS). Data were obtained from the 2014 Viva Survey, which included 86 services from 24 capitals and the Federal District. The demographic profile of the indigenous, the event and the attendance were characterized. Most of the attended people were male in the 20-39 years age group. Falls and traffic accidents were the main reasons for attendance. Alcohol use was informed by 5.6% of the attended people, a figure that increases to 19.1% in traffic accidents, 26.1% among drivers and 22.8% among motorcyclists. There was a statistical difference between genders in relation to age, disability, place of occurrence of the event, work-related event and victim's condition in the traffic accident. We emphasize the importance of providing visibility to accidents with indigenous and engage them in the prevention of such events. Data reliability depends on the adequate completion in indigenous health information systems.

The hookworm Ancylostoma ceylanicum: An emerging public health risk in Australian tropical rainforests and Indigenous communities.

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Smout, Felicity A; Skerratt, Lee F; Butler, James R A; Johnson, Christopher N; Congdon, Bradley C; Thompson, R C Andrew

2017-06-01

Ancylostoma ceylanicum is the common hookworm of domestic dogs and cats throughout Asia, and is an emerging but little understood public health risk in tropical northern Australia. We investigated the prevalence of A. ceylanicum in soil and free-ranging domestic dogs at six rainforest locations in Far North Queensland that are Indigenous Australian communities and popular tourist attractions within the Wet Tropics World Heritage Area. By combining PCR-based techniques with traditional methods of hookworm species identification, we found the prevalence of hookworm in Indigenous community dogs was high (96.3% and 91.9% from necropsy and faecal samples, respectively). The majority of these infections were A. caninum. We also observed, for the first time, the presence of A. ceylanicum infection in domestic dogs (21.7%) and soil (55.6%) in an Indigenous community. A. ceylanicum was present in soil samples from two out of the three popular tourist locations sampled. Our results contribute to the understanding of dogs as a public health risk to Indigenous communities and tourists in the Wet Tropics. Dog health needs to be more fully addressed as part of the Australian Government's commitments to "closing the gap" in chronic disease between Indigenous and other Australians, and encouraging tourism in similar locations.

The hookworm Ancylostoma ceylanicum: An emerging public health risk in Australian tropical rainforests and Indigenous communities

Directory of Open Access Journals (Sweden)

Felicity A. Smout

2017-06-01

Full Text Available Ancylostoma ceylanicum is the common hookworm of domestic dogs and cats throughout Asia, and is an emerging but little understood public health risk in tropical northern Australia. We investigated the prevalence of A. ceylanicum in soil and free-ranging domestic dogs at six rainforest locations in Far North Queensland that are Indigenous Australian communities and popular tourist attractions within the Wet Tropics World Heritage Area. By combining PCR-based techniques with traditional methods of hookworm species identification, we found the prevalence of hookworm in Indigenous community dogs was high (96.3% and 91.9% from necropsy and faecal samples, respectively. The majority of these infections were A. caninum. We also observed, for the first time, the presence of A. ceylanicum infection in domestic dogs (21.7% and soil (55.6% in an Indigenous community. A. ceylanicum was present in soil samples from two out of the three popular tourist locations sampled. Our results contribute to the understanding of dogs as a public health risk to Indigenous communities and tourists in the Wet Tropics. Dog health needs to be more fully addressed as part of the Australian Government's commitments to “closing the gap” in chronic disease between Indigenous and other Australians, and encouraging tourism in similar locations.

'Culture' as HIV prevention: Indigenous youth speak up!

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Ciann Wilson

2016-09-01

Full Text Available This article explores the ways in which (a Indigenous youth involved in an HIV intervention took up and reclaimed their cultures as a project of defining ‘self’, and (b how Indigenous ‘culture’ can be used as a tool for resistance, HIV prevention and health promotion. Data were drawn from the Taking Action Project: Using arts-based approaches to develop Aboriginal youth leadership in HIV prevention. ‘By youth, for youth’ HIV education and awareness workshops were facilitated in six Indigenous communities across Canada, incorporating traditional and contemporary art forms to explore how youth perceived the links between structural inequality and HIV vulnerability. Over 100 youth participated, with 70 partaking in individual interviews to reflect on their experiences at the workshops. Interviews were audio-recorded, transcribed verbatim and analysed using NVivo software. Indigenous youth understood culture as a complex construct that included reconnecting to land, body, history, community and ceremony. For many youth, being Aboriginal and participating in cultural activities was seen as important for intergenerational healing, empowerment, health and combatting HIV. Youth spoke excitedly of their attempts to reclaim their languages and cultures despite barriers. They also understood art as a medium for self-expression and as an important site of cultural evolution. Our project demonstrates that the incorporation of culture within health strategies is important for effective HIV prevention amongst Indigenous youth. Reclaiming Indigenous cultures, languages and ceremonies may help to nurture future generations, diminish cycles of victimisation and combat hopelessness by reconnecting youth to stories of resistance and survival. Keywords: Indigenous youth, culture, HIV prevention, arts-based research

Is Hunting Still Healthy? Understanding the Interrelationships between Indigenous Participation in Land-Based Practices and Human-Environmental Health

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Ursula King

2014-05-01

Full Text Available Indigenous participation in land-based practices such as hunting, fishing, ceremony, and land care has a long history. In recent years, researchers and policy makers have advocated the benefits of these practices for both Indigenous people and the places they live. However, there have also been documented risks associated with participation in these activities. Environmental change brought about by shifts in land use, climate changes, and the accumulation of contaminants in the food chain sit alongside equally rapid shifts in social, economic and cultural circumstances, preferences and practices. To date, the literature has not offered a wide-ranging review of the available cross-disciplinary or cross-ecozone evidence for these intersecting benefits and risks, for both human and environmental health and wellbeing. By utilising hunting as a case study, this paper seeks to fill part of that gap through a transdisciplinary meta-analysis of the international literature exploring the ways in which Indigenous participation in land-based practices and human-environmental health have been studied, where the current gaps are, and how these findings could be used to inform research and policy. The result is an intriguing summary of disparate research that highlights the patchwork of contradictory understandings, and uneven regional emphasis, that have been documented. A new model was subsequently developed that facilitates a more in-depth consideration of these complex issues within local-global scale considerations. These findings challenge the bounded disciplinary and geographic spaces in which much of this work has occurred to date, and opens a dialogue to consider the importance of approaching these issues holistically.

Is hunting still healthy? Understanding the interrelationships between indigenous participation in land-based practices and human-environmental health.

Science.gov (United States)

King, Ursula; Furgal, Christopher

2014-05-28

Indigenous participation in land-based practices such as hunting, fishing, ceremony, and land care has a long history. In recent years, researchers and policy makers have advocated the benefits of these practices for both Indigenous people and the places they live. However, there have also been documented risks associated with participation in these activities. Environmental change brought about by shifts in land use, climate changes, and the accumulation of contaminants in the food chain sit alongside equally rapid shifts in social, economic and cultural circumstances, preferences and practices. To date, the literature has not offered a wide-ranging review of the available cross-disciplinary or cross-ecozone evidence for these intersecting benefits and risks, for both human and environmental health and wellbeing. By utilising hunting as a case study, this paper seeks to fill part of that gap through a transdisciplinary meta-analysis of the international literature exploring the ways in which Indigenous participation in land-based practices and human-environmental health have been studied, where the current gaps are, and how these findings could be used to inform research and policy. The result is an intriguing summary of disparate research that highlights the patchwork of contradictory understandings, and uneven regional emphasis, that have been documented. A new model was subsequently developed that facilitates a more in-depth consideration of these complex issues within local-global scale considerations. These findings challenge the bounded disciplinary and geographic spaces in which much of this work has occurred to date, and opens a dialogue to consider the importance of approaching these issues holistically.

P450 Pharmacogenetics in Indigenous North American Populations

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Lindsay M. Henderson

2018-02-01

Full Text Available Indigenous North American populations, including American Indian and Alaska Native peoples in the United States, the First Nations, Métis and Inuit peoples in Canada and Amerindians in Mexico, are historically under-represented in biomedical research, including genomic research on drug disposition and response. Without adequate representation in pharmacogenetic studies establishing genotype-phenotype relationships, Indigenous populations may not benefit fully from new innovations in precision medicine testing to tailor and improve the safety and efficacy of drug treatment, resulting in health care disparities. The purpose of this review is to summarize and evaluate what is currently known about cytochrome P450 genetic variation in Indigenous populations in North America and to highlight the importance of including these groups in future pharmacogenetic studies for implementation of personalized drug therapy.

Dietary Adherence, Glycemic Control, and Psychological Factors Associated with Binge Eating Among Indigenous and Non-Indigenous Chileans with Type 2 Diabetes.

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Herbozo, Sylvia; Flynn, Patricia M; Stevens, Serena D; Betancourt, Hector

2015-12-01

Despite the strong association between obesity and binge eating, limited research has examined the implications of binge eating on dietary adherence and psychological factors in ethnically diverse type 2 diabetes patients. This study investigated the prevalence of binge eating and its association with dietary adherence, glycemic control, and psychological factors among indigenous and non-indigenous type 2 diabetes patients in Chile. Participants were 387 indigenous (Mapuche) and non-indigenous (non-Mapuche) adults with type 2 diabetes. Self-report measures of binge eating, dietary adherence, diet self-efficacy, body image dissatisfaction, and psychological well-being were administered. Participants' weight, height, and glycemic control (HbA(1c)) were also obtained. Approximately 8 % of the type 2 diabetes patients reported binge eating. The prevalence among Mapuche patients was 4.9 %, and among non-Mapuche patients, it was 9.9 %. Compared to non-binge eaters, binge eating diabetes patients had greater body mass index values, consumed more high-fat foods, were less likely to adhere to their eating plan, and reported poorer body image and emotional well-being. Results of this study extend previous research by examining the co-occurrence of binge eating and type 2 diabetes as well as the associated dietary behaviors, glycemic control, and psychological factors among indigenous and non-indigenous patients in Chile. These findings may increase our understanding of the health challenges faced by indigenous populations from other countries and highlight the need for additional research that may inform interventions addressing binge eating in diverse patients with type 2 diabetes.

Deadly Choices empowering Indigenous Australians through social networking sites.

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McPhail-Bell, Karen; Appo, Nathan; Haymes, Alana; Bond, Chelsea; Brough, Mark; Fredericks, Bronwyn

2017-04-05

The potential for health promotion through social networking sites (SNSs) is widely recognized. However, while health promotion prides itself in focusing on the social determinants of health, its partiality for persuading individuals to comply with health behaviours dominates the way health promotion utilizes SNSs. This paper contributes to an understanding of collaborative ways SNSs can work for health promotion agendas of self-determination and empowerment in an Indigenous Australia context. An ethnographic study was undertaken with Deadly Choices, an Indigenous-led health promotion initiative. The study involved participant observation of interactions on Deadly Choices SNSs between Deadly Choices and its online community members. Deadly Choices provides an example of SNSs providing a powerful tool to create a safe, inclusive and positive space for Indigenous people and communities to profile their healthy choices, according to Indigenous notions of health and identity. The study found five principles that underpin Deadly Choices' use of SNSs for health promotion. These are: create a dialogue; build community online and offline; incentivise healthy online engagement; celebrate Indigenous identity and culture; and prioritize partnerships. Deadly Choices SNSs empowers Indigenous people and communities to be health promoters themselves, which represents a power shift from health promotion practitioner to Indigenous people and communities and more broadly, an enactment of Indigenous self-determination on SNSs. Mainstream health promotion can learn from Indigenous health promotion practice regarding the use of SNSs for health promotion agendas. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

De/colonizing methodologies in science education: rebraiding research theory-practice-ethics with Indigenous theories and theorists

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Higgins, Marc; Kim, Eun-Ji Amy

2018-02-01

The purpose of this article is to differentially engage in the work of thinking with Indigenous theorists and theories with decolonizing science education research methodologies in mind. As a rejoinder to Tracey McMahon, Emily Griese, and DenYelle Baete Kenyon's Cultivating Native American scientists: An application of an Indigenous model to an undergraduate research experience, we extend the notion of educationally centering Indigenous processes, pedagogies, and protocols by considering methodology a site in which (neo-)colonial logics often linger. We suggest that (re)designing methodology with Indigenous theorists and theories is an important act of resistance, refusal, and resignification; we demonstrate this significance through braiding together narratives of our engagement in this task and provide insights as to what is produced or producible.

Guaman Poma de Ayala's "New Chronicle and Good Government" A testimony on the health of the Indigenous populations in XVIth century Peru

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Axel M. Klohn

2015-06-01

Full Text Available The demographic collapse of indigenous population in early colonial Peru after colonial contact raises questions about its possible causes: imported infectious agents, mistreatment, or other. Guaman Poma de Ayala provides a unique first hand account, in an indigenous perspective, of the situation. He identifies as causes of decline of the indigenous population: deportation for forced labour in lethal environments, widespread abuses, exploitation and violence exerted by the colonizers, and disruption of social organization. Guaman Poma's account for Peru is in line with prior accounts by Bartolomé de Las Casas for the Caribbean and Mexico; it also appears, partly, in Spanish XVIth century historiography. Current archaeological research shows a pattern of high biological stress and impaired health of indigenous populations following colonial contact. Early protective measures are discussed together with their consequences and relevance.

Emerging Ideas for Innovation in Indigenous Education: A Research Synthesis of Indigenous Educative Roles in Mainstream and Flexi Schools

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Shay, Marnee

2017-01-01

The Indigenous education agenda in Australia remains focused on mainstream schooling contexts. Although overlooked in Indigenous education discourse, flexi schools appear to be engaging with disproportionately high numbers of Indigenous students and staff. The educative roles of Indigenous peoples in broader Indigenous education discourse are…

Screening for depression among indigenous Mexican migrant farmworkers using the Patient Health Questionnaire-9.

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Donlan, William; Lee, Junghee

2010-04-01

U.S. farmworkers include growing numbers of individuals from indigenous, pre-Columbian communities in southern Mexico with distinctive languages and cultures. Given the high stress these farmworkers experience in their challenging work environments, they are very susceptible to depression and other mental and emotional health disorders. The present study explores the Spanish version of the Patient Health Questionnaire-9 (PHQ-9) as a screen for the presence and severity of depression among 123 indigenous Mexican-origin, migrant farmworkers in Oregon. Factor structure and inter-item correlations of the PHQ-9 are examined, along with associations between depression and culture-bound syndromes, self-esteem, self-efficacy, acculturation stress, and other sample psychosocial characteristics. The PHQ-9 exhibited strong factor loadings and internal consistency, and its severity score significantly correlated with other indicators of health status that were observed in previous studies to be significantly associated with depression. The PHQ-9 appears to be culturally relevant for use with Mexicans coming from a variety of indigenous cultures and having very low education and literacy.

Are Indigenous Determinants of Health Associated with Self-Reported Health Professional-Diagnosed Anxiety Disorders Among Canadian First Nations Adults?: Findings from the 2012 Aboriginal Peoples Survey.

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Nasreen, Sharifa; Brar, Ramanpreet; Brar, Samanpreet; Maltby, Alana; Wilk, Piotr

2018-05-01

We estimated the prevalence of self-reported health professional-diagnosed anxiety disorders among Canadian First Nations adults living off-reserve, and assessed the relationship between anxiety disorders and Indigenous determinants of health (Status Indian, residential school attendance, knowledge of Indigenous language, and participation in traditional activities) using the 2012 Aboriginal Peoples Survey. Multivariable logistic regression models were performed using bootstrap weights. The prevalence of anxiety disorders was 14.5% among off-reserve First Nations adults. There was an increased odds of anxiety disorders among those participating in traditional activities compared to their counterparts (aOR 1.46, 95% CI 1.12-1.90). No association was found between anxiety disorders and other Indigenous determinants of health. There is a high prevalence of self-reported anxiety among First Nations adults living off-reserve. However, further studies are warranted to identify and assess the role of Indigenous determinants of health for anxiety disorders and other prevalent mental health conditions in this population.

Model's proposal in health for the indigenous towns of the Amazonian area

International Nuclear Information System (INIS)

Suarez Mutis, Martha Cecilia

2001-01-01

the author refers to the indigenous communities which should not be considered alone in the speeches, like one of the high-priority groups for the attention of the state and the society, but rather it is fundamental to think a model in health that allows to overcome the cultural barriers and the existent distrust in front of our society, as well as the contempt that they still have some sectors in the indigenous communities. The new constitutional order of Colombia conceives to the country like a nation multi-ethnic and pluri-cultural. The article 7 of the constitution promulgated in 1991 assign to the state the obligation of to recognize and to protect the ethnic diversity. The paper makes reference to the antecedents, organization of the services of health, basic plan of attention, obligatory plan of health, training and its installation in the amazons

Indigenous Young People Transitioning from Out-of-Home Care (OOHC in Victoria, Australia: The Perspectives of Workers in Indigenous-Specific and Non-Indigenous Non-Government Services

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Philip Mendes

2016-08-01

Full Text Available Indigenous children and young people are overrepresented in the Australian out-of-home care (OOHC system. To date, specific research has not been undertaken on workers' perspectives regarding the Indigenous-specific and non-Indigenous supports and services available to Indigenous young people exiting the system. This exploratory research involved focus group consultations with workers from seven child and family welfare agencies to examine the current support services available to Indigenous young people who are in or will be leaving out-of-home care in the State of Victoria. Findings suggest that Aboriginal Community Controlled Organisations (ACCOs play a positive role in working with non-Indigenous agencies to assist Indigenous care leavers. Participants identified some key strategies to improve outcomes, such as facilitating stronger relationships between Indigenous and non-Indigenous services, and improving the resourcing of ACCOs.

Improving Indigenous access to cancer screening and treatment services: descriptive findings and a preliminary report on the Midwest Indigenous Women’s Cancer Support Group

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Lisabeth D Finn

2008-01-01

Full Text Available BackgroundHigher cancer morbidity and mortality rates for the Indigenous population comparedto the overall Australian population has underlined the critical need to improve accessfor Aboriginal people to cancer treatment services. This paper describes anIndigenous Women’s Cancer Support Group (IWCSG established to supportIndigenous people with cancer and their carers/relatives and to facilitate Aboriginalaccess to cancer screening and treatment. Preliminary findings from an evaluation ofthe group are presented.MethodsThe study employed qualitative research methods to describe IWCSG operations andinvestigate the group’s effectiveness. It included one-on-one interviews with 11Geraldton-based health service providers, the IWCSG coordinator, and 10 womenwho have been linked to IWCSG support, as well as observation of group meetings.ResultsDescriptive outcomes relate to group operations, group effectiveness, group benefitsand future development of the group. A cultural strength of IWCSG is its ability tooperate confidentially behind the scenes, providing emotional support and practicalhelp directly to Indigenous people concerned about privacy and shame issues. Theimportant cultural role IWCSG plays in overcoming communication and othercultural barriers to accessing cancer treatment was unanimously recognised by healthservice providers. Aboriginal women supported by IWCSG spoke about an increasedsense of safety, trust and support in accessing and navigating mainstream cancerservices. A critical issue emerging from the research is the need for further development of effective collaborative working relationships between IWCSGmembers and health service providers.ConclusionsThe IWCSG has the potential to inform an effective model for facilitating Indigenousaccess both to cancer treatment and to mainstream treatment for a variety of healthproblems. Future research is required to explore the applicability of Indigenoussupport groups and to focus on the

Differences in primary health care delivery to Australia’s Indigenous population: a template for use in economic evaluations

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Ong Katherine S

2012-09-01

Full Text Available Abstract Background Health economics is increasingly used to inform resource allocation decision-making, however, there is comparatively little evidence relevant to minority groups. In part, this is due to lack of cost and effectiveness data specific to these groups upon which economic evaluations can be based. Consequently, resource allocation decisions often rely on mainstream evidence which may not be representative, resulting in inequitable funding decisions. This paper describes a method to overcome this deficiency for Australia’s Indigenous population. A template has been developed which can adapt mainstream health intervention data to the Indigenous setting. Methods The ‘Indigenous Health Service Delivery Template’ has been constructed using mixed methods, which include literature review, stakeholder discussions and key informant interviews. The template quantifies the differences in intervention delivery between best practice primary health care for the Indigenous population via Aboriginal Community Controlled Health Services (ACCHSs, and mainstream general practitioner (GP practices. Differences in costs and outcomes have been identified, measured and valued. This template can then be used to adapt mainstream health intervention data to allow its economic evaluation as if delivered from an ACCHS. Results The template indicates that more resources are required in the delivery of health interventions via ACCHSs, due to their comprehensive nature. As a result, the costs of such interventions are greater, however this is accompanied by greater benefits due to improved health service access. In the example case of the polypill intervention, 58% more costs were involved in delivery via ACCHSs, with 50% more benefits. Cost-effectiveness ratios were also altered accordingly. Conclusions The Indigenous Health Service Delivery Template reveals significant differences in the way health interventions are delivered from ACCHSs compared to

[Differences in mortality between indigenous and non-indigenous persons in Brazil based on the 2010 Population Census].

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Campos, Marden Barbosa de; Borges, Gabriel Mendes; Queiroz, Bernardo Lanza; Santos, Ricardo Ventura

2017-06-12

There have been no previous estimates on differences in adult or overall mortality in indigenous peoples in Brazil, although such indicators are extremely important for reducing social iniquities in health in this population segment. Brazil has made significant strides in recent decades to fill the gaps in data on indigenous peoples in the national statistics. The aim of this paper is to present estimated mortality rates for indigenous and non-indigenous persons in different age groups, based on data from the 2010 Population Census. The estimates used the question on deaths from specific household surveys. The results indicate important differences in mortality rates between indigenous and non-indigenous persons in all the selected age groups and in both sexes. These differences are more pronounced in childhood, especially in girls. The indicators corroborate the fact that indigenous peoples in Brazil are in a situation of extreme vulnerability in terms of their health, based on these unprecedented estimates of the size of these differences.

Morbidity and mortality disparities among colonist and indigenous populations in the Ecuadorian Amazon.

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Kuang-Yao Pan, William; Erlien, Christine; Bilsborrow, Richard E

2010-02-01

Rural populations living in the northern Ecuadorian Amazon (NEA) experience the highest health burden of any region in the country. Two independent studies of colonist and indigenous groups living in the NEA are used to compare their morbidity and mortality experiences. Colonist data are from a probability sample of land plots in 1999, while indigenous data are from a representative sample of the five largest ethnicities (Quichua, Shuar, Huaorani, Cofan, Secoya) collected in 2001. Poisson regression was used to compare morbidity. Results indicate clear differences in health between populations. Indigenous groups had 30% higher probability of mortality and 63% higher incidence rate of all-cause morbidity compared to colonists. Vector-borne, chronic, gastrointestinal, and diseases of unknown origin were particularly high among indigenous groups. Factors associated with morbidity varied: morbidity rates were similar for the two youngest age groups (0-4 and 5-9), but indigenous people aged 15-39 and 40+ had almost double the morbidity compared to colonists; larger households, later months of data collection and less pollution were associated with less morbidity in both groups; better infrastructure access (electricity and roads) was generally associated with lower morbidity in both groups; and associations of land use were different by group with more cultivation of perennials and fewer annuals associated with less morbidity for colonists, but more for indigenous groups. These results demonstrate the health disparities that exist among indigenous and non-indigenous populations even when living in the same geographic region. Land use itself exemplifies the cultural and contextual differences that are evident in health, since land use decisions are related to broader demographic and economic factors that influence overall ecological and human health. Ongoing population-environment and/or environment-health research needs to recognize the broader factors involved when

Diagnosis and treatment for vulvar cancer for indigenous women from East Arnhem Land, Northern Territory: bioethical reflections.

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McGrath, Pam; Rawson, Nicole; Adidi, Leonora

2015-06-01

This paper explores the bioethical issues associated with the diagnosis and treatment of vulvar cancer for Indigenous women in East Arnhem Land, Northern Territory, Australia. Based on a qualitative study of a vulvar cancer cluster of Indigenous women, the article highlights four main topics of bioethical concern drawn from the findings: informed consent, removal of body parts, pain management, and issues at the interface of Indigenous and Western health care. The article seeks to make a contribution towards Indigenous health and bioethics and bring to light areas of further research.

Indigenizing CBPR: evaluation of a community-based and participatory research process implementation of the Elluam Tungiinun (towards wellness) program in Alaska.

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Rasmus, Stacy M

2014-09-01

The process that community based participatory research (CBPR) implementation takes in indigenous community contexts has serious implications for health intervention outcomes and sustainability. An evaluation of the Elluam Tungiinun (Towards Wellness) Project aimed to explore the experience of a Yup'ik Alaska Native community engaged within a CBPR process and describe the effects of CBPR process implementation from an indigenous community member perspective. CBPR is acknowledged as an effective strategy for engaging American Indian and Alaska Native communities in research process, but we still know very little about the experience from a local, community member perspective. What are the perceived outcomes of participation in CBPR from a local, community member perspective? Qualitative methods were used to elicit community member perspectives of participation in a CBPR process engaged with one Yup'ik community in southwest Alaska. Results focus on community member perceptions of CBPR implementation, involvement in the process and partnership, ownership of the project with outcomes observed and perceived at the community, family and individual levels, and challenges. A discussion of findings demonstrates how ownership of the intervention arose from a translational and indigenizing process initiated by the community that was supported and enhanced through the implementation of CBPR. Community member perspectives of their participation in the research reveal important process points that stand to contribute meaningfully to implementation science for interventions developed by and for indigenous and other minority and culturally diverse peoples.

Smoking behaviour and preferences for cessation support among clients of an Indigenous community-controlled health service.

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Cockburn, Nicole; Gartner, Coral; Ford, Pauline J

2018-03-02

Reducing smoking prevalence among Indigenous Australians is a vital part of closing the health gap between Indigenous and non-Indigenous Australians. Community-controlled health clinics are an important setting for delivering smoking cessation advice and assistance. This study measured tobacco and e-cigarette use, knowledge of smoking-related health effects, motivations to quit and interest in cessation aids. Clients of Aboriginal & Torres Strait Islander Community Health Service dental clinics in Southeast Queensland (n = 421) completed a brief written questionnaire while in the waiting room. Nearly half (n = 184, 47%) of the participants currently smoked daily, of which 9% (n = 7) currently used e-cigarettes. Few smokers (8%, n = 13) had no intention to quit smoking. For current smokers, previously used quit methods were abrupt cessation (42%, n = 78), nicotine replacement therapies (NRT; 25%, n = 45), prescription medications (23%, n = 43), e-cigarettes (9%, n = 17) and other methods (3%, n = 6). Current smokers were most interested in cutting down (85%, n = 110), abrupt cessation (75%, n = 98) and free NRT (72%, n = 101). Fewer (34%, n = 36) were interested in purchasing NRT for smoking cessation. Our study found there was interest in accessing smoking cessation aids among the clients of this community-controlled health clinic, particularly if provided free of charge. Embedding smoking cessation advice and assistance into a range of community-controlled health clinics could provide opportunities for addressing the high smoking prevalence among Indigenous Australians. © 2018 Australasian Professional Society on Alcohol and other Drugs.

'Sometimes they run away, that's how scared they feel': the peadiatric hospitalisation experiences of Indigenous families from remote areas of Australia.

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Tanner, Laura; Agius, Kendall; Darbyshire, Philip

Hospitalisation can be a traumatic experience for any child and family but the experience can be significantly more so for Indigenous parents and children from remote areas of Australia. Despite the importance of this issue for child and family health and for Indigenous health, the hospitalisation experiences of Indigenous families and children have received almost no research attention. This paper describes selected findings from a recently completed Honours research study which used the participatory and collaborative Indigenous research approach of Dadirri to explore this question. Following a brief description of the methodology of Dadirri, the paper presents the participating families' depictions of their experiences of 'Coming Down' and 'Being in Hospital', where they revealed the extent and effects of marked culture shock. The significant cultural differences between staff and Indigenous families contributed to the parents' sense of fear, powerlessness and isolation from their child, home community and culture. For these families this isolation was not merely geographic but intricately linked to their health and wellbeing.

Acculturation and self-rated health among Arctic indigenous peoples: a population-based cross-sectional study

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Eliassen Bent-Martin

2012-11-01

Full Text Available Abstract Background Acculturation is for indigenous peoples related to the process of colonisation over centuries as well as the on-going social transition experienced in the Arctic today. Changing living conditions and lifestyle affect health in numerous ways in Arctic indigenous populations. Self-rated health (SRH is a relevant variable in primary health care and in general public health assessments and monitoring. Exploring the relationship between acculturation and SRH in indigenous populations having experienced great societal and cultural change is thus of great importance. Methods The principal method in the Survey of Living Conditions in the Arctic (SLiCA was standardised face-to-face interviews using a questionnaire. Very high overall participation rates of 83% were obtained in Greenland and Alaska, whilst a more conventional rate of 57% was achieved in Norway. Acculturation was conceptualised as certain traditional subsistence activities being of lesser importance for people’s ethnic identity, and poorer spoken indigenous language ability (SILA. Acculturation was included in six separate gender- and country-specific ordinal logistic regressions to assess qualitative effects on SRH. Results Multivariable analyses showed that acculturation significantly predicted poorer SRH in Greenland. An increased subsistence score gave an OR of 2.32 (P Conclusions This study shows that aggregate acculturation is a strong risk factor for poorer SRH among the Kalaallit of Greenland and female Iñupiat of Alaska, but our cross-sectional study design does not allow any conclusion with regard to causality. Limitations with regard to wording, categorisations, assumed cultural differences in the conceptualisation of SRH, and confounding effects of health care use, SES and discrimination, make it difficult to appropriately assess how strong this effect is though.

A review of protective factors and causal mechanisms that enhance the mental health of Indigenous Circumpolar youth

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Joanna Petrasek MacDonald

2013-12-01

Full Text Available Objectives . To review the protective factors and causal mechanisms which promote and enhance Indigenous youth mental health in the Circumpolar North. Study design . A systematic literature review of peer-reviewed English-language research was conducted to systematically examine the protective factors and causal mechanisms which promote and enhance Indigenous youth mental health in the Circumpolar North. Methods . This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines, with elements of a realist review. From 160 records identified in the initial search of 3 databases, 15 met the inclusion criteria and were retained for full review. Data were extracted using a codebook to organize and synthesize relevant information from the articles. Results . More than 40 protective factors at the individual, family, and community levels were identified as enhancing Indigenous youth mental health. These included practicing and holding traditional knowledge and skills, the desire to be useful and to contribute meaningfully to one's community, having positive role models, and believing in one's self. Broadly, protective factors at the family and community levels were identified as positively creating and impacting one's social environment, which interacts with factors at the individual level to enhance resilience. An emphasis on the roles of cultural and land-based activities, history, and language, as well as on the importance of social and family supports, also emerged throughout the literature. Conclusions . Healthy communities and families foster and support youth who are resilient to mental health challenges and able to adapt and cope with multiple stressors, be they social, economic, or environmental. Creating opportunities and environments where youth can successfully navigate challenges and enhance their resilience can in turn contribute to fostering healthy Circumpolar communities. Looking at the

Implementing Indigenous community control in health care: lessons from Canada.

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Lavoie, Josée G; Dwyer, Judith

2016-09-01

Objective Over past decades, Australian and Canadian Indigenous primary healthcare policies have focused on supporting community controlled Indigenous health organisations. After more than 20 years of sustained effort, over 89% of eligible communities in Canada are currently engaged in the planning, management and provision of community controlled health services. In Australia, policy commitment to community control has also been in place for more than 25 years, but implementation has been complicated by unrealistic timelines, underdeveloped change management processes, inflexible funding agreements and distrust. This paper discusses the lessons from the Canadian experience to inform the continuing efforts to achieve the implementation of community control in Australia. Methods We reviewed Canadian policy and evaluation grey literature documents, and assessed lessons and recommendations for relevance to the Australian context. Results Our analysis yielded three broad lessons. First, implementing community control takes time. It took Canada 20 years to achieve 89% implementation. To succeed, Australia will need to make a firm long term commitment to this objective. Second, implementing community control is complex. Communities require adequate resources to support change management. And third, accountability frameworks must be tailored to the Indigenous primary health care context to be meaningful. Conclusions We conclude that although the Canadian experience is based on a different context, the processes and tools created to implement community control in Canada can help inform the Australian context. What is known about the topic? Although Australia has promoted Indigenous control over primary healthcare (PHC) services, implementation remains incomplete. Enduring barriers to the transfer of PHC services to community control have not been addressed in the largely sporadic attention to this challenge to date, despite significant recent efforts in some jurisdictions

Evaluation of strategies designed to enhance student engagement and success of indigenous midwifery students in an Away-From-Base Bachelor of Midwifery Program in Australia: A qualitative research study.

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Schulz, Paula M; Dunne, Carmel L; Burdett-Jones, Denise; Gamble, Natalie S; Kosiak, Machellee M; Neal, Joclyn M; Baker, Gail E

2018-04-01

A strategy to close the gap in relation to Indigenous health is the employment of more Indigenous health professionals. However, despite government reviews, research studies and educational initiatives, Indigenous students' retention and completion rates of tertiary education remains below those of non-Indigenous Australians. To evaluate two enhancements to an Away-from-Base Bachelor of Midwifery program for Indigenous students, namely the appointment of an Indigenous Academic Liaison Midwife to provide academic and cultural support and an additional clinical placement in a high-volume tertiary hospital. In this qualitative study, 10 Indigenous students enrolled in the Away-from-Base Bachelor of Midwifery program participated in one of two focus groups. Focus group transcriptions were subjected to a manual thematic analysis, and key themes were identified and explored. The role of the Indigenous Academic Liaison Midwife was highly valued as students had access to a resource who provided cultural and academic support, and who encouraged and advocated for them. Regular contact with the Indigenous Academic Liaison Midwife enabled students to stay connected with and focussed on their study. Students were overwhelmingly positive about the opportunity to undertake the additional clinical placement, as it exposed them to complex clinical cases they may not have seen in their home communities. The introduction of an Indigenous Academic Liaison Midwife and an additional clinical placement in a high-volume tertiary hospital were perceived as valuable additions to the range of support mechanisms already in place for Indigenous Away-from-Base Bachelor of Midwifery students. These interventions have had a direct impact on retention, course progression and completion rates for Indigenous students. Students expressed enhanced clinical learning and knowledge retention as a result of the additional clinical placement, and the Indigenous Academic Liaison Midwife provided culturally

The health impact of tourism on local and indigenous populations in resource-poor countries.

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Bauer, Irmgard

2008-09-01

In the vast Travel Health literature there is still a considerable dearth on tourism's impact on local communities. This review attempts to remedy the situation. Its focus is on potential health impacts on populations living at tourist destinations outside the industrialised world. To facilitate a better understanding of how health is linked to tourism today, a brief overview of the historical and theoretical evolution of tourism is presented. Ecotourism is given special attention as it is perceived as a version of the industry that is more benign on environment and people. After discussing Indigenous Tourism, a variety of potential health implications is outlined. These follow a previously suggested classification of indirect and direct impacts, with the indirect impacts being based on economic, environmental, socio-cultural and, more recently, political impacts, and the direct impacts originating from immediate encounters between tourism and people. Finally, the urgent need for more research is highlighted, and some solutions to minimize health impact are suggested.

Changes in Area-level Socioeconomic Status and Oral Health of Indigenous Australian Children.

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Ha, Diep H; Do, Loc G; Luzzi, Liana; Mejia, Gloria C; Jamieson, Lisa

2016-01-01

Dental diseases have shown to be influenced by area-level socioeconomic status. This study aims to assess the effects of change in area-level SES on the oral health of Australian Indigenous children. Data were collected from a national surveillance survey for children's dental health at two points of time (2000-2002/2007-2010). The study examines caries experienced by area-level SES and whether changes in area-level SES (stable-high, upwardly-mobile, downwardly-mobile and stable low) affects caries experience. Dental caries in both the deciduous and permanent dentition increased significantly among Indigenous children during the study period. In stable low-SES areas, the experience of decayed, missing and overall dmft/DMFT in both dentitions was highest compared with other groups at both Time 1(2.15 vs 1.61, 1.77, 1.87 and 0.86 vs 0.55, 0.67, 0.70 respectively) and Time 2 (3.23 vs 2.08, 2.17, 2.02 and 1.49 vs 1.18, 1.21 respectively). A change in area-level SES was associated with experience of dental disease among Indigenous Australian children.

Assessing service use for mental health by Indigenous populations in Australia, Canada, New Zealand and the United States of America: a rapid review of population surveys.

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McIntyre, Cecily; Harris, Meredith G; Baxter, Amanda J; Leske, Stuart; Diminic, Sandra; Gone, Joseph P; Hunter, Ernest; Whiteford, Harvey

2017-08-04

Indigenous people in Australia, Canada, New Zealand and the United States of America experience disproportionately poor mental health compared to their non-Indigenous counterparts. To optimally allocate resources, health planners require information about the services Indigenous people use for mental health, their unmet treatment needs and the barriers to care. We reviewed population surveys of Indigenous people to determine whether the information needed to guide service development is being collected. We sought national- or state-level epidemiological surveys of Indigenous populations conducted in each of the four selected countries since 1990 that asked about service use for mental health. Surveys were identified from literature reviews and web searches. We developed a framework for categorising the content of each survey. Using this framework, we compared the service use content of the surveys of Indigenous people to each other and to general population mental health surveys. We focused on identifying gaps in information coverage and topics that may require Indigenous-specific questions or response options. Nine surveys met our inclusion criteria. More than half of these included questions about health professionals consulted, barriers to care, perceived need for care, medications taken, number, duration, location and payment of health professional visits or use of support services or self-management. Less than half included questions about interventions received, hospital admissions or treatment dropout. Indigenous-specific content was most common in questions regarding use of support services or self-management, types of health professionals consulted, barriers to care and interventions received. Epidemiological surveys measuring service use for mental health among Indigenous populations have been less comprehensive and less standardised than surveys of the general population, despite having assessed similar content. To better understand the gaps in mental

Social media and digital technology use among Indigenous young people in Australia: a literature review.

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Rice, Emma S; Haynes, Emma; Royce, Paul; Thompson, Sandra C

2016-05-25

use of social media invites its further use, including in arenas where this group may not usually participate, such as in research. Future research could examine ways to minimise the misuse of social media while maximising its positive potential in the lives of Indigenous young people. Future research should also focus on the positive application of social media and showing evidence in health promotion interventions in order to reduce health inequities between Indigenous and non-Indigenous young people.

Lost in Maps: Regionalization and Indigenous Health Services.

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Lavoie, Josée G; Kornelsen, Derek; Boyer, Yvonne; Wylie, Lloy

The settlement of the land now known as Canada meant the erasure - sometimes from ignorance, often purposeful - of Indigenous place-names, and understandings of territory and associated obligations. The Canadian map with its three territories and ten provinces, electoral boundaries and districts, reflects boundaries that continue to fragment Indigenous nations and traditional lands. Each fragment adds institutional requirements and organizational complexities that Indigenous nations must engage with when attempting to realize the benefits taken for granted under the Canadian social contract.

Indigenous Peoples' food systems, nutrition, and gender: Conceptual and methodological considerations.

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Lemke, Stefanie; Delormier, Treena

2017-11-01

Indigenous Peoples, especially women and children, are affected disproportionately by malnutrition and diet-related health problems. Addressing this requires an investigation of the structural conditions that underlie unequal access to resources and loss of traditional lifestyles and necessitates inclusive approaches that shed light onto these issues and provide strategies to leverage change. Indigenous Peoples' food systems are inextricably connected to land, which in turn is interwoven with issues of self-determination, livelihoods, health, cultural and spiritual heritage, and gender. Ongoing loss of land and the dominant agri-food model further threaten Indigenous Peoples' food systems. Continuing gender-based discrimination undermines the self-determination and rights of women and negatively impacts their health, nutritional status, and overall well-being, as well as the well-being of households and communities. We suggest that feminist political ecology and modern matriarchal studies provide holistic interlinking frameworks for investigating underlying issues of power and inequality. We further argue that a focus on the principles of respect, responsibility, and relationships, and an openness to different worldviews, can facilitate a bridging of Indigenous and Western approaches in research and community action conducted in partnership with Indigenous Peoples. This can contribute to creating new ways of knowing regarding Indigenous Peoples' food systems, equally valuing both knowledge systems. Indigenous Peoples' rights, right to food, and food sovereignty are frames that, despite some tensions, have the common goal of self-determination. Through their ability to inform, empower, and mobilize, they provide tools for social movements and communities to challenge existing structural inequalities and leverage social change. © 2018 John Wiley & Sons Ltd.

Review of health research on indigenous populations in Latin America, 1995-2004 Revisión de la investigación en salud en poblaciones indígenas de Latinoamérica, 1995-2004

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Miguel San Sebastián

2007-08-01

Full Text Available OBJECTIVE: To review health research conducted among indigenous populations in Latin America during the period 1995-2004. Material and methods. The search strategy was purposely broad to ensure the identification of all relevant studies indexed in the PubMed and Lilacs databases. RESULTS: Six-hundred ninety citations were included. One hundred fifty-nine (23.0% papers dealt with indigenous populations in Central America and 509 (73.8% papers with South American populations. Three hundred two (43.8% of the studies were quantitative, 39 (5.7% qualitative, 259 (37.5% mainly based on laboratory work and 24 (3.5% dealt with policy analyses. The most common researched theme was human biology with 200 (29.0 % papers, followed by communicable diseases (150 papers, 21.7 %. CONCLUSIONS: There is a special need for policy studies in the field of indigenous health. An increased commitment to resources and capacity building will be the real challenge for indigenous health research in the nearest future.OBJETIVO: Revisar la investigación en salud realizada en poblaciones indígenas de Latinoamérica, de 1995 a 2004. MATERIAL Y MÉTODOS: La estrategia de búsqueda fue amplia para asegurar la identificación de todos aquellos estudios relevantes catalogados en las bases de datos PubMed y Lilacs. RESULTADOS: Se incluyeron 690 citaciones; de ellas, 509 (73.8% artículos trataron sobre poblaciones indígenas sudamericanas y 159 (23.0% sobre poblaciones indígenas de Centroamérica. Trescientos dos (43.8% de los estudios fueron cuantitativos, 39 (5.7% cualitativos, 259 (37.5% basados principalmente en trabajo de laboratorio y 24 (3.5% trataron sobre análisis de políticas de salud. El tema de investigación más estudiado fue el de biología humana con 200 artículos (29.0%, seguido de enfermedades transmisibles (150 artículos, 21.7%. CONCLUSIONES: Existe una necesidad especial de estudios de políticas de salud en el campo de la salud indígena. Un mayor

The work process and care production in a Brazilian indigenous health service

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Aridiane Alves Ribeiro

2017-09-01

Full Text Available Abstract Objective: To understand the constitutive elements of the work process and care production in an Indigenous Health Support Service. Methods: Case study. Systematic observation and semi-structured interviews were conducted in January and February of 2012. The participants were 10 nursing professionals of an Indigenous Health Support Center, located in Mato Grosso do Sul state, Brazil. The work process was used as a conceptual and analytical category. Results: Through interpretative analysis, the data were organized into three categories. The results showed that care production was focused on procedures and guided by rigid institutional rules and bureaucracy. The prioritization of institutional rules and procedures was detrimental to the provision of person-centered care. Conclusion: The temporary employment contracts and rigid bureaucratic organization generated a tense work environment. These aspects do not maximize the efforts of the nursing staff to provide person-centered care.

[Health and gender relations: a reflection on the challenges for the implementation of public policies for health care for indigenous women].

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Ferreira, Luciane Ouriques

2013-04-01

This article presents some contrasts that exist between the discourses of public policies concerning women's health care, especially with respect to indigenous women, and the ethnological discourse which emphasizes the specificity of gender relations within indigenous societies. We worked on the assumption that the development of these public policies as well as the organization of health care services offered, which in fact are necessary, have a transforming effect on prevailing gender relations within Amerindian Societies. On the one hand, gender relations between indigenous people are associated with the domains of kinship and corporeality. On the other hand, the process of creating public policies, by means of biomedical intervention and the medicalization of the female body, constitutes a powerful tool for body modeling and the construction of subjectivities contributing to making women worthy of citizenship. The female gender is under discussion and its content is being negotiated.

Mapping Point-of-Purchase Influencers of Food Choice in Australian Remote Indigenous Communities

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Joanna Henryks

2016-02-01

Full Text Available Closing the health gap between Indigenous and non-Indigenous Australians relies, in part, on addressing the poor levels of nutrition in remote Indigenous communities (RIC. This article identifies and maps key influencers of food choice at the point-of-purchase (POP in Australian RIC and identifies gaps in our knowledge. It is based on a narrative review of the literature pertaining to food in RIC from a range of disciplinary perspectives including nutrition, ethnography, public health, anthropology, and remote health to map POP drivers of food choice. In particular, the role of habit is identified as a key factor that has previously not been discussed in the literature. The conceptual framework can be used as a basis for future POP research in RIC and provides guidance for social marketers, public health, nutrition, and policy workers operating in this field.

Discourses of culture and illness in South African mental health care and indigenous healing, Part I: Western psychiatric power.

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Yen, Jeffery; Wilbraham, Lindy

2003-12-01

This discourse analytic study explores constructions of culture and illness in the talk of psychiatrists, psychologists and indigenous healers as they discuss possibilities for collaboration in South African mental health care. Versions of 'culture', and disputes over what constitutes 'disorder', are an important site for the negotiation of power relations between mental health practitioners and indigenous healers. The results of this study are presented in two parts. Part I explores discourses about western psychiatric/psychological professionalism, tensions in diagnosis between cultural relativism and psychiatric universalism, and how assertion of 'cultural differences' may be used to resist psychiatric power. Part II explores how discursive constructions of 'African culture' and 'African madness' work to marginalize indigenous healing in South African mental health care, despite repeated calls for collaboration.

The possible worlds of global health research: An ethics-focused discourse analysis.

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Brisbois, Ben; Plamondon, Katrina

2018-01-01

Representations of the world enable global health research (GHR), discursively constructing sites in which studies can legitimately take place. Depoliticized portrayals of the global South frequently obscure messy legacies of colonialism and motivate technical responses to health problems with political and economic root causes. Such problematic representations of the world have not yet been rigorously examined in relation to global health ethics, a major site of scholarly effort towards GHR that promotes justice and fairness. We carried out a discourse analysis of four guidance documents relevant to the ethical practice of GHR, purposively selecting texts covering different genres (UN documents and journal articles) and prominent GHR foci (HIV and clinical trials). In light of increasing acknowledgement of the lessons Indigenous health scholarship holds for global health ethics, the four analyzed texts also included a set of principles developed to support Indigenous nation-building. Three of four documents featured global disparities as reasons for ethical caution. These inequalities appeared without explanation or causes, with generation of new scientific knowledge following as a logical response to such disparities. The fourth - Indigenous health-focused - document clearly identified 'colonialism' as a reason for both inequities in society, and related harmful research practices. Solutions to disparities in this text did not necessarily involve cutting-edge research, but focused instead on empowerment and responsiveness to community priorities and needs. These contrasting representations of the world were accomplished in ways that depended on texts' 'participants', or the people they represented; specific vocabularies or language usages; intertextual relationships to prior texts; and overall objectives or intentions of the author(s). Our results illustrate how ethics and other guidance documents serve as an important terrain for constructing, naturalizing or

ATTENTION OF CHILDBIRTH, RURAL-URBAN MIGRATION AND PUBLIC POLITICS OF REPRODUCTIVE HEALTH IN INDIGENOUS POPULATION OF CHIAPAS

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Austreberta Nazar Beutelspacher, Benito Salvatierra Izaba y Emma Zapata Martelo

2007-12-01

Full Text Available In this paper it’s analyze the tendencies of childbirth attention of urban indigenous women excluded in Chiapas, from rural settlement in Los Altos de Chiapas. It’s an exploratory essay which contributes to clear up the relation that establishes immigrant indigenous population with institutional health services for childbirth attention and modifications in traditional medicine. Are discussed the scopes of these changes in the operation of the institutional program of reproductive health and the risk of mother death.

Burden of tuberculosis in indigenous peoples globally: a systematic review.

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Tollefson, D; Bloss, E; Fanning, A; Redd, J T; Barker, K; McCray, E

2013-09-01

The burden of tuberculosis (TB) in the estimated 370 million indigenous peoples worldwide is unknown. To conduct a literature review to summarize the TB burden in indigenous peoples, identify gaps in current knowledge, and provide the foundation for a research agenda prioritizing indigenous health within TB control. A systematic literature review identified articles published between January 1990 and November 2011 quantifying TB disease burden in indigenous populations worldwide. Among the 91 articles from 19 countries included in the review, only 56 were from outside Australia, Canada, New Zealand and the United States. The majority of the studies showed higher TB rates among indigenous groups than non-indigenous groups. Studies from the Amazon generally reported the highest TB prevalence and incidence, but select populations from South-East Asia and Africa were found to have similarly high rates of TB. In North America, the Inuit had the highest reported TB incidence (156/100000), whereas the Metis of Canada and American Indians/Alaska Natives experienced rates of indigenous groups. Where data exist, indigenous peoples were generally found to have higher rates of TB disease than non-indigenous peoples; however, this burden varied greatly. The paucity of published information on TB burden among indigenous peoples highlights the need to implement and improve TB surveillance to better measure and understand global disparities in TB rates.

The "ripple effect": Health and community perceptions of the Indigenous Marathon Program on Thursday Island in the Torres Strait, Australia.

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Macniven, Rona; Plater, Suzanne; Canuto, Karla; Dickson, Michelle; Gwynn, Josephine; Bauman, Adrian; Richards, Justin

2018-02-19

Physical inactivity is a key health risk among Aboriginal and Torres Strait Islander (Indigenous) Australians. We examined perceptions of the Indigenous Marathon Program (IMP) in a remote Torres Strait island community. Semi-structured interviews with community and program stakeholders (n = 18; 14 Indigenous) examined barriers and enablers to running and the influence of the IMP on the community. A questionnaire asked 104 running event participants (n = 42 Indigenous) about their physical activity behaviours, running motivation and perceptions of program impact. Qualitative data were analysed using thematic content analysis, and quantitative data were analysed using descriptive statistics. Interviews revealed six main themes: community readiness, changing social norms to adopt healthy lifestyles, importance of social support, program appeal to hard-to-reach population groups, program sustainability and initiation of broader healthy lifestyle ripple effects beyond running. Barriers to running in the community were personal (cultural attitudes; shyness) and environmental (infrastructure; weather; dogs). Enablers reflected potential strategies to overcome described barriers. Indigenous questionnaire respondents were more likely to report being inspired to run by IMP runners than non-Indigenous respondents. Positive "ripple" effects of the IMP on running and broader health were described to have occurred through local role modelling of healthy lifestyles by IMP runners that reduced levels of "shame" and embarrassment, a common barrier to physical activity among Indigenous Australians. A high initial level of community readiness for behaviour change was also reported. SO WHAT?: Strategies to overcome this "shame" factor and community readiness measurement should be incorporated into the design of future Indigenous physical activity programs. © 2018 Australian Health Promotion Association.

A community-based mixed methods approach to developing behavioural health interventions among indigenous adolescent populations

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Tingey, L.L.

2016-01-01

Native American and indigenous populations experience the greatest behavioural health disparities in the world. A constellation of factors impacting Native American Tribes contributes to high rates and co-morbidity of mental health disorders, substance use and sexually transmitted infection (STI),

Risk factors, incidence, consequences and prevention strategies for falls and fall-injury within older indigenous populations: a systematic review.

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Lukaszyk, Caroline; Harvey, Lara; Sherrington, Cathie; Keay, Lisa; Tiedemann, Anne; Coombes, Julieann; Clemson, Lindy; Ivers, Rebecca

2016-12-01

To examine the risk factors, incidence, consequences and existing prevention strategies for falls and fall-related injury in older indigenous people. Relevant literature was identified through searching 14 electronic databases, a range of institutional websites, online search engines and government databases, using search terms pertaining to indigenous status, injury and ageing. Thirteen studies from Australia, the United States, Central America and Canada were identified. Few studies reported on fall rates but two reported that around 30% of indigenous people aged 45 years and above experienced at least one fall during the past year. The most common hospitalised fall injuries among older indigenous people were hip fracture and head injury. Risk factors significantly associated with falls within indigenous populations included poor mobility, a history of stroke, epilepsy, head injury, poor hearing and urinary incontinence. No formally evaluated, indigenous-specific fall prevention interventions were identified. Falls are a significant and growing health issue for older indigenous people worldwide that can lead to severe health consequences and even death. No fully-evaluated, indigenous-specific fall prevention programs were identified. Implications for Public Health: Research into fall patterns and fall-related injury among indigenous people is necessary for the development of appropriate fall prevention interventions. © 2016 Public Health Association of Australia.

35 years of ICCH: evolution or stagnation of circumpolar health research?

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Bjerregaard, P; Young, T K; Curtis, T

2004-01-01

congress in 2003 and found a shift of focus from biology to sociology of health. Today, circumpolar health research is primarily focused on three major topics: 1. epidemiology of indigenous peoples of the North; 2. health care delivery in the North; and 3. the effect of physical factors on human physiology......The first Circumpolar Health symposium took place in Fairbanks in 1967. Approximately every three years since, an increasing number of researchers have met to present and discuss the health conditions of the North. We analysed the proceedings from the 11 congresses and the abstracts from the 12th...... and health. Despite the diverse research interests, it is remarkable how a community of circumpolar scientists and practitioners has emerged over the past 35 years....

More than words: Using visual graphics for community-based health research.

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Morton Ninomiya, Melody E

2017-04-20

With increased attention to knowledge translation and community engagement in the applied health research field, many researchers aim to find effective ways of engaging health policy and decision makers and community stakeholders. While visual graphics such as graphs, charts, figures and photographs are common in scientific research dissemination, they are less common as a communication tool in research. In this commentary, I illustrate how and why visual graphics were created and used to facilitate dialogue and communication throughout all phases of a community-based health research study with a rural Indigenous community, advancing community engagement and knowledge utilization of a research study. I suggest that it is essential that researchers consider the use of visual graphics to accurately communicate and translate important health research concepts and content in accessible forms for diverse research stakeholders and target audiences.

Community-based health care for indigenous women in Mexico: a qualitative evaluation.

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Pelcastre-Villafuerte, Blanca; Ruiz, Myriam; Meneses, Sergio; Amaya, Claudia; Márquez, Margarita; Taboada, Arianna; Careaga, Katherine

2014-01-06

Indigenous women in Mexico represent a vulnerable population in which three kinds of discrimination converge (ethnicity, gender and class), having direct repercussions on health status. The discrimination and inequity in health care settings brought this population to the fore as a priority group for institutional action. The objective of this study was to evaluate the processes and performance of the "Casa de la Mujer Indígena", a community based project for culturally and linguistically appropriate service delivery for indigenous women. The evaluation summarizes perspectives from diverse stakeholders involved in the implementation of the model, including users, local authorities, and institutional representatives. The study covered five Casas implementation sites located in four Mexican states. A qualitative process evaluation focused on systematically analyzing the Casas project processes and performance was conducted using archival information and semi-structured interviews. Sixty-two interviews were conducted, and grounded theory approach was applied for data analysis. Few similarities were observed between the proposed model of service delivery and its implementation in diverse locations, signaling discordant operating processes. Evidence gathered from Casas personnel highlighted their ability to detect obstetric emergencies and domestic violence cases, as well as contribute to the empowerment of women in the indigenous communities served by the project. These themes directly translated to increases in the reporting of abuse and referrals for obstetric emergencies. The model's cultural and linguistic competency, and contributions to increased referrals for obstetric emergencies and abuse are notable successes. The flexibility and community-based nature of the model has allowed it to be adapted to the particularities of diverse indigenous contexts. Local, culturally appropriate implementation has been facilitated by the fact that the Casas have been

The burden of stomach cancer in indigenous populations: a systematic review and global assessment.

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Arnold, Melina; Moore, Suzanne P; Hassler, Sven; Ellison-Loschmann, Lis; Forman, David; Bray, Freddie

2014-01-01

Stomach cancer is a leading cause of cancer death, especially in developing countries. Incidence has been associated with poverty and is also reported to disproportionately affect indigenous peoples, many of whom live in poor socioeconomic circumstances and experience lower standards of health. In this comprehensive assessment, we explore the burden of stomach cancer among indigenous peoples globally. The literature was searched systematically for studies on stomach cancer incidence, mortality and survival in indigenous populations, including Indigenous Australians, Maori in New Zealand, indigenous peoples from the circumpolar region, native Americans and Alaska natives in the USA, and the Mapuche peoples in Chile. Data from the New Zealand Health Information Service and the Surveillance Epidemiology and End Results (SEER) Program were used to estimate trends in incidence. Elevated rates of stomach cancer incidence and mortality were found in almost all indigenous peoples relative to corresponding non-indigenous populations in the same regions or countries. This was particularly evident among Inuit residing in the circumpolar region (standardised incidence ratios (SIR) males: 3.9, females: 3.6) and in Maori (SIR males: 2.2, females: 3.2). Increasing trends in incidence were found for some groups. We found a higher burden of stomach cancer in indigenous populations globally, and rising incidence in some indigenous groups, in stark contrast to the decreasing global trends. This is of major public health concern requiring close surveillance and further research of potential risk factors. Given evidence that improving nutrition and housing sanitation, and Helicobacter pylori eradication programmes could reduce stomach cancer rates, policies which address these initiatives could reduce inequalities in stomach cancer burden for indigenous peoples.

A bibliometric review of drug and alcohol research focused on Indigenous peoples of Australia, New Zealand, Canada and the United States.

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Clifford, Anton; Shakeshaft, Anthony

2017-07-01

Indigenous peoples of Australia, New Zealand, Canada and the United States experience a disproportionately high burden of harms from substance misuse. Research is therefore required to improve our understanding of substance use in Indigenous populations and provide evidence on strategies effective for reducing harmful use. A search of 13 electronic databases for peer-reviewed articles published between 1993 and 2014 focusing on substance use and Indigenous peoples of Australia, New Zealand, Canada and the United States. Relevant abstracts were classified as data or non-data based research. Data-based studies were further classified as measurement, descriptive or intervention and their trends examined by country and drug type. Intervention studies were classified by type and their evaluation designs classified using the Cochrane Effective Practice and Organisation of Care (EPOC) data collection checklist. There was a statistically significant increase from 1993 to 2014 in the percentage of total publications that were data-based (P Indigenous drug and alcohol field are required. The dominance of descriptive research in the Indigenous drug and alcohol field is less than optimal for generating evidence to inform Indigenous drug and alcohol policy and programs. [Clifford A, Shakeshaft A. A bibliometric review of drug and alcohol research focused on Indigenous peoples of Australia, New Zealand, Canada and the United States. Drug Alcohol Rev 2017;36:509-522]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Intercultural health practices: towards an equal recognition between indigenous medicine and biomedicine? A case study from Chile.

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Torri, Maria Costanza

2012-03-01

Over the past few years, intercultural health has become an emerging issue in health policy. Intercultural health is an approach in health that aims at reducing the gap between indigenous and western health systems, on the basis of mutual respect and equal recognition of these knowledge systems. This article questions the applicability of such a concept in the context of Chile. Here, conflicting interests between the Mapuche and the Chilean state are related to aspects of economic development, modernity processes, integration, intercultural relations, and indigenous rights and are deeply reflected also in projects for an intercultural health system. By analysing the experience of the intercultural practice of Makewe Hospital, this article argues that effective and equitable intercultural health practices will not take place unless there will be an integral valorisation of the Mapuche culture from a broader perspective.

Measuring cancer in indigenous populations.

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Sarfati, Diana; Garvey, Gail; Robson, Bridget; Moore, Suzanne; Cunningham, Ruth; Withrow, Diana; Griffiths, Kalinda; Caron, Nadine R; Bray, Freddie

2018-05-01

It is estimated that there are 370 million indigenous peoples in 90 countries globally. Indigenous peoples generally face substantial disadvantage and poorer health status compared with nonindigenous peoples. Population-level cancer surveillance provides data to set priorities, inform policies, and monitor progress over time. Measuring the cancer burden of vulnerable subpopulations, particularly indigenous peoples, is problematic. There are a number of practical and methodological issues potentially resulting in substantial underestimation of cancer incidence and mortality rates, and biased survival rates, among indigenous peoples. This, in turn, may result in a deprioritization of cancer-related programs and policies among these populations. This commentary describes key issues relating to cancer surveillance among indigenous populations including 1) suboptimal identification of indigenous populations, 2) numerator-denominator bias, 3) problems with data linkage in survival analysis, and 4) statistical analytic considerations. We suggest solutions that can be implemented to strengthen the visibility of indigenous peoples around the world. These include acknowledgment of the central importance of full engagement of indigenous peoples with all data-related processes, encouraging the use of indigenous identifiers in national and regional data sets and mitigation and/or careful assessment of biases inherent in cancer surveillance methods for indigenous peoples. Copyright © 2018 Elsevier Inc. All rights reserved.

Supporting English Literacy and Numeracy Learning for Indigenous Students in the Early Years. ACER Research Monograph 57

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Frigo, Tracey; Corrigan, Matthew; Adams, Isabelle; Hughes, Paul; Stephens, Maria; Woods, Davina

2003-01-01

Despite some improvements over time, national statistics point to a continuing gap in the average English literacy and numeracy achievement of Australian indigenous students when compared with non-indigenous students. A longitudinal study by the Australian Council for Educational Research (ACER) has been monitoring growth in the English literacy…

Place of the indigenous and the western systems of medicine in the health services of India.

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Banerji, D

1979-01-01

The interrelationships of the indigenous (traditional and western (modern) systems of medicine are a function of the interplay of social, economic, and political forces in the community. In India, western medicine was used as a political weapon by the colonialists to strengthen the oppressing classes and to weaken the oppressed. Not only were the masses denied access to the western system of medicine, but this system contributed to the decay and degeneration of the preexisting indigenous systems. This western and privileged-class orientation of the health services has been actively perpetuated and promoted by the postcolonial leadership of India. The issue in formulating an alternative health care system for India is essentially that of rectifying the distortions which have been brought about by various forces. The basic premise for such an alternative will be to start with the people. Action in this field will lead to a more harmonious mix between the indigenous and western systems of medicine.

Differential Effects of Temperature Extremes on Hospital Admission Rates for Respiratory Disease between Indigenous and Non-Indigenous Australians in the Northern Territory

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Green, Donna; Bambrick, Hilary; Tait, Peter; Goldie, James; Schultz, Rosalie; Webb, Leanne; Alexander, Lisa; Pitman, Andrew

2015-01-01

The health gap between Indigenous and non-Indigenous Australians may be exacerbated by climate change if temperature extremes have disproportionate adverse effects on Indigenous people. To explore this issue, we analysed the effect of temperature extremes on hospital admissions for respiratory diseases, stratified by age, Indigenous status and sex, for people living in two different climates zones in the Northern Territory during the period 1993–2011. We examined admissions for both acute and chronic respiratory diagnoses, controlling for day of the week and seasonality variables. Our analysis showed that: (1) overall, Indigenous hospital admission rates far exceeded non-Indigenous admission rates for acute and chronic diagnoses, and Top End climate zone admission rates exceeded Central Australia climate zone admission rates; (2) extreme cold and hot temperatures were associated with inconsistent changes in admission rates for acute respiratory disease in Indigenous and non-Indigenous children and older adults; and (3) no response to cold or hot temperature extremes was found for chronic respiratory diagnoses. These findings support our two hypotheses, that extreme hot and cold temperatures have a different effect on hospitalisations for respiratory disease between Indigenous and non-Indigenous people, and that these health risks vary between the different climate zones. We did not, however, find that there were differing responses to temperature extremes in the two populations, suggesting that any increased vulnerability to climate change in the Indigenous population of the Northern Territory arises from an increased underlying risk to respiratory disease and an already greater existing health burden. PMID:26633456

Differential Effects of Temperature Extremes on Hospital Admission Rates for Respiratory Disease between Indigenous and Non-Indigenous Australians in the Northern Territory

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Donna Green

2015-12-01

Full Text Available The health gap between Indigenous and non-Indigenous Australians may be exacerbated by climate change if temperature extremes have disproportionate adverse effects on Indigenous people. To explore this issue, we analysed the effect of temperature extremes on hospital admissions for respiratory diseases, stratified by age, Indigenous status and sex, for people living in two different climates zones in the Northern Territory during the period 1993–2011. We examined admissions for both acute and chronic respiratory diagnoses, controlling for day of the week and seasonality variables. Our analysis showed that: (1 overall, Indigenous hospital admission rates far exceeded non-Indigenous admission rates for acute and chronic diagnoses, and Top End climate zone admission rates exceeded Central Australia climate zone admission rates; (2 extreme cold and hot temperatures were associated with inconsistent changes in admission rates for acute respiratory disease in Indigenous and non-Indigenous children and older adults; and (3 no response to cold or hot temperature extremes was found for chronic respiratory diagnoses. These findings support our two hypotheses, that extreme hot and cold temperatures have a different effect on hospitalisations for respiratory disease between Indigenous and non-Indigenous people, and that these health risks vary between the different climate zones. We did not, however, find that there were differing responses to temperature extremes in the two populations, suggesting that any increased vulnerability to climate change in the Indigenous population of the Northern Territory arises from an increased underlying risk to respiratory disease and an already greater existing health burden.

A review of protective factors and causal mechanisms that enhance the mental health of Indigenous Circumpolar youth.

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MacDonald, Joanna Petrasek; Ford, James D; Willox, Ashlee Cunsolo; Ross, Nancy A

2013-12-09

To review the protective factors and causal mechanisms which promote and enhance Indigenous youth mental health in the Circumpolar North. A systematic literature review of peer-reviewed English-language research was conducted to systematically examine the protective factors and causal mechanisms which promote and enhance Indigenous youth mental health in the Circumpolar North. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with elements of a realist review. From 160 records identified in the initial search of 3 databases, 15 met the inclusion criteria and were retained for full review. Data were extracted using a codebook to organize and synthesize relevant information from the articles. More than 40 protective factors at the individual, family, and community levels were identified as enhancing Indigenous youth mental health. These included practicing and holding traditional knowledge and skills, the desire to be useful and to contribute meaningfully to one's community, having positive role models, and believing in one's self. Broadly, protective factors at the family and community levels were identified as positively creating and impacting one's social environment, which interacts with factors at the individual level to enhance resilience. An emphasis on the roles of cultural and land-based activities, history, and language, as well as on the importance of social and family supports, also emerged throughout the literature. More than 40 protective factors at the individual, family, and community levels were identified as enhancing Indigenous youth mental health. These included practicing and holding traditional knowledge and skills, the desire to be useful and to contribute meaningfully to one's community, having positive role models, and believing in one's self. Broadly, protective factors at the family and community levels were identified as positively creating and impacting one's social

Article Commentary: Researching Prescription Drug Misuse among First Nations in Canada: Starting from a Health Promotion Framework

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Colleen Anne Dell

2012-01-01

Full Text Available The intentional misuse of psychotropic drugs is recognized as a significant public health concern in Canada, although there is a lack of empirical research detailing this. Even less research has been documented on the misuse of prescription drugs among First Nations in Canada. In the past, Western biomedical and individual-based approaches to researching Indigenous health have been applied, whereas First Nations’ understandings of health are founded on a holistic view of wellbeing. Recognition of this disjuncture, alongside the protective influence of First Nations traditional culture, is foundational to establishing an empirical understanding of and comprehensive response to prescription drug misuse. We propose health promotion as a framework from which to begin to explore this. Our work with a health promotion framework has conveyed its potential to support the consideration of Western and Indigenous worldviews together in an ‘ethical space’, with illustrations provided. Health promotion also allots for the consideration of Canada's colonial history of knowledge production in public health and supports First Nations’ self-determination. Based on this, we recommend three immediate ways in which a health promotion framework can advance research on prescription drug misuse among First Nations in Canada.

Strength-based well-being indicators for Indigenous children and families: A literature review of Indigenous communities' identified well-being indicators.

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Rountree, Jennifer; Smith, Addie

2016-01-01

Mainstream child and family well-being indicators frequently are based on measuring health, economic, and social deficits, and do not reflect Indigenous holistic and strength-based definitions of health and well-being. The present article is a review of literature that features Indigenous communities' self-identified strength-based indicators of child and family well-being. The literature search included Indigenous communities from across the world, incorporating findings from American Indians and Alaska Natives, First Nations, Native Hawaiians, Māori, Aboriginal Australians, and Sámi communities. Sorting the identified indicators into the quadrants of the Relational Worldview, an Indigenous framework for well-being based on medicine wheel teachings that views health and well-being as a balance among physical, mental, contextual, and spiritual factors, the authors discuss the findings.

Indigenous Policy Conference Summary Report: Beyond Reconciliation

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Sophie Lorefice

2017-10-01

Full Text Available The School of Public Policy (SPP at the University of Calgary organized a conference to announce the establishment of its Indigenous Policy program and to share knowledge and stories about policy issues critical to Indigenous Peoples in Canada. The conference, titled “Beyond Reconciliation,” was held at the University of Calgary Downtown Campus on Nov. 21, 2016 and was attended by 73 participants. This included Indigenous elders, chiefs and leaders, and members of Indigenous organizations, including a women’s group. Also included were members of universities and academic institutions, including students; industry representatives from the oil and gas, pipeline, forestry, electricity, legal and financial sectors; as well as representatives from government and regulatory agencies. The purpose of the conference was established with the following abstract, which was circulated to speakers and participants: The School of Public Policy is establishing a new Indigenous Policy program in order to produce widely disseminated research and engage in outreach that covers an array of policy areas, such as health, education, self-government, and natural resource development. The program will directly engage Indigenous communities in the search for original, long-term, and evidence-based solutions, as part of an effort to improve our national capacity in problem-solving and policy development. The conference will provide a platform to launch the program, showcasing preliminary research and providing a venue for discussion of policy solutions. The conference included three moderated panel sessions and a keynote speaker.1 The first panel considered business and entrepreneurship in Indigenous communities; the second panel showcased case studies that are examining the experiences of Indigenous communities with natural resource development projects, and particularly their experiences with consultation and engagement. The final panel focused on ways of

Maternal health issues and cardio-metabolic outcomes in the offspring: a focus on Indigenous populations.

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Wicklow, Brandy A; Sellers, Elizabeth A C

2015-01-01

Non-communicable diseases (NCDs) including diabetes, obesity and cardiovascular disease are the leading causes of death worldwide. Indigenous populations are disproportionally affected. In an effort to halt the increasing disease burden, the mechanisms underlying the increasing rate of NCDs are an important area of study. Recent evidence has focused on the perinatal period as an influential period impacting the future cardio-metabolic health of the offspring. This concept has been defined as metabolic foetal programming and supports the importance of the developmental origins of health and disease in research and clinical practice, specifically in prevention efforts to protect future generations from NCDs. An understanding of the underlying mechanisms involved is not clear as of yet. However, an understanding of these mechanisms is imperative in order to plan effective intervention strategies. As much of the discussion below is gleaned from large epidemiological studies and animal studies, further research with prospective cohorts is necessary. Copyright © 2014. Published by Elsevier Ltd.

Integrating the Self and the Spirit: Strategies for Aligning Qualitative Research Teaching with Indigenous Methods, Methodologies, and Epistemology

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Sarah K. Knudson

2015-07-01

Full Text Available Many universities internationally now make concerted efforts to promote curriculum development and classroom and campus cultures that recognize diversity in student viewpoints and life experiences. Increasingly, these efforts have involved promoting recognition and inclusion of indigenous knowledges in the university setting. If adopted in the classroom, the promotion of indigenous perspectives suggests exciting possibilities for teaching qualitative research critically. Existing educational resources, however, offer little guidance on achieving this through undergraduate qualitative methods teaching. Using examples of Canadian undergraduate teaching initiatives, I suggest that by integrating indigenous methods, perspectives, and epistemology, particularly through student opportunities for community-engaged learning and exposure to participatory action research, teaching qualitative research can promote critical recognition of multiple ways of knowing. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs150347

African Indigenous science in higher education in Uganda

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Akena Adyanga, Francis

This study examines African Indigenous Science (AIS) in higher education in Uganda. To achieve this, I use anticolonial theory and Indigenous knowledge discursive frameworks to situate the subjugation of Indigenous science from the education system within a colonial historical context. These theories allow for a critical examination of the intersection of power relations rooted in the politics of knowledge production, validation, and dissemination, and how this process has become a systemic and complex method of subjugating one knowledge system over the other. I also employ qualitative and autoethnographic research methodologies. Using a qualitative research method, I interviewed 10 students and 10 professors from two universities in Uganda. My research was guided by the following key questions: What is African Indigenous Science? What methodology would help us to indigenize science education in Uganda? How can we work with Indigenous knowledge and anticolonial theoretical discursive frameworks to understand and challenge the dominance of Eurocentric knowledge in mainstream education? My research findings revealed that AIS can be defined in multiple ways, in other words, there is no universal definition of AIS. However, there were some common elements that my participants talked about such as: (a) knowledge by Indigenous communities developed over a long period of time through a trial and error approach to respond to the social, economic and political challenges of their society. The science practices are generational and synergistic with other disciplines such as history, spirituality, sociology, anthropology, geography, and trade among others, (b) a cumulative practice of the use, interactions with and of biotic and abiotic organism in everyday life for the continued existence of a community in its' totality. The research findings also indicate that Indigenous science is largely lacking from Uganda's education curriculum because of the influence of colonial and

What keeps you strong? A systematic review identifying how primary health-care and aged-care services can support the well-being of older Indigenous peoples.

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Davy, Carol; Kite, Elaine; Aitken, Graham; Dodd, Garth; Rigney, Janice; Hayes, Jenny; Van Emden, Jan

2016-06-01

The objective of this systematic review was to identify primary health-care or aged-care strategies that have or could support the well-being of older Indigenous peoples. A search was undertaken of primary databases including Medical Literature Analysis and Retrieval System Online and Cumulative Index to Nursing and Allied Health Literature. Papers which reported on the perspectives of older Indigenous peoples, community members and provider participants were included. Findings were pooled using a meta-aggregative approach. Three high-level synthesised findings - maintaining Indigenous identity, promoting independence and delivering culturally safe care - were believed to be important for supporting the well-being of older Indigenous peoples. As physical independence often diminishes with age, having the support of culturally safe primary health-care and aged-care services that understand the importance of maintaining an Indigenous identity and promoting independence will be crucial for the well-being of older Indigenous peoples. © 2016 AJA Inc.

Indigenous well-being in four countries: An application of the UNDP'S Human Development Index to Indigenous Peoples in Australia, Canada, New Zealand, and the United States

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Guimond Eric

2007-12-01

Full Text Available Abstract Background Canada, the United States, Australia, and New Zealand consistently place near the top of the United Nations Development Programme's Human Development Index (HDI rankings, yet all have minority Indigenous populations with much poorer health and social conditions than non-Indigenous peoples. It is unclear just how the socioeconomic and health status of Indigenous peoples in these countries has changed in recent decades, and it remains generally unknown whether the overall conditions of Indigenous peoples are improving and whether the gaps between Indigenous peoples and other citizens have indeed narrowed. There is unsettling evidence that they may not have. It was the purpose of this study to determine how these gaps have narrowed or widened during the decade 1990 to 2000. Methods Census data and life expectancy estimates from government sources were used to adapt the Human Development Index (HDI to examine how the broad social, economic, and health status of Indigenous populations in these countries have changed since 1990. Three indices – life expectancy, educational attainment, and income – were combined into a single HDI measure. Results Between 1990 and 2000, the HDI scores of Indigenous peoples in North America and New Zealand improved at a faster rate than the general populations, closing the gap in human development. In Australia, the HDI scores of Indigenous peoples decreased while the general populations improved, widening the gap in human development. While these countries are considered to have high human development according to the UNDP, the Indigenous populations that reside within them have only medium levels of human development. Conclusion The inconsistent progress in the health and well-being of Indigenous populations over time, and relative to non-Indigenous populations, points to the need for further efforts to improve the social, economic, and physical health of Indigenous peoples.

Indigenous well-being in four countries: an application of the UNDP'S human development index to indigenous peoples in Australia, Canada, New Zealand, and the United States.

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Cooke, Martin; Mitrou, Francis; Lawrence, David; Guimond, Eric; Beavon, Dan

2007-12-20

Canada, the United States, Australia, and New Zealand consistently place near the top of the United Nations Development Programme's Human Development Index (HDI) rankings, yet all have minority Indigenous populations with much poorer health and social conditions than non-Indigenous peoples. It is unclear just how the socioeconomic and health status of Indigenous peoples in these countries has changed in recent decades, and it remains generally unknown whether the overall conditions of Indigenous peoples are improving and whether the gaps between Indigenous peoples and other citizens have indeed narrowed. There is unsettling evidence that they may not have. It was the purpose of this study to determine how these gaps have narrowed or widened during the decade 1990 to 2000. Census data and life expectancy estimates from government sources were used to adapt the Human Development Index (HDI) to examine how the broad social, economic, and health status of Indigenous populations in these countries have changed since 1990. Three indices - life expectancy, educational attainment, and income - were combined into a single HDI measure. Between 1990 and 2000, the HDI scores of Indigenous peoples in North America and New Zealand improved at a faster rate than the general populations, closing the gap in human development. In Australia, the HDI scores of Indigenous peoples decreased while the general populations improved, widening the gap in human development. While these countries are considered to have high human development according to the UNDP, the Indigenous populations that reside within them have only medium levels of human development. The inconsistent progress in the health and well-being of Indigenous populations over time, and relative to non-Indigenous populations, points to the need for further efforts to improve the social, economic, and physical health of Indigenous peoples.

[Health, globalization and interculturalism: an anthropological approach to the situation of indigenous peoples in South America].

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Hita, Susana Ramírez

2014-10-01

This article reflects upon the impact of globalization and interculturalism on the living conditions of indigenous peoples in South America. Through two examples - Bolivia and Argentina - it is seen how health interculturalism has transformed into a discourse and a practice that both global organizations and most Latin American countries have used to assimilate and attract indigenous communities. Traditional medicine is respected and valued without proposing changes to improve the living conditions of these population groups. This is especially true in those areas where land is being expropriated or contaminated with the extraction of gas, oil, minerals and the construction of dams, along with indiscriminate deforestation of the rainforest. Health/illness cannot be separated from the territorial conditions of these peoples since environmental health is critical for their survival.

Responding to Indigenous Australian Sexual Assault

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Janya McCalman

2014-01-01

Full Text Available Indigenous Australians experience a high prevalence of sexual assault, yet a regional sexual assault service found few Indigenous Australians accessed their services. This prompted exploration of how its services might be improved. A resultant systematic search of the literature is reported in this article. Seven electronic databases and seven websites were systematically searched for peer reviewed and gray literature documenting responses to the sexual assault of Indigenous Australians. These publications were then classified by response type and study type. Twenty-three publications met the inclusion criteria. They included studies of legal justice, media, and community-based and mainstream service responses for Indigenous survivors and perpetrators. We located program descriptions, measurement, and descriptive research, but no intervention studies. There is currently insufficient evidence to confidently prescribe what works to effectively respond to Indigenous Australian sexual assault. The study revealed an urgent need for researchers, Indigenous communities, and services to work together to develop the evidence base.

Spatial distribution of tuberculosis in indigenous and non-indigenous populations in the state of Pará, Brazil, 2005-2013

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Paiva, Bárbara Lopes; Azeredo, Jéssica Quelé; Nogueira, Laura Maria Vidal; Santos, Bruno de Oliveira; Rodrigues, Ivaneide Leal Ataide; Santos, Marcandra Nogueira de Almeida

2017-01-01

Abstract Objective: To analyze the incidence of tuberculosis in indigenous and non-indigenous residents in the state of Pará from 2005-2013. Method: An ecological study was performed with data from SINAN, stratified for the 13 existing Regional Health Centers in Pará. The tuberculosis incidence rates were calculated for indigenous and non-indigenous populations in the 13 regions and maps were prepared to visualize the magnitude of the occurrence of tuberculosis. Results: Significant differ...

Doing Climate Science in Indigenous Communities

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Pandya, R. E.; Bennett, B.

2009-12-01

Historically, the goal of broadening participation in the geosciences has been expressed and approached from the viewpoint of the majority-dominated geoscience community. The need for more students who are American Indian, Native Hawaiian, or Alaska Native is expressed in terms of the need to diversify the research community, and strategies to engage more students are often posed around the question “what can we do to get more indigenous students interested in coming to our institutions to do geosciences?” This approach can lead to neglecting indigenous ways of knowing, inadvertently prioritizes western values over traditional ones, and doesn’t necessarily honor tribal community’s desire to hold on to their talented youth. Further, while this approach has resulted in some modest success, the overall participation in geoscience by students from indigenous backgrounds remains low. Many successful programs, however, have tried an alternate approach; they begin by approaching the geosciences from the viewpoint of indigenous communities. The questions they ask center around how geosciences can advance the priorities of indigenous communities, and their approaches focus on building capacity for the geosciences within indigenous communities. Most importantly, perhaps, these efforts originate in Tribal communities themselves, and invite the geoscience research community to partner in projects that are rooted in indigenous culture and values. Finally, these programs recognize that scientific expertise is only one among many skills indigenous peoples employ in their relation with their homelands. Climate change, like all things related to the landscape, is intimately connected to the core of indigenous cultures. Thus, emerging concerns about climate change provide a venue for developing new, indigenous-centered, approaches to the persistent problem of broadening participation in the geoscience. This presentation will highlight three indigenous-led efforts in to

Determining adult type 2 diabetes-related health care needs in an indigenous population from rural Guatemala: a mixed-methods preliminary study

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Chary Anita

2012-12-01

Full Text Available Abstract Background In Guatemala, diabetes is an emerging public health concern. Guatemala has one of the largest indigenous populations in Latin America, and this population frequently does not access the formal health care system. Therefore, knowledge about the emergence of diabetes in this population is limited. Methods Interview participants (n=23 were recruited from a convenience sample of indigenous adults with type 2 diabetes at one rural diabetes clinic in Guatemala. A structured interview was used to assess knowledge about diabetes and its complications; access to diabetes-related health care and treatment; dietary and lifestyle changes; and family and social supports for individuals living with diabetes. Interviews were supplemented with two group interviews with community leaders and health care providers. Thematic analysis was used to produce insights into diabetes knowledge, attitudes, and practices. In addition, a chart review of the clinic’s electronic medical record identified all adult patients (n=80 presenting in one calendar year for a first-time diabetic consultation. Sociodemographic and clinical variables were extracted and summarized from these records. Results Salient demographic factors in both the structured interview and chart review samples included low educational levels and high indigenous language preference. In the interview sample, major gaps in biomedical knowledge about diabetes included understanding the causes, chronicity, and long-term end-organ complications of diabetes. Medication costs, medical pluralism, and limited social supports for dietary and lifestyles changes were major practical barriers to disease management. Quantitative data from medical records review revealed high rates of poor glycemic control, overweight and obesity, and medication prescription. Conclusions This study provides a preliminary sketch of type 2 diabetes in an indigenous Guatemalan population. Combined qualitative and

Integrated systematic review on educational strategies that promote academic success and resilience in undergraduate indigenous students.

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Milne, T; Creedy, D K; West, R

2016-01-01

Despite numerous recommendations by governments, researchers, and education policymakers the recruitment, retention and success of undergraduate indigenous students in higher education is not commensurate of the wider student population. There is minimal evidence of valuing indigenous worldviews and perspectives in curricula, and effectiveness of educational strategies to strengthen indigenous student success rates in completing undergraduate studies. To conduct an integrative systematic review of educational strategies to promote academic success and resilience in undergraduate indigenous students. Major databases of Scopus, ProQuest, Informit and Web of Science were searched. Inclusion criteria were peer reviewed research articles from scholarly journals that referenced indigenous, aboriginal, First Nation or Māori students in undergraduate programs in higher education. The search was limited to English language and studies conducted from 1995 to 2014. The search yielded 156 research papers which reduced to 16 papers that met the inclusion criteria. The included papers were critiqued from a standpoint theory approach that reflects feminism, cultural respect, and humanism. Much of the literature describes issues, and provides qualitative analyses of experiences, but empirical evaluations of interventions are rare. There was a gap in current research evaluating strategies to improve indigenous student success and resilience. Key strategies for indigenous student success are multi-faceted, layered support, underpinned by the principles of respect, relationships, and responsibility. Implications for nursing and midwifery education, research and health care practice are outlined. Copyright © 2015 Elsevier Ltd. All rights reserved.

Factors Associated with Effective Nutrition Interventions for Pregnant Indigenous Women: A Systematic Review.

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Ashman, Amy M; Brown, Leanne J; Collins, Clare E; Rollo, Megan E; Rae, Kym M

2017-08-01

Indigenous people continue to experience health disparities relative to non-Indigenous populations. Interventions to improve nutrition during pregnancy in these groups may improve health outcomes for mothers and their infants. The effectiveness of existing nutrition intervention programs has not been reviewed previously. The objective was to identify interventions targeting improving nutrition-related outcomes for pregnant Indigenous women residing in Organisation for Economic Co-operation and Development countries, and to identify positive factors contributing to successful programs. Thirteen electronic databases were searched up until October 2015. Key words identified studies intervening to improve nutrition-related outcomes for pregnant Indigenous women. Two reviewers assessed articles for inclusion and study quality and extracted data. Only studies published in English were included. Data were summarized narratively. Abstracts and titles were screened (n=2,566) and 315 full texts were reviewed for eligibility. This review included 27 articles from 20 intervention programs from Australia, Canada, and the United States. The most prevalent measurable outcomes were birth weight (n=9) and breastfeeding initiation/duration (n=11). Programs with statistically significant results for these outcomes employed the following nutrition activities: individual counseling/education (n=8); delivery by senior Indigenous woman (n=2), peer counselor (n=3), or other Indigenous health worker (n=4); community-wide interventions (n=2); media campaigns (n=2); delivery by non-Indigenous health professional (n=3); and home visits (n=3). Heterogeneity of included studies made it challenging to make firm recommendations regarding program success. Authors of included studies recommended community consultation be included when designing studies and working with communities at all stages of the research process. Individualized counseling/education can contribute to successful program

Non-Indigenous Women Teaching Indigenous Education: A Duoethnographic Exploration of Untold Stories

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Burm, Sarah; Burleigh, Dawn

2017-01-01

Identifying as non-Indigenous, we are often left considering our positionality and identity in Indigenous education, how we have come to be invested in this area of research, and what we see as our contribution. In conversation with one another, we realized we choose to share certain stories and not others about our experiences working in…

Socioeconomic status and self-reported asthma in Indigenous and non-Indigenous Australian adults aged 18-64 years: analysis of national survey data

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Cunningham Joan

2010-08-01

Full Text Available Abstract Background Asthma is more common among Indigenous than non-Indigenous Australian adults, but little is known about socioeconomic patterning of asthma within the Indigenous population, or whether it is similar to the non-Indigenous population. Methods I analysed weighted data on self-reported current diagnosed asthma and a range of socio-economic and demographic measures for 5,417 Indigenous and 15,432 non-Indigenous adults aged 18-64 years from two nationally representative surveys conducted in parallel by the Australian Bureau of Statistics in 2004-05. Results Current asthma prevalence was higher for Indigenous than non-Indigenous people in every age group. After adjusting for age and sex, main language and place of residence were significantly associated with asthma prevalence in both populations. Traditional SES variables such as education, income and employment status were significantly associated with asthma in the non-Indigenous but not the Indigenous population. For example, age-and sex-adjusted relative odds of asthma among those who did not complete Year 10 (versus those who did was 1.2 (95% confidence interval (CI 1.0-1.5 in the non-Indigenous population versus 1.0 (95% CI 0.8-1.3 in the Indigenous population. Conclusions The socioeconomic patterning of asthma among Indigenous Australians is much less pronounced than for other chronic diseases such as diabetes and kidney disease, and contrasts with asthma patterns in the non-Indigenous population. This may be due in part to the episodic nature of asthma, and the well-known challenges in diagnosing it, especially among people with limited health literacy and/or limited access to health care, both of which are more likely in the Indigenous population. It may also reflect the importance of exposures occurring across the socioeconomic spectrum among Indigenous Australians, such as racism, and discrimination, marginalization and dispossession, chronic stress and exposure to

Recent developments in suicide prevention among the Indigenous peoples of Australia.

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Dudgeon, Pat; Holland, Christopher

2018-04-01

Suicide is an Aboriginal and Torres Strait Islander (hereafter 'Indigenous') population health issue. Over 2015-2016, the Aboriginal and Torres Strait Islander Suicide Prevention Project (ATSISPEP) aimed to identify success factors in Indigenous suicide prevention. For non-Indigenous practitioners working with indigenous clients at risk of suicide, ATSISPEP identified important considerations to make treatment more effective. The start is acknowledging the differences in the historical, cultural, political, social and economic experiences of Indigenous peoples, and their greater exposure to trauma, psychological distress and risks to mental health. These mental health difficulties are specific and more prevalent amongst Indigenous peoples and communities due to the ongoing impacts of colonisation in Australia including a range of social determinants impacting on the well-being of Indigenous peoples today. Working effectively with Indigenous clients also includes being able to establish culturally safe work environments, and the ability of non-Indigenous practitioners to work in a culturally competent and trauma-informed manner. There are also considerations regarding time protocols and client follow-up. Further, postvention responses might be required. Supporting selective suicide prevention activity among younger people (and other groups at increased risk) and community-level work is an important complement to working with Indigenous individuals at risk of suicide.

The health of urban Aboriginal people: insufficient data to close the gap.

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Eades, Sandra J; Taylor, Bronwen; Bailey, Sandra; Williamson, Anna B; Craig, Jonathan C; Redman, Sally

2010-11-01

The Australian Government has committed to reducing Indigenous disadvantage, including closing the life-expectancy gap within a generation, and to halving the gap in mortality rates for children under 5 years of age within a decade. Sixty per cent of the health gap between Indigenous and non-Indigenous Australians is attributable to the health of Indigenous people living in non-remote areas of Australia. We conducted a brief review of recent Australian original research publications on the health of the 53% of Indigenous people who live in urban areas, and found that data are sparse; there were only 63 studies in the past 5 years (11% of all articles about Indigenous health during this period). Although Indigenous Australians living in remote areas experience greater health disparity, the government will not achieve its aims without paying due attention to the non-remote-living population. More research is required, and particularly research that actually tests the impact of policies and programs.

Leadership as a Personal Journey: An Indigenous Perspective.

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Doyle, Kerrie; Hungerford, Catherine

2015-05-01

Indigenous Australians have higher levels of mental illness, self-harm, suicide and substance abuse than non-Indigenous Australians, as well as more frequent contact with the criminal justice system. These indices point to the need for strong leadership to support Close the Gap programmes that have now been implemented across Australia. This article considers leadership as a journey of learning for Australian Indigenous leaders. Through the use of story, it is suggested that a situational leadership approach, incorporating the principles of mindfulness, provides the most appropriate framework for Indigenous leaders who work with Indigenous communities. Flexible approaches are needed to meet the needs of diverse Indigenous populations, and address the complex challenges involved, including lateral violence. Such flexibility will enable Indigenous leaders and communities to work together to achieve improvements in the health outcomes, not only for Indigenous Australians, but also for Indigenous populations worldwide.

Age standardisation – an indigenous standard?

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Simmonds Shirley

2007-05-01

Full Text Available Abstract The study of inequities in health is a critical component of monitoring government obligations to uphold the rights of Indigenous Peoples. In Aotearoa/New Zealand the indigenous Māori population has a substantially younger age structure than the non-indigenous population making it necessary to account for age differences when comparing population health outcomes. An age-standardised rate is a summary measure of a rate that a population would have if it had a standard age structure. Changing age standards have stimulated interest in the potential impact of population standards on disparities data and consequently on health policy. This paper compares the age structure of the Māori and non-Māori populations with two standard populations commonly used in New Zealand: Segi's world and WHO world populations. The performance of these standards in Māori and non-Māori mortality data was then measured against the use of the Māori population as a standard. It was found that the choice of population standard affects the magnitude of mortality rates, rate ratios and rate differences, the relative ranking of causes of death, and the relative width of confidence intervals. This in turn will affect the monitoring of trends in health outcomes and health policy decision-making. It is concluded that the choice of age standard has political implications and the development and utilisation of an international indigenous population standard should be considered.

Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care

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Percival, Nikki; O’Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

2016-01-01

Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers. PMID:27066470

Improving health promotion using quality improvement techniques in Australian Indigenous primary health care

Directory of Open Access Journals (Sweden)

Nikki ePercival

2016-03-01

Full Text Available While some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centres. Our study objectives were to: (a describe the scope and quality of health promotion activities; (b describe the status of health centre system support for health promotion activities; and (c introduce a CQI intervention and examine the impact on health promotion activities and health centres systems over two years. Baseline assessments showed sub-optimal health centre systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health centre systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence based health promotion by engaging front line health practitioners in decision making processes about the design/redesign of health centre systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff and members of the local community to address organisational and policy level barriers.

Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care.

Science.gov (United States)

Percival, Nikki; O'Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

2016-01-01

Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers.

[Beyond the indigenous: health and interculturality at the global level].

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Knipper, Michael

2010-03-01

Health inequalities are broadly documented for ethnic minority groups and immigrants worldwide. Intercultural perspectives in health are thus developed in very different places and situations. Both the criteria for defining the target groups as well as the ways the health problems of these groups are looked at, are shaped by the particular local context. However, some challenges are common to almost all situations where the topic of ethnic diversity and health is considered. And in contrast to the rather novel term, the issues at stake in "intercultural heath" are not new at all. Against this background, the present article brings into focus three essential points: the necessity of defining ethnicity adequately to avoid stereotyping and the creation of new inequalities; the challenge of converting ethnicity into a helpful and thus "healthy" category in the field of medicine and health; and the need for the integration of explicit and serious reflections on medical ethics and human rights that provide for the normative framework and moral orientation of health activities with indigenous, migrant and other particularly vulnerable groups.

Indigenous VET Participation, Completion and Outcomes: Change over the Past Decade. Research Report

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Windley, Georgina

2017-01-01

It has been eight years since the National Indigenous Reform Agreement (also known as "Closing the Gap") set out a series of areas and targets designed to close the gap between Indigenous and non-Indigenous outcomes on a range of measures. A key objective was to halve the gap in employment outcomes between Indigenous and non-Indigenous…

Teenage pregnancy and long-term mental health outcomes among Indigenous women in Canada.

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Xavier, Chloé G; Brown, Hilary K; Benoit, Anita C

2017-11-22

Our objectives were to (1) compare the risks for poor long-term mental health outcomes among indigenous women with and without a teenage pregnancy and (2) determine if community and cultural factors modify this risk. We conducted a secondary analysis of the 2012 Aboriginal Peoples Survey. Respondents were women aged 25 to 49 years who had given birth to at least one child. Teenage mothers (age at first birth 13 to 19 years; n = 1330) were compared to adult mothers (age at first birth 20 years or older; n = 2630). Mental health outcomes were psychological distress, mental health status, suicide ideation/attempt, and alcohol consumption. To address objective 1, we used binary logistic regression analyses before and after controlling for covariates. To address objective 2, we tested the significance of interaction terms between teenage pregnancy status and effect measure modifiers. In unadjusted analyses, teenage pregnancy was associated with increased risk for poor/fair mental health [odds ratio (OR) 1.77, 95% confidence interval (CI) 1.24-2.53] and suicide attempt/ideation (OR 1.95, 95% CI 1.07-3.54). However, the associations were not statistically significant after adjusting for demographic, socioeconomic, environmental, and health covariates. Teenage pregnancy was not associated with increased risk for high psychological distress or heavy alcohol consumption in unadjusted or adjusted analyses. The interaction term for involvement in cultural activities was statistically significant for poor/fair mental health; however, after stratification, ORs were non-significant. Among indigenous mothers, teenage pregnancy was less important than broader social and health circumstances in predicting long-term mental health.

[Mental Health, Emotional Suffering, Mental Problems and Disorders in Indigenous Colombians. Data From the National Mental Health Survey 2015].

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Gómez-Restrepo, Carlos; Rincón, Carlos Javier; Urrego-Mendoza, Zulma

2016-12-01

Indigenous people represent 5% of the world population and one-third of the poor ones. Alcoholism rates, substance abuse problems, and mental disorders are shown to be higher than the general population. An analysis was made of the data from the National Mental Health Survey 2015. In this survey, it was asked if self-recognition as a native was according to the culture, the people, or physical features. A total of 902 indigenous people were surveyed, corresponding to 8.3% of the surveyed adult population. The majority (39.5%) lived in the Pacific region, with 23.7% Atlantic region, and 20% in the Eastern region. More than one-quarter (26.6%) reported a status of poverty, 31.7% spoke the language of their people, and 17.8% reported displacement due to violence. Mental health was defined as, "having good physical health, to eat, sleep and rest, by 42.9%. As regards problems and mental disorders, 8% reported excessive consumption and 7.9% a risk consumption of alcohol. As regards general psychopathology, measured by the (Self-reporting questionnaire) SRQ, 8.1% of the population had symptoms. The life prevalences of anxiety and depressive mental disorders were reported by 6.7% women and 8.4% men, and the associated risk factors that show higher risk were: aged between 18 to 44 years, not speaking the language of their people, living in Bogota, living in urban areas, and consuming psychoactive substances and tobacco. People who recognised themselves as indigenous have higher rates of displacement by violence, report problems and common mental disorders that are associated with factors consistent with loss of cultural characteristics. Copyright © 2016. Publicado por Elsevier España.

Injury prevention in Australian Indigenous communities.

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Ivers, Rebecca; Clapham, Kathleen; Senserrick, Teresa; Lyford, Marilyn; Stevenson, Mark

2008-12-01

Injury prevention in Indigenous communities in Australia is a continuing national challenge, with Indigenous fatality rates due to injury three times higher than the general population. Suicide and transport are the leading causes of injury mortality, and assault, transport and falls the primary causes of injury morbidity. Addressing the complex range of injury problems in disadvantaged Indigenous communities requires considerable work in building or enhancing existing capacity of communities to address local safety issues. Poor data, lack of funding and absence of targeted programs are some of the issues that impede injury prevention activities. Traditional approaches to injury prevention can be used to highlight key areas of need, however adaptations are needed in keeping with Indigenous peoples' holistic approach to health, linked to land and linked to community in order to address the complex spiritual, emotional and social determinants of Indigenous injury.

[A critical examination of public policies related to indigenous health, traditional medicine, and interculturality in Mexico (1990-2016)].

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Navarro, Roberto Campos; Sánchez, Edith Yesenia Peña; Maya, Alfredo Paulo

2017-01-01

Over the last 26 years, the Mexican government has developed a number of activities and discourses around what has been called "intercultural health," directed especially at indigenous peoples in Mexico (some 62, according to linguistic criteria). In this way, the government has built health care institutions (rural centers, clinics, and hospitals) in states like Puebla, Nayarit, Oaxaca, Chiapas, Queretaro, and Jalisco, proposing the implementation of cultural pertinence indicators (which are minimal and inadequate). Nevertheless, the health conditions among indigenous populations and the quality of health care provided by public institutions continue to be precarious in terms of human and material resources (health personnel, drugs, etc.) and discriminatory with respect to the form and content of the provided services. This paper describes some of the governmental interventions that purport to be institutional improvements in the field of interculturality, but that actually represent the continuity of arbitrary and exclusive policies.

Stabilizing Dog Populations and Improving Animal and Public Health Through a Participatory Approach in Indigenous Communities.

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Schurer, J M; Phipps, K; Okemow, C; Beatch, H; Jenkins, E

2015-09-01

Free-roaming dog populations are a global concern for animal and human health including transmission of infectious disease (e.g. rabies, distemper and parasites), dog bite injuries/mortalities, animal welfare and adverse effects on wildlife. In Saskatchewan (SK), Canada, veterinary care is difficult to access in the remote and sparsely inhabited northern half of the province, where the population is predominately Indigenous. Even where veterinary clinics are readily available, there are important barriers such as cost, lack of transportation, unique cultural perspectives on dog husbandry and perceived need for veterinary care. We report the effects of introducing a community action plan designed to improve animal and human health, increase animal health literacy and benefit community well-being in two Indigenous communities where a dog-related child fatality recently occurred. Initial door-to-door dog demographic surveys indicated that most dogs were sexually intact (92% of 382 dogs), and few had ever been vaccinated (6%) or dewormed (6%). Approximately three animal-related injuries requiring medical care were reported in the communities per 1000 persons per year (95% CL: 1.6-6.6), and approximately 86% of 145 environmentally collected dog faecal samples contained parasites, far above levels reported in other urban or rural settings in SK. Following two subsidized spay/neuter clinics and active rehoming of dogs, parasite levels in dog faeces decreased significantly (P important changes were observed in the dog demographic profile. This project demonstrates the importance of engaging people using familiar, local resources and taking a community specific approach. As well, it highlights the value of integrated, cross-jurisdictional cooperation, utilizing the resources of university researchers, veterinary personnel, public health, environmental health and community-based advocates to work together to solve complex issues in One Health. On-going surveillance on dog

Key factors impacting on diagnosis and treatment for vulvar cancer for Indigenous women: findings from Australia.

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McGrath, Pam; Rawson, Nicole

2013-10-01

To date, there has been limited research on the topic of vulvar cancer. This paper provides findings from a qualitative study conducted with Indigenous women in East Arnhem Land, Northern Territory, Australia on the psychosocial impact of diagnosis and treatment for vulvar cancer. The insights from the study outlined in this paper not only make a contribution to deepening our understanding of the experience of vulvar cancer for Indigenous women, but provide practical recommendations to ensure effective and early engagement for diagnosis and treatment. A qualitative research method was employed through in-depth, open-ended interviews. The participants of the study were a purposive sample of Indigenous women with the condition, health professionals, and Aboriginal health workers. There were a total of 40 participants; with twelve (n = 12) Indigenous women affected with the condition, fourteen (n = 14) Aboriginal Health Workers, ten (n = 10) nurses, three (n = 3) doctors, and one (n = 1) community member. This paper addresses three key issues highlighted by the participants which include the fact that the private nature of the disease makes the condition 'women's business', that there is a sense of shame associated with the condition, and that there is fear and worry generated by the seriousness of the condition. The private nature of the disease and the sense of shame associated with the condition impact upon the diagnosis and treatment for many Indigenous women. In addition, the limitation of resources for health service delivery for East Arnhem Land exacerbates the problems faced by these communities. This paper puts forward suggestions to facilitate early diagnosis and treatment for women affected with the condition.

Active transportation to support diabetes prevention: Expanding school health promotion programming in an Indigenous community.

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Macridis, Soultana; Garcia Bengoechea, Enrique; McComber, Alex M; Jacobs, Judi; Macaulay, Ann C

2016-06-01

School-based physical activity (PA) interventions, including school active transportation (AT), provide opportunities to increase daily PA levels, improves fitness, and reduces risk of diseases, such as type 2 diabetes. Based on a community-identified need, the Kahnawake Schools Diabetes Prevention Project, within an Indigenous community, undertook school travel planning to contribute to PA programming for two elementary schools. Using community-based participatory research, the Active & Safe Routes to School's School Travel Planning (STP) process was undertaken in two schools with an STP-Committee comprised of community stakeholders and researchers. STP activities were adapted for local context including: school profile form, family survey, in-class travel survey, pedestrian-traffic observations, walkability checklist, and student mapping. STP data were jointly collected, analyzed and interpreted by researchers and community. Traffic-pedestrian observations, walkability and parent surveys identified key pedestrian-traffic locations, helped develop safe/direct routes, and traffic calming strategies. In-class travel and mapping surveys identified a need and student desire to increase school AT. The STP-Committee translated findings into STP-action plans for two schools, which were implemented in 2014-2015 school year. Combining CBPR with STP merges community and researcher expertise. This project offered evidence-informed practice for active living promotions. Experience and findings could benefit Indigenous and non-Indigenous communities. Copyright © 2016 Elsevier Ltd. All rights reserved.

The gambling behavior of indigenous Australians.

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Hing, Nerilee; Breen, Helen; Gordon, Ashley; Russell, Alex

2014-06-01

The gambling activities of minority groups such as Indigenous peoples are usually culturally complex and poorly understood. To redress the scarcity of information and contribute to a better understanding of gambling by Indigenous people, this paper presents quantitative evidence gathered at three Australian Indigenous festivals, online and in several Indigenous communities. With support from Indigenous communities, the study collected and analyzed surveys from 1,259 self-selected Indigenous adults. Approximately 33 % of respondents gambled on card games while 80 % gambled on commercial gambling forms in the previous year. Gambling participation and involvement are high, particularly on electronic gaming machines (EGMs), the favorite and most regular form of gambling. Men are significantly more likely to participate in gambling and to gamble more frequently on EGMs, horse/dog races, sports betting and instant scratch tickets. This elevated participation and frequency of gambling on continuous forms would appear to heighten gambling risks for Indigenous men. This is particularly the case for younger Indigenous men, who are more likely than their older counterparts to gamble on EGMs, table games and poker. While distinct differences between the gambling behaviors of our Indigenous sample and non-Indigenous Australians are apparent, Australian Indigenous behavior appears similar to that of some Indigenous and First Nations populations in other countries. Although this study represents the largest survey of Indigenous Australian gambling ever conducted in New South Wales and Queensland, further research is needed to extend our knowledge of Indigenous gambling and to limit the risks from gambling for Indigenous peoples.

Potential Factors Influencing Indigenous Education Participation and Achievement. Research Report

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Biddle, Nicholas; Cameron, Timothy

2012-01-01

This report examines two sets of issues, the first being whether Indigenous Australians obtain a lower return on investment in education and training than other Australians. If they do, then this would partly explain why, in general, Indigenous participation in education and training is relatively low. The second issue is whether Indigenous…

Starting to smoke: a qualitative study of the experiences of Australian indigenous youth

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Johnston Vanessa

2012-11-01

Full Text Available Abstract Background Adult smoking has its roots in adolescence. If individuals do not initiate smoking during this period it is unlikely they ever will. In high income countries, smoking rates among Indigenous youth are disproportionately high. However, despite a wealth of literature in other populations, there is less evidence on the determinants of smoking initiation among Indigenous youth. The aim of this study was to explore the determinants of smoking among Australian Indigenous young people with a particular emphasis on the social and cultural processes that underlie tobacco use patterns among this group. Methods This project was undertaken in northern Australia. We undertook group interviews with 65 participants and individual in-depth interviews with 11 youth aged 13–20 years led by trained youth ‘peer researchers.’ We also used visual methods (photo-elicitation with individual interviewees to investigate the social context in which young people do or do not smoke. Included in the sample were a smaller number of non-Indigenous youth to explore any significant differences between ethnic groups in determinants of early smoking experiences. The theory of triadic influence, an ecological model of health behaviour, was used as an organising theory for analysis. Results Family and peer influences play a central role in smoking uptake among Indigenous youth. Social influences to smoke are similar between Indigenous and non-Indigenous youth but are more pervasive (especially in the family domain among Indigenous youth. While Indigenous youth report high levels of exposure to smoking role models and smoking socialisation practices among their family and social networks, this study provides some indication of a progressive denormalisation of smoking among some Indigenous youth. Conclusions Future initiatives aimed at preventing smoking uptake in this population need to focus on changing social normative beliefs around smoking, both at a

Effective strategies to reduce commercial tobacco use in Indigenous communities globally: A systematic review.

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Minichiello, Alexa; Lefkowitz, Ayla R F; Firestone, Michelle; Smylie, Janet K; Schwartz, Robert

2016-01-11

growing community interest in addressing the high rates of commercial tobacco use. Interventions were unable to produce any measured change in prevalence rates. The extent of this research in Indigenous communities globally suggests a growing prioritization and readiness to address the high rates of commercial tobacco use through the use of both comprehensive and tailored interventions. A comprehensive approach that uses multiple activities, the centring of Aboriginal leadership, long term community investments, and the provision of culturally appropriate health materials and activities appear to have an important influence in producing desired change.

"Until I Became a Professional, I Was Not, Consciously, Indigenous": One Intercultural Bilingual Educator's Trajectory in Indigenous Language Revitalization

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Hornberger, Nancy H.

2014-01-01

Drawing from long-term ethnographic research in the Andes, this paper examines one Quechua-speaking Indigenous bilingual educator's trajectory as she traversed (and traverses) from rural highland communities of southern Peru through development as teacher, teacher educator, researcher, and advocate for Indigenous identity and language…

Cost-effectiveness of interventions to prevent cardiovascular disease in Australia's indigenous population.

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Ong, Katherine S; Carter, Rob; Vos, Theo; Kelaher, Margaret; Anderson, Ian

2014-05-01

Cardiovascular disease is the leading cause of disease burden in Australia's Indigenous population, and the greatest contributor to the Indigenous 'health gap'. Economic evidence can help identify interventions that efficiently address this discrepancy. Five interventions (one community-based and four pharmacological) to prevent cardiovascular disease in Australia's Indigenous population were subject to economic evaluation. Pharmacological interventions were evaluated as delivered either via Aboriginal Community Controlled Health Services or mainstream general practitioner services. Cost-utility analysis methods were used, with health benefit measured in disability-adjusted life-years saved. All pharmacological interventions produced more Indigenous health benefit when delivered via Indigenous health services, but cost-effectiveness ratios were higher due to greater health service costs. Cost-effectiveness ratios were also higher in remote than in non-remote regions. The polypill was the most cost-effective intervention evaluated, while the community-based intervention produced the most health gain. Local and decision-making contextual factors are important in the conduct and interpretation of economic evaluations. For Australia's Indigenous population, different models of health service provision impact on reach and cost-effectiveness results. Both the extent of health gain and cost-effectiveness are important considerations for policy-makers in light of government objectives to address health inequities and bridge the health gap. Copyright © 2013 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved.

Capacity building in indigenous men's groups and sheds across Australia.

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Southcombe, Amie; Cavanagh, Jillian; Bartram, Timothy

2015-09-01

This article presents an investigation into capacity building, at the community level, in Aboriginal and Torres Strait Islander Men's Groups and Sheds. As safe men's spaces, Men's Groups and Sheds represent an ever-growing social, and health and well-being community service across Australia. The study is qualitative and employs 'yarning circles' (focus groups), semi-structured interviews and observations to gather data from 15 Groups/Sheds involving 45 men from urban, regional and remote communities. We found that capacity building is primarily about securing relationships between Group Leaders/Shed Co-ordinators and Government services. Capacity building establishes links to services such as Centrelink, Medicare, Department of Housing, Probation and Control, and positive outcomes such as Indigenous men securing housing and Centrelink payments. Capacity building results in better health outcomes and, educates and empowers men to improve their social, cultural, emotional and economic well-being. It helps men to better connect with family and community. The current research paves the way for countries worldwide to explore the conceptual and empirical approach of capacity building applicable to other Indigenous [and non-Indigenous] Men's Groups/Sheds. We recommend feasibilities studies, on approaches to capacity building in Indigenous Groups/Sheds, be carried out within urban, regional and remote regions across the country. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Reconnecting art and science for sustainability: learning from indigenous knowledge through participatory action-research in the Amazon

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Simone Athayde

2017-06-01

Full Text Available Sustainability science focuses on generating and applying knowledge to environmentally sound human development around the world. It requires working toward greater integration of different types of knowledge, ways of knowing, and between academy and society. We contribute to the development of approaches for learning from indigenous knowledge, through enhanced understanding of the system of values, meanings, and relationships afforded by indigenous arts. We focus on a long-term, participatory action research project developed for the revitalization of weaving knowledge among three Kawaiwete (also known as Kaiabi indigenous groups in the Amazon. The problem was originally defined by indigenous communities, concerned with the erosion of weaving knowledge of basketry and textiles among men and women. Methods for coproduction of knowledge included dialogical methods and tools, indigenous-led strategies, and quantitative and qualitative approaches across biophysical and social sciences. Longitudinal and cross-sectional studies considered multiple dimensions, scales, and networks of knowledge creation, distribution, and transmission. Innovation and articulation with western systems, along with shamanism, gender, and leadership, were key factors enhancing artistic knowledge resilience. We reflect on lessons learned and implications of this initiative for broadening the understanding of art and science intersections toward a sustainable future.

[Health inequality among vulnerable groups in Mexico: older adults, indigenous people, and migrants].

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Juárez-Ramírez, Clara; Márquez-Serrano, Margarita; Salgado de Snyder, Nelly; Pelcastre-Villafuerte, Blanca Estela; Ruelas-González, María Guadalupe; Reyes-Morales, Hortensia

2014-04-01

Health vulnerability refers to a lack of protection for specific population groups with specific health problems, as well as the disadvantages they face in solving them in comparison with other population groups. This major public health problem has multiple and diverse causes, including a shortage of trained health care personnel and the lack of family, social, economic, and institutional support in obtaining care and minimizing health risks. Health vulnerability is a dynamic condition arising from the confluence of multiple social determinants. This article attempts to describe the health situation of three vulnerable groups in Mexico-older adults, indigenous people, and migrants-and, after defining the needs of each, explore measures that could contribute to the design and implementation of public health policies better tailored to their respective needs.

The consumption of indigenous fruits and vegetables and health risk ...

African Journals Online (AJOL)

Indigenous foods contain phytochemicals that are linked to protection against the development of diseases such as cancer, diabetes and hypertension. Some of these indigenous foods have been chemically analysed and contain active compounds such as organic sulphur, hypoglycaemic alkaloids, flavonoids, phytosterin ...

Risk indicators for severe impaired oral health among indigenous Australian young adults

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Roberts-Thomson Kaye F

2010-01-01

Full Text Available Abstract Background Oral health impairment comprises three conceptual domains; pain, appearance and function. This study sought to: (1 estimate the prevalence of severe oral health impairment as assessed by a summary oral health impairment measure, including aspects of dental pain, dissatisfaction with dental appearance and difficulty eating, among a birth cohort of Indigenous Australian young adults (n = 442, age range 16-20 years; (2 compare prevalence according to demographic, socio-economic, behavioural, dental service utilisation and oral health outcome risk indicators; and (3 ascertain the independent contribution of those risk indicators to severe oral health impairment in this population. Methods Data were from the Aboriginal Birth Cohort (ABC study, a prospective longitudinal investigation of Aboriginal individuals born 1987-1990 at an Australian regional hospital. Data for this analysis pertained to Wave-3 of the study only. Severe oral health impairment was defined as reported experience of toothache, poor dental appearance and food avoidance in the last 12 months. Logistic regression models were used to evaluate effects of demographic, socio-economic, behavioural, dental service utilisation and clinical oral disease indicators on severe oral health impairment. Effects were quantified as odds ratios (OR. Results The percent of participants with severe oral health impairment was 16.3 (95% CI 12.9-19.7. In the multivariate model, severe oral health impairment was associated with untreated dental decay (OR 4.0, 95% CI 1.6-9.6. In addition to that clinical indicator, greater odds of severe oral health impairment were associated with being female (OR 2.0, 95% CI 1.2-3.6, being aged 19-20 years (OR 2.1, 95% CI 1.2-3.6, soft drink consumption every day or a few days a week (OR 2.6, 95% 1.2-5.6 and non-ownership of a toothbrush (OR 1.9, 95% CI 1.1-3.4. Conclusions Severe oral health impairment was prevalent among this population. The findings

Healthcare Access and Health Beliefs of the Indigenous Peoples in Remote Amazonian Peru

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Brierley, Charlotte K.; Suarez, Nicolas; Arora, Gitanjli; Graham, Devon

2014-01-01

Little is published about the health issues of traditional communities in the remote Peruvian Amazon. This study assessed healthcare access, health perceptions, and beliefs of the indigenous population along the Ampiyacu and Yaguasyacu rivers in north-eastern Peru. One hundred and seventy-nine adult inhabitants of 10 remote settlements attending health clinics were interviewed during a medical services trip in April 2012. Demographics, health status, access to healthcare, health education, sanitation, alcohol use, and smoke exposure were recorded. Our findings indicate that poverty, household overcrowding, and poor sanitation remain commonplace in this group. Furthermore, there are poor levels of health education and on-going barriers to accessing healthcare. Healthcare access and health education remain poor in the remote Peruvian Amazon. This combined with poverty and its sequelae render this population vulnerable to disease. PMID:24277789

Healthcare access and health beliefs of the indigenous peoples in remote Amazonian Peru.

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Brierley, Charlotte K; Suarez, Nicolas; Arora, Gitanjli; Graham, Devon

2014-01-01

Little is published about the health issues of traditional communities in the remote Peruvian Amazon. This study assessed healthcare access, health perceptions, and beliefs of the indigenous population along the Ampiyacu and Yaguasyacu rivers in north-eastern Peru. One hundred and seventy-nine adult inhabitants of 10 remote settlements attending health clinics were interviewed during a medical services trip in April 2012. Demographics, health status, access to healthcare, health education, sanitation, alcohol use, and smoke exposure were recorded. Our findings indicate that poverty, household overcrowding, and poor sanitation remain commonplace in this group. Furthermore, there are poor levels of health education and on-going barriers to accessing healthcare. Healthcare access and health education remain poor in the remote Peruvian Amazon. This combined with poverty and its sequelae render this population vulnerable to disease.

Indigenous healthcare worker involvement for Indigenous adults and children with asthma.

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Chang, Anne B; Taylor, Brett; Masters, I Brent; Laifoo, Yancy; Brown, Alexander Dh

2010-05-12

Asthma education is regarded as an important step in the management of asthma in national guidelines. Racial, ethnicity and socio-economic factors are associated with markers of asthma severity, including recurrent acute presentations to emergency health facilities. Worldwide, indigenous groups are disproportionately represented in the severe end of the asthma spectrum. Appropriate models of care are important in the successful delivery of services, and are likely contributors to improved outcomes for people with asthma. To determine whether involvement of an indigenous healthcare worker (IHW) in comparison to absence of an IHW in asthma education programs, improves asthma related outcomes in indigenous children and adults with asthma. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Airways Group Specialised Register, MEDLINE and EMBASE databases, review articles and reference lists of relevant articles. The latest search was in January 2010. All randomised controlled trials comparing involvement of an indigenous healthcare worker (IHW) in comparison to absence of an IHW in asthma education programs for indigenous people with asthma. Two independent review authors selected data for inclusion, a single author extracted the data. Both review authors independently assessed study quality. We contacted authors for further information. As it was not possible to analyse data as "intention-to-treat", we analysed data as "treatment received". Two studies fulfilled inclusion criteria involving 133 children randomised to an asthma education programme involving an IHW, compared to a similar education programme without an IHW. One study was not strictly Indigenous. 110 of these children completed the trials. Children's asthma knowledge score was significantly better in the group that had IHW education compared with control (mean difference 3.30; 95% CI 1.07 to 5.53), parents' asthma knowledge score (standardised mean difference (SMD) 1

Otitis media in Indigenous Australian children: review of epidemiology and risk factors.

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Jervis-Bardy, Jake; Sanchez, L; Carney, A S

2014-01-01

Otitis media represents a major health concern in Australian Indigenous children ('Indigenous children'), which has persisted, despite public health measures, for over 30 years. Global searches were performed to retrieve peer-reviewed and 'grey' literature investigating the epidemiology of and risk factors for otitis media in Indigenous children, published between 1985 and 2012. In Indigenous children, the prevalence of otitis media subtypes is 7.1-12.8 per cent for acute otitis media, 10.5-30.3 per cent for active chronic otitis media and 31-50 per cent for tympanic membrane perforation. The initial onset of otitis media in Indigenous children occurs earlier and persists for longer after the first year of life, compared with non-Indigenous children. Indigenous children are colonised by otopathogens more frequently, at younger ages and with a higher bacterial load. Poor community and domestic infrastructure, overcrowding and exposure to tobacco smoke increase the risk of otitis media in Indigenous children; however, the availability of swimming pools plays no role in the prevention or management of otitis media. Despite awareness of the epidemiological burden of otitis media and its risk factors in Indigenous children, studies undertaken since 1985 demonstrate that otitis media remains a significant public health concern in this population.

Reference Intervals for Non-Fasting CVD Lipids and Inflammation Markers in Pregnant Indigenous Australian Women.

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Schumacher, Tracy L; Oldmeadow, Christopher; Clausen, Don; Weatherall, Loretta; Keogh, Lyniece; Pringle, Kirsty G; Rae, Kym M

2017-10-14

Indigenous Australians experience high rates of cardiovascular disease (CVD). The origins of CVD may commence during pregnancy, yet few serum reference values for CVD biomarkers exist specific to the pregnancy period. The Gomeroi gaaynggal research project is a program that undertakes research and provides some health services to pregnant Indigenous women. Three hundred and ninety-nine non-fasting samples provided by the study participants (206 pregnancies and 175 women) have been used to construct reference intervals for CVD biomarkers during this critical time. A pragmatic design was used, in that women were not excluded for the presence of chronic or acute health states. Percentile bands for non-linear relationships were constructed according to the methods of Wright and Royston (2008), using the xriml package in StataIC 13.1. Serum cholesterol, triglycerides, cystatin-C and alkaline phosphatase increased as gestational age progressed, with little change seen in high-sensitivity C-Reactive Protein and γ glutamyl transferase. Values provided in the reference intervals are consistent with findings from other research projects. These reference intervals will form a basis with which future CVD biomarkers for pregnant Indigenous Australian women can be compared.

Indigenous Knowledge and Sea Ice Science: What Can We Learn from Indigenous Ice Users?

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Eicken, H.

2010-12-01

Drawing on examples mostly from Iñupiaq and Yup’ik sea-ice expertise in coastal Alaska, this contribution examines how local, indigenous knowledge (LIK) can inform and guide geophysical and biological sea-ice research. Part of the relevance of LIK derives from its linkage to sea-ice use and the services coastal communities derive from the ice cover. As a result, indigenous experts keep track of a broad range of sea-ice variables at a particular location. These observations are embedded into a broader worldview that speaks to both long-term variability or change and to the system of values associated with ice use. The contribution examines eight different contexts in which LIK in study site selection and assessment of a sampling campaign in the context of inter annual variability, the identification of rare or inconspicuous phenomena or events, the contribution by indigenous experts to hazard assessment and emergency response, the record of past and present climate embedded in LIK, and the value of holistic sea-ice knowledge in detecting subtle, intertwined patterns of environmental change. The relevance of local, indigenous sea-ice expertise in helping advance adaptation and responses to climate change as well as its potential role in guiding research questions and hypotheses are also examined. The challenges that may have to be overcome in creating an interface for exchange between indigenous experts and seaice researchers are considered. Promising approaches to overcome these challenges include cross-cultural, interdisciplinary education, and the fostering of Communities of Practice.

Indigenous Australians, Intellectual Disability and Incarceration: A Confluence of Rights Violations

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Claire E. Brolan

2018-02-01

Full Text Available Abstract: This article reviews the health and wellbeing of Aboriginal and Torres Strait Islander Australians with intellectual disability in the Australian prison system through a human rights lens. There is an information gap on this group of Australian prisoners in the health and disability literature and the multi-disciplinary criminal law and human rights law literature. This article will consider the context of Indigenous imprisonment in Australia and examine the status of prisoner health in that country, as well as the status of the health and wellbeing of prisoners with intellectual disability. It will then specifically explore the health, wellbeing and impact of imprisonment on Indigenous Australians with intellectual disability, and highlight how intersectional rights deficits (including health and human rights deficits causally impact the ability of Indigenous Australians with intellectual disability to access due process, equal recognition and justice in the criminal justice and prison system. A central barrier to improving intersectional and discriminatory landscapes relating to health, human rights and justice for Indigenous Australian inmates with intellectual disability, and prisoners with intellectual disability more broadly in the Australian context, is the lack of sufficient governance and accountability mechanisms (including Indigenous-led mechanisms to enforce the operationalisation of consistent, transparent, culturally responsive, rights-based remedies.

Can the democratic ideal of participatory research be achieved? An inside look at an academic-indigenous community partnership.

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Cargo, Margaret; Delormier, Treena; Lévesque, Lucie; Horn-Miller, Kahente; McComber, Alex; Macaulay, Ann C

2008-10-01

Democratic or equal participation in decision making is an ideal that community and academic stakeholders engaged in participatory research strive to achieve. This ideal, however, may compete with indigenous peoples' right to self-determination. Study objectives were to assess the perceived influence of multiple community (indigenous) and academic stakeholders engaged in the Kahnawake Schools Diabetes Prevention Project (KSDPP) across six domains of project decision making and to test the hypothesis that KSDPP would be directed by community stakeholders. Self-report surveys were completed by 51 stakeholders comprising the KSDPP Community Advisory Board (CAB), KSDPP staff, academic researchers and supervisory board members. KSDPP staff were perceived to share similar levels of influence with (i) CAB on maintaining partnership ethics and CAB activities and (ii) academic researchers on research and dissemination activities. KSDPP staff were perceived to carry significantly more influence than other stakeholders on decisions related to annual activities, program operations and intervention activities. CAB and staff were the perceived owners of KSDPP. The strong community leadership aligns KSDPP with a model of community-directed research and suggests that equitable participation-distinct from democratic or equal participation-is reflected by indigenous community partners exerting greater influence than academic partners in decision making.

Drug and alcohol use and treatment for Australian Indigenous and non-Indigenous prisoners: demand reduction strategies.

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Dolan, Kate; Rodas, Ana; Bode, Adam

2015-01-01

The purpose of this paper is to compare the use of drugs and alcohol by Indigenous and non-Indigenous prisoners and examine relevant treatment in Australian prisons. Prison authorities were surveyed about alcohol and drug use by prisoners prior to and during imprisonment and drug and alcohol treatment programs in prison. The literature was review for information on alcohol and drug use and treatment in Australian prisons. In 2009, over 80 percent of Indigenous and non-Indigenous inmates smoked. Prior to imprisonment, many Indigenous and non-Indigenous inmates drank alcohol at risky levels (65 vs 47 percent) and used illicit drugs (over 70 percent for both groups). Reports of using heroin (15 vs 21 percent), ATS (21 vs 33 percent), cannabis (59 vs 50 percent) and injecting (61 vs 53 percent) were similarly high for both groups. Prison-based programs included detoxification, Opioid Substitution Treatment, counselling and drug free units, but access was limited especially among Indigenous prisoners. Drug and alcohol use was a significant issue in Australian prisons. Prisoners were over five times more likely than the general population to have a substance use disorder. Imprisonment provides an important opportunity for rehabilitation for offenders. This opportunity is especially relevant to Indigenous prisoners who were more likely to use health services when in prison than in the community and given their vast over representations in prison populations. Given the effectiveness of treatment in reducing re-offending rates, it is important to expand drug treatment and especially culturally appropriate treatment programs for Indigenous inmates. Very little is known about Indigenous specific drug and alcohol programs in Australian prisons.

“I Don't Think that Any Peer Review Committee . . . Would Ever ‘Get’ What I Currently Do”: How Institutional Metrics for Success and Merit Risk Perpetuating the (Reproduction of Colonial Relationships in Community-Based Participatory Research Involving Indigenous Peoples in Canada

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Heather Castleden

2015-09-01

Full Text Available This article reports on findings from a study that explored how a group of leading health researchers who do Indigenous community-engaged research (n = 20 in Canada envision enacting ethically sound research with Indigenous communities, as well as the concomitant tensions associated with doing so. In particular, we explore how institutional metrics for assessing merit and granting tenure are seen to privilege conventional discourses of productivity and validity in research and, as a result, are largely incongruent with the relational values associated with decolonizing research through community-based participatory health research. Our findings reveal that colonial incursion from the academy risk filtering into such research agendas and create a conflict between relational accountability to community partners and academic accountability to one’s discipline and peers.

[Social determinants of health associated to the human immunodeficiency virus of indigenous women in north Oaxaca, México].

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Juan-Martínez, Berenice; Castillo-Arcos, Lubia Del Carmen

2016-01-01

The vulnerability to the human immunodeficiency virus (HIV) infection may increase based on specific social determinants of health, which can also affect the lack of adherence to a safe sexual behavior and access to antiretroviral treatment in indigenous women. Consequently, it is necessary to review, through a documentary study, what are those determinants in the case of a group of indigenous women from the North of Oaxaca and how these aspects affect those women, as well as the important role of nursing for the best approach. Social determinants are classified into 3 levels: macro (socioeconomic status, income, migration and education), meso (culture, gender and access to health services) and micro (lifestyles and adoption of safe sex). Indigenous women with limited resources become easy targets of HIV by engaging in risky sexual behaviors inadvertently. The nurse is a key professional who can influence behaviors of women through effective interventions that help foster self-confidence and empowerment, using the resources that the person possesses. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Study Protocol--Alcohol Management Plans (AMPs) in remote indigenous communities in Queensland: their impacts on injury, violence, health and social indicators and their cost-effectiveness.

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Clough, Alan R; Fitts, Michelle S; Robertson, Jan A; Shakeshaft, Anthony; Miller, Adrian; Doran, Christopher M; Muller, Reinhold; Ypinazar, Valmae; Martin, David; McDermott, Robyn; Sanson-Fisher, Rob; Towle, Simon; Margolis, Stephen A; West, Caryn

2014-01-09

In 2002/03 the Queensland Government responded to high rates of alcohol-related harm in discrete Indigenous communities by implementing alcohol management plans (AMPs), designed to include supply and harm reduction and treatment measures. Tighter alcohol supply and carriage restrictions followed in 2008 following indications of reductions in violence and injury. Despite the plans being in place for over a decade, no comprehensive independent review has assessed to what level the designed aims were achieved and what effect the plans have had on Indigenous community residents and service providers. This study will describe the long-term impacts on important health, economic and social outcomes of Queensland's AMPs. The project has two main studies, 1) outcome evaluation using de-identified epidemiological data on injury, violence and other health and social indicators for across Queensland, including de-identified databases compiled from relevant routinely-available administrative data sets, and 2) a process evaluation to map the nature, timing and content of intervention components targeting alcohol. Process evaluation will also be used to assess the fidelity with which the designed intervention components have been implemented, their uptake and community responses to them and their perceived impacts on alcohol supply and consumption, injury, violence and community health. Interviews and focus groups with Indigenous residents and service providers will be used. The study will be conducted in all 24 of Queensland's Indigenous communities affected by alcohol management plans. This evaluation will report on the impacts of the original aims for AMPs, what impact they have had on Indigenous residents and service providers. A central outcome will be the establishment of relevant databases describing the parameters of the changes seen. This will permit comprehensive and rigorous surveillance systems to be put in place and provided to communities empowering them with the

Social Determinants of Traumatic Brain Injury in the North American Indigenous Population: A Review.

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Zeiler, Kaitlin J; Zeiler, Frederick A

2017-09-01

Given the difficult to navigate literature on social determinants in Indigenous traumatic brain injury (TBI) we wished to identify all available literature on the social determinants of health linked to TBI in the North American Indigenous populations. We performed a systematically conducted review. We searched MEDLINE, BIOSIS, EMBASE, Global Health, SCOPUS, and Cochrane Library from inception to January 2016. A two-step review process of the search results was performed, applying defined inclusion/exclusion criteria. The final group of articles had the data extracted and summarized. Ten manuscripts were identified to discuss some social determinant linked to TBI in the North American Indigenous populations. Two studies were focused on Canadian populations, with the remaining 8 studies focused on populations within the United States. Six social health determinants were identified within the studies, including: Rural location (Physical Environment) in seven studies, Male gender in five studies and Female gender in one study (in the setting of interpersonal violence) (Gender), Substance use in four studies and failure to utilize personal protective equipment in one study (Personal Health Practices and Coping Skills), Interpersonal Violence in one study (Social Environment), availability of rehabilitation services in one study (Health Services), and lack of family and friend presence during meetings with healthcare professionals in one study (Social Support Network). To date, little literature is available on the social determinants that impact TBI in the North American Indigenous population. Further research is warranted to better determine the incidence and social determinants associated.

Educator Perspectives on Indigenous Cultural Content in an Occupational Therapy Curriculum

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Melchert, Belinda; Gray, Marion; Miller, Adrian

2016-01-01

Health professionals must understand Indigenous perspectives to deliver effective health services. This study set out to determine the amount, type and effectiveness of current Indigenous content in an occupational therapy curriculum at an Australian regional university and the progress in meeting the National Aboriginal Health Strategy (NAHS)…

Reducing disease burden and health inequalities arising from chronic disease among indigenous children: an early childhood caries intervention in Aotearoa/New Zealand.

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Broughton, John R; Maipi, Joyce Te H; Person, Marie; Thomson, W Murray; Morgaine, Kate C; Tiakiwai, Sarah-Jane; Kilgour, Jonathan; Berryman, Kay; Lawrence, Herenia P; Jamieson, Lisa M

2013-12-13

Maaori are the Indigenous people of New Zealand and do not enjoy the same oral health status as the non-Indigenous majority. To overcome oral health disparities, the life course approach affords a valid foundation on which to develop a process that will contribute to the protection of the oral health of young infants. The key to this process is the support that could be provided to the parents or care givers of Maaori infants during the pregnancy of the mother and the early years of the child. This study seeks to determine whether implementing a kaupapa Maaori (Maaori philosophical viewpoint) in an early childhood caries (ECC) intervention reduces dental disease burden among Maaori children. The intervention consists of four approaches to prevent early childhood caries: dental care provided during pregnancy, fluoride varnish application to the teeth of children, motivational interviewing, and anticipatory guidance. The participants are Maaori women who are expecting a child and who reside within the Maaori tribal area of Waikato-Tainui.This randomised-control trial will be undertaken utilising the principles of kaupapa Maaori research, which encompasses Maaori leadership, Maaori relationships, Maaori customary practices, etiquette and protocol. Participants will be monitored through clinical and self-reported information collected throughout the ECC intervention. Self-report information will be collected in a baseline questionnaire during pregnancy and when children are aged 24 and 36 months. Clinical oral health data will be collected during standardised examinations at ages 24 and 36 months by calibrated dental professionals. All participants receive the ECC intervention benefits, with the intervention delayed by 24 months for participants who are randomised to the control-delayed arm. The development and evaluation of oral health interventions may produce evidence that supports the application of the principles of kaupapa Maaori research in the research

Beasts of burden or organised cooperation: the story of a mental health team in remote, Indigenous Australia.

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Hunter, Ernest; Onnis, Leigh-Ann; Santhanam-Martin, Radhika; Skalicky, Judy; Gynther, Bruce; Dyer, Geraldine

2013-12-01

This paper aims to describe the growth of a regionally-based mental health team providing services to remote Indigenous communities in far north Queensland. By drawing on their experience, the authors are able to identify factors supporting the development and sustained capacity of integrated mental health teams, working in challenging remote settings.

Utilization of maternal health care services among indigenous women in Bangladesh: A study on the Mru tribe.

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Islam, Rakibul M

2017-01-01

Despite startling developments in maternal health care services, use of these services has been disproportionately distributed among different minority groups in Bangladesh. This study aimed to explore the factors associated with the use of these services among the Mru indigenous women in Bangladesh. A total of 374 currently married Mru women were interviewed using convenience sampling from three administrative sub-districts of the Bandarban district from June to August of 2009. Associations were assessed using Chi-square tests, and a binary logistic regression model was employed to explore factors associated with the use of maternal health care services. Among the women surveyed, 30% had ever visited maternal health care services in the Mru community, a very low proportion compared with mainstream society. Multivariable logistic regression analyses revealed that place of residence, religion, school attendance, place of service provided, distance to the service center, and exposure to mass media were factors significantly associated with the use of maternal health care services among Mru women. Considering indigenous socio-cultural beliefs and practices, comprehensive community-based outreach health programs are recommended in the community with a special emphasis on awareness through maternal health education and training packages for the Mru adolescents.

Designing an implementation intervention with the Behaviour Change Wheel for health provider smoking cessation care for Australian Indigenous pregnant women.

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Gould, Gillian S; Bar-Zeev, Yael; Bovill, Michelle; Atkins, Lou; Gruppetta, Maree; Clarke, Marilyn J; Bonevski, Billie

2017-09-15

Indigenous smoking rates are up to 80% among pregnant women: prevalence among pregnant Australian Indigenous women was 45% in 2014, contributing significantly to the health gap for Indigenous Australians. We aimed to develop an implementation intervention to improve smoking cessation care (SCC) for pregnant Indigenous smokers, an outcome to be achieved by training health providers at Aboriginal Medical Services (AMS) in a culturally competent approach, developed collaboratively with AMS. The Behaviour Change Wheel (BCW), incorporating the COM-B model (capability, opportunity and motivation for behavioural interventions), provided a framework for the development of the Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy implementation intervention at provider and patient levels. We identified evidence-practice gaps through (i) systematic literature reviews, (ii) a national survey of clinicians and (iii) a qualitative study of smoking and quitting with Aboriginal mothers. We followed the three stages recommended in Michie et al.'s "Behaviour Change Wheel" guide. Targets identified for health provider behaviour change included the following: capability (psychological capability, knowledge and skills) by training clinicians in pharmacotherapy to assist women to quit; motivation (optimism) by presenting evidence of effectiveness, and positive testimonials from patients and clinicians; and opportunity (environmental context and resources) by promoting a whole-of-service approach and structuring consultations using a flipchart and prompts. Education and training were selected as the main intervention functions. For health providers, the delivery mode was webinar, to accommodate time and location constraints, bringing the training to the services; for patients, face-to-face consultations were supported by a booklet embedded with videos to improve patients' capability, opportunity and motivation. The ICAN QUIT in Pregnancy was an intervention to train health

Indigeneity and Homeland: Land, History, Ceremony, and Language

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Lerma, Michael

2012-01-01

What is the relationship between Indigenous peoples and violent reactions to contemporary states? This research explores differing, culturally informed notions of attachment to land or place territory. Mechanistic ties and organic ties to land are linked to a key distinction between Indigenous peoples and non-Indigenous peoples. Utilizing the…

Resisting Dominant Discourses: Implications of Indigenous, African Feminist Theory and Methods for Gender and Education Research

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Chilisa, Bagele; Ntseane, Gabo

2010-01-01

In this paper we explore tensions between Western gender theory and research, and post-colonial and indigenous feminist standpoints, which challenge us to re-define our roles as feminist-activist educators and researchers working with formerly colonised and historically marginalised communities. We discuss how African and Black feminist approaches…

Smoking cessation and tobacco prevention in Indigenous populations

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Adrian Esterman

2014-09-01

Full Text Available This article systematically reviews 91 smoking cessation and tobacco prevention studies tailored for Indigenous populations around the world, with a particular focus on Aboriginal and Torres Strait Islander populations in Australia. We identified several components of effective interventions, including the use of multifaceted programs that simultaneously address the behavioural, psychological and biochemical aspects of addiction, using resources culturally tailored for the needs of individual Indigenous populations. Pharmacotherapy for smoking cessation was effective when combined with culturally tailored behavioural interventions and health professional support, though it is generally underused in clinical practice. From a policy perspective, interventions of greater intensity, with more components, were more likely to be effective than those of lower intensity and shorter duration. For any new policy it is important to consider community capacity building, development of knowledge, and sustainability of the policy beyond guided implementation. Future research should address how the intervention can be supported into standard practice, policy, or translation into the front-line of clinical care. Investigations are also required to determine the efficacy of emerging therapies (such as e-cigarettes and the use of social media to tackle youth smoking, and under-researched interventions that hold promise based on non-Indigenous studies, such as the use of Champix. We conclude that more methodologically rigorous investigations are required to determine components of the less-successful interventions to aid future policy, practice and research initiatives.

Historical Trauma, Substance Use, and Indigenous Peoples: Seven Generations of Harm From a "Big Event".

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Nutton, Jennifer; Fast, Elizabeth

2015-01-01

Indigenous peoples the world over have and continue to experience the devastating effects of colonialism including loss of life, land, language, culture, and identity. Indigenous peoples suffer disproportionately across many health risk factors including an increased risk of substance use. We use the term "Big Event" to describe the historical trauma attributed to colonial policies as a potential pathway to explain the disparity in rates of substance use among many Indigenous populations. We present "Big Solutions" that have the potential to buffer the negative effects of the Big Event, including: (1) decolonizing strategies, (2) identity development, and (3) culturally adapted interventions. Study limitations are noted and future needed research is suggested.

Phenomenology, Hermeneutics and the study of indigenous ...

African Journals Online (AJOL)

Indilinga: African Journal of Indigenous Knowledge Systems ... Yet in Africa, where traditional religions and thought systems of the indigenous people of Africa were formerly ... and the active participation of respondents in the research process.

The development of a healing model of care for an Indigenous drug and alcohol residential rehabilitation service: a community-based participatory research approach.

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Munro, Alice; Shakeshaft, Anthony; Clifford, Anton

2017-12-04

Given the well-established evidence of disproportionately high rates of substance-related morbidity and mortality after release from incarceration for Indigenous Australians, access to comprehensive, effective and culturally safe residential rehabilitation treatment will likely assist in reducing recidivism to both prison and substance dependence for this population. In the absence of methodologically rigorous evidence, the delivery of Indigenous drug and alcohol residential rehabilitation services vary widely, and divergent views exist regarding the appropriateness and efficacy of different potential treatment components. One way to increase the methodological quality of evaluations of Indigenous residential rehabilitation services is to develop partnerships with researchers to better align models of care with the client's, and the community's, needs. An emerging research paradigm to guide the development of high quality evidence through a number of sequential steps that equitably involves services, stakeholders and researchers is community-based participatory research (CBPR). The purpose of this study is to articulate an Indigenous drug and alcohol residential rehabilitation service model of care, developed in collaboration between clients, service providers and researchers using a CBPR approach. This research adopted a mixed methods CBPR approach to triangulate collected data to inform the development of a model of care for a remote Indigenous drug and alcohol residential rehabilitation service. Four iterative CBPR steps of research activity were recorded during the 3-year research partnership. As a direct outcome of the CBPR framework, the service and researchers co-designed a Healing Model of Care that comprises six core treatment components, three core organisational components and is articulated in two program logics. The program logics were designed to specifically align each component and outcome with the mechanism of change for the client or organisation

Indigenous traditional medicine and intercultural healthcare in Bolivia: a case study from the Potosi region.

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Torri, Maria Costanza; Hollenberg, Daniel

2013-01-01

Indigenous peoples have the worst socio-demographic indicators and the largest inequalities in terms of access to social services and health in the Latin American region, Bolivia included. In the last few years, attempts to implement policies that support indigenous people's health rights led to the development of intercultural health approaches. Yet, acceptance and integration of indigenous medicine into the biomedical health system presents a major challenge to intercultural health in Latin America. The objective of this article is to analyze the case of a health center in Tinguipaya, one of the first and few examples of intercultural health initiatives in Bolivia. This intercultural health project, which represents a pioneer experience with regard to the creation of intercultural health services in Bolivia, aims to create a network between local communities, traditional healers, and biomedical staff and offer a more culturally sensitive and holistic health service for indigenous people living in the area. The aim of this article is to critically assess this initiative and to analyze the main challenges met in the creation of a more effective intercultural health policy. The extent to which this initiative succeeded in promoting the integration between indigenous health practitioners and biomedical staff as well as in improving access to health care for local indigenous patients will also be examined.

Mental health first aid for Indigenous Australians: using Delphi consensus studies to develop guidelines for culturally appropriate responses to mental health problems

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Kelly Claire M

2009-08-01

Full Text Available Abstract Background Ethnic minority groups are under-represented in mental health care services because of barriers such as poor mental health literacy. In 2007, the Mental Health First Aid (MHFA program implemented a cultural adaptation of its first aid course to improve the capacity of Indigenous Australians to recognise and respond to mental health issues within their own communities. It became apparent that the content of this training would be improved by the development of best practice guidelines. This research aimed to develop culturally appropriate guidelines for providing first aid to an Australian Aboriginal or Torres Strait Islander person who is experiencing a mental health crisis or developing a mental illness. Methods A panel of Australian Aboriginal people who are experts in Aboriginal mental health, participated in six independent Delphi studies investigating depression, psychosis, suicidal thoughts and behaviours, deliberate self-injury, trauma and loss, and cultural considerations. The panel varied in size across the studies, from 20-24 participants. Panellists were presented with statements about possible first aid actions via online questionnaires and were encouraged to suggest additional actions not covered by the survey content. Statements were accepted for inclusion in a guideline if they were endorsed by ≥ 90% of panellists as essential or important. Each study developed one guideline from the outcomes of three Delphi questionnaire rounds. At the end of the six Delphi studies, participants were asked to give feedback on the value of the project and their participation experience. Results From a total of 1,016 statements shown to the panel of experts, 536 statements were endorsed (94 for depression, 151 for psychosis, 52 for suicidal thoughts and behaviours, 53 for deliberate self-injury, 155 for trauma and loss, and 31 for cultural considerations. The methodology and the guidelines themselves were found to be useful

Leveraging quality improvement through use of the Systems Assessment Tool in Indigenous primary health care services: a mixed methods study.

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Cunningham, Frances C; Ferguson-Hill, Sue; Matthews, Veronica; Bailie, Ross

2016-10-18

Assessment of the quality of primary health care health delivery systems is a vital part of continuous quality improvement (CQI) processes. The Systems Assessment Tool (SAT) was designed to support Indigenous PHC services in assessing and improving their health care systems. It was based on the Assessment of Chronic Illness Care scale, and on practical experience with applying systems assessments in quality improvement in Indigenous primary health care. We describe the development and application of the SAT, report on a survey to assess the utility of the SAT and review the use of the SAT in other CQI research programs. The mixed methods approach involved a review of documents and internal reports relating to experience with use of the SAT since its development in 2002 and a survey of key informants on their experience with using the SAT. The paper drew from documents and internal reports to describe the SAT development and application in primary health care services from 2002 to 2014. Survey feedback highlighted the benefit to the whole primary health care team from participating in the SAT, bringing to light issues that might not emerge with separate individual tool completion. A majority of respondents reported changes in their health centres as a result of using the SAT. Good organisational and management support assisted with ensuring allocation of time and resources for SAT conduct. Respondents identified the importance of having a skilled, external facilitator. Originally designed as a measurement tool, the SAT rapidly evolved to become an important development tool, assisting teams in learning about primary health care system functioning, applying best practice and contributing to team strengthening. It is valued by primary health care centres as a lever in implementing improvements to strengthen centre delivery systems, and has potential for further adaptation and wider application in Australia and internationally.

From knowing our needs to enacting change: findings from community consultations with indigenous communities in Bangladesh.

Science.gov (United States)

Hussain, Sameera; Ruano, Ana Lorena; Rahman, Atiya; Rashid, Sabina Faiz; Hill, Peter S

2015-11-09

Indigenous peoples are among the most marginalized peoples in the world due to issues relating to well-being, political representation, and economic production. The research consortium Goals and Governance for Global Health (Go4Health) conducted a community consultation process among marginalized groups across the global South aimed at including their voices in the global discourse around health in the post-2015 development agenda. This paper presents findings from the consultations carried out among indigenous communities in Bangladesh. For this qualitative study, our research team consulted the Tripura and Mro communities in Bandarban district living in the isolated Chittagong Hill Tracts region. Community members, leaders, and key informants working in health service delivery were interviewed. Data was analyzed using thematic analysis. Our findings show that remoteness shapes the daily lives of the communities, and their lack of access to natural resources and basic services prevents them from following health promotion messages. The communities feel that their needs are impossible to secure in a politically indifferent and sometimes hostile environment. Communities are keen to participate and work with duty bearers in creating the conditions that will lead to their improved quality of life. Clear policies that recognize the status of indigenous peoples are necessary in the Bangladeshi context to allow for the development of services and infrastructure.

In Indigenous Words: Exploring Vignettes as a Narrative Strategy for Presenting the Research Voices of Aboriginal Community Members

Science.gov (United States)

Blodgett, Amy T.; Schinke, Robert J.; Smith, Brett; Peltier, Duke; Pheasant, Chris

2011-01-01

Recently, awareness within academia has grown regarding the incompatibilities of mainstream research with indigenous cultures as well as the historical injustices that have accrued through colonizing practices. Accordingly, support for alternative (non-Westernized) research approaches has been increasing. Participatory action research (PAR) and…

Expanding the Conversation: Further Explorations into Indigenous Environmental Science Education Theory, Research, and Practice

Science.gov (United States)

Lowan, Greg

2012-01-01

Indigenous environmental science education is a diverse, dynamic, and rapidly expanding field of research, theory, and practice. This article highlights, challenges, and expands upon key areas of discussion presented by Mack et al. (Cult Stud Sci Educ 7, "2012") as part of the forum on their article "Effective Practices for Creating…

Potential utility of SumbandilaSat imagery for monitoring indigenous forest health

CSIR Research Space (South Africa)

Cho, Moses A

2010-09-01

Full Text Available Indigenous forest degradation is regarded as one of the most important environmental issues facing sub-Saharan Africa and South Africa in particular. Indigenous forest degradation is characterised by habitat fragmentation stemming from logging...

The Complexities of Intimate Partner Violence: Mental Health, Disabilities, and Child Abuse History for White, Indigenous, and Other Visible Minority Canadian Women.

Science.gov (United States)

Tutty, Leslie M; Radtke, H L; Ateah, Christine A; Ursel, E Jane; Thurston, Wilfreda E Billie; Hampton, Mary; Nixon, Kendra

2017-11-01

This research examines how mental health issues associated with intimate partner violence (IPV) relate to women's intersecting identities of race/ethnicity, disability status, and child abuse history. Data ( N = 595) from a Canadian triprovincial study included women who were White ( n = 263, 44.8%), Indigenous ( n = 292, 49.7%), or visible minority ( n = 32, 5.5%). Few demographic differences were found. None of the mental health measures (Symptom Checklist-Short Form [SCL-10], Centre for Epidemiological Studies-Depression [CES-D-10], Posttraumatic Stress Disorder [PTSD] Checklist) were in the clinical ranges. In a MANCOVA on the mental health scales, with IPV severity, racial group, disability status, and child abuse history as variables, only disability was significantly associated with more mental health symptoms.

Benefit sharing in health research

African Journals Online (AJOL)

2015-08-02

Aug 2, 2015 ... [4] Those who contribute to scientific research ought to share in its benefits. .... women to form new relationships, social networks and develop a sense of ... or discoveries about the indigenous biological resources before.

Knowledge, indigenous knowledge, peace and development ...

African Journals Online (AJOL)

This paper seeks to understand the nature of knowledge, introduce the concept of indigenous knowledge, provide some idea of the status of Indigenous ... African professionals, scholars, researchers, policy makers and activists attempting to understand or promote IK run the risk of a cool reception, ridicule or even outright ...

Barriers in education of indigenous nursing students: a literature review.

Science.gov (United States)

Foxall, Donna

2013-11-01

The poor health status of indigenous people has been identified internationally as a critical issue. It is now commonly accepted that the ability to address this concern is hindered, in part, by the disproportionately low number of indigenous health professionals, including nurses. This paper reports the findings of a review of literature that aimed to identify key barriers in the education of the indigenous undergraduate nursing students in the tertiary sector, to identify strategies to overcome these, and discuss these elements within the New Zealand context. A number of health-related databases were searched and a total of 16 peer-reviewed articles from Canada, U.S.A., Australia and New Zealand were reviewed. Key barriers to recruitment and retention and strategies to overcome these are presented. Barriers to recruitment included: academic unpreparedness; poor understanding of cultural needs; and conflicting obligations, and financial constraints. Barriers to retention included lack of cultural and academic support, family obligations and financial hardship. Strategies to address recruitment barriers included: addressing pre-entry education requirements; targeted promotion of nursing programmes; indigenous role models in the recruitment process; and streamlining enrolment processes to make programmes attractive and attainable for indigenous students. Strategies to address retention barriers included: cultural relevance within the curriculum; identifying and supporting cultural needs of indigenous students with active participation of indigenous staff; engaging communities and funding support. The crucial development of partnerships between academic institutes and indigenous communities to ensure the provision of a culturally safe, supportive environment for the students was stressed. In New Zealand, while government-level policy exists to promote the success of MBori nursing students, the translation of what is known about the recruitment and retention of

Delivery of maternal health care in Indigenous primary care services: baseline data for an ongoing quality improvement initiative

Directory of Open Access Journals (Sweden)

Kwedza Ru K

2011-03-01

Full Text Available Abstract Background Australia's Aboriginal and Torres Strait Islander (Indigenous populations have disproportionately high rates of adverse perinatal outcomes relative to other Australians. Poorer access to good quality maternal health care is a key driver of this disparity. The aim of this study was to describe patterns of delivery of maternity care and service gaps in primary care services in Australian Indigenous communities. Methods We undertook a cross-sectional baseline audit for a quality improvement intervention. Medical records of 535 women from 34 Indigenous community health centres in five regions (Top End of Northern Territory 13, Central Australia 2, Far West New South Wales 6, Western Australia 9, and North Queensland 4 were audited. The main outcome measures included: adherence to recommended protocols and procedures in the antenatal and postnatal periods including: clinical, laboratory and ultrasound investigations; screening for gestational diabetes and Group B Streptococcus; brief intervention/advice on health-related behaviours and risks; and follow up of identified health problems. Results The proportion of women presenting for their first antenatal visit in the first trimester ranged from 34% to 49% between regions; consequently, documentation of care early in pregnancy was poor. Overall, documentation of routine antenatal investigations and brief interventions/advice regarding health behaviours varied, and generally indicated that these services were underutilised. For example, 46% of known smokers received smoking cessation advice/counselling; 52% of all women received antenatal education and 51% had investigation for gestational diabetes. Overall, there was relatively good documentation of follow up of identified problems related to hypertension or diabetes, with over 70% of identified women being referred to a GP/Obstetrician. Conclusion Participating services had both strengths and weaknesses in the delivery of maternal

Harnessing indigenous knowledge for sustainable forest management in Ghana

Directory of Open Access Journals (Sweden)

Margaret Sraku-Lartey

2015-01-01

Full Text Available This paper makes a case for harnessing indigenous knowledge (IK for sustainable national development in Ghana. IK according to the World Bank is the basic component of any country’s knowledge system and it is upon this knowledge that scientific research builds. In Ghana the Government has recognized the need to harness IK for sustainable national development and has therefore incorporated it into the National Science, Technology and Innovation Development Programme. But there is no evidence however that scientific research in Ghana actually takes IK into consideration during the research process. This paper discusses the concept of indigenous knowledge, its relevance in scientific discourse and the need for harnessing it for national development in Ghana. A desk study was conducted using journal publications, research and technical reports, online databases and the internet. About sixty articles were analysed using the thematic synthesis method under the following broad headings: Importance of Indigenous knowledge, Indigenous forest foods, Indigenous medicines, IK and food security, the management and processing of IK and the protection of Indigenous Knowledge.The results of the study established the need to document the local knowledge using appropriate procedures and strategies. It also concludes by suggesting that IK in Ghana must be protected by law and integrated into formal science.

Indigenous homelessness

DEFF Research Database (Denmark)

Being homeless in one’s homeland is a colonial legacy for many Indigenous people in settler societies. The construction of Commonwealth nation-states from colonial settler societies depended on the dispossession of Indigenous peoples from their lands. The legacy of that dispossession and related...... attempts at assimilation that disrupted Indigenous practices, languages, and cultures—including patterns of housing and land use—can be seen today in the disproportionate number of Indigenous people affected by homelessness in both rural and urban settings. Essays in this collection explore the meaning...... and scope of Indigenous homelessness in the Canada, Australia, and New Zealand. They argue that effective policy and support programs aimed at relieving Indigenous homelessness must be rooted in Indigenous conceptions of home, land, and kinship, and cannot ignore the context of systemic inequality...

A scoping review of Indigenous suicide prevention in circumpolar regions

DEFF Research Database (Denmark)

Redvers, Jennifer; Bjerregaard, Peter; Eriksen, Heidi

2015-01-01

, families and communities. The persistence of suicide has made it clear that more needs to be done. OBJECTIVE: Our aim was to undertake a scoping review of the peer-reviewed literature on suicide prevention and interventions in Indigenous communities across the circumpolar north. Our objective...... Indigenous populations; 19 articles discussed specific suicide-related interventions and 7 of these described program evaluation methods and results in detail. The majority of publications on specific interventions were found in North American countries. The majority of prevention or intervention......BACKGROUND: Suicide is a serious public health challenge in circumpolar regions, especially among Indigenous youth. Indigenous communities, government agencies and health care providers are making concerted efforts to reduce the burden of suicide and strengthen protective factors for individuals...

Resituating the ethical gaze: government morality and the local worlds of impoverished Indigenous women

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Caroline L. Tait

2013-08-01

Full Text Available Background. Over generations, government policies have impacted upon the lives of Indigenous peoples of Canada in unique and often devastating ways. In this context, Indigenous women who struggle with poverty, mental illness, trauma and substance abuse are among the most vulnerable, as are Indigenous children involved in child welfare systems. Objective. By examining the life history of Wanda, a First Nations woman, this article examines the intergenerational role that government policies play in the lives of impoverished Indigenous women and their families. Questions of moral governance and responsibility and the need for ethical policies are raised. Design. The life narrative presented in this article is part of a larger qualitative research programme that has collected over 100 life histories of Indigenous women with addictions and who have involvement with the child welfare system, as children or adults. Wanda’s life story exemplifies the impact of government policies that is characteristic of vulnerable Indigenous women and draws attention to the lack of ethical standards in government policymaking in child welfare, public health and mental health/addictions. Results. The path to recovery for Canadian Indigenous women in need of treatment for co-occurring mental disorders and substance addiction is too frequently characterized by an inadequate and ever shifting continuum of care. For those who feel intimidated, suspicious or have simply given up on seeking supports, a profound invisibility or forgetting of their struggle exists in areas of government policy and programming provision. Living outside the scope of mental health and addiction priorities, they become visible to the human service sector only if they become pregnant, their parenting draws the attention of child and family services (CFS, they need emergency health care, or are in trouble with the law. The intergenerational cycle of substance abuse, mental illness and poverty is

Resituating the ethical gaze: government morality and the local worlds of impoverished Indigenous women.

Science.gov (United States)

Tait, Caroline L

2013-01-01

Over generations, government policies have impacted upon the lives of Indigenous peoples of Canada in unique and often devastating ways. In this context, Indigenous women who struggle with poverty, mental illness, trauma and substance abuse are among the most vulnerable, as are Indigenous children involved in child welfare systems. By examining the life history of Wanda, a First Nations woman, this article examines the intergenerational role that government policies play in the lives of impoverished Indigenous women and their families. Questions of moral governance and responsibility and the need for ethical policies are raised. The life narrative presented in this article is part of a larger qualitative research programme that has collected over 100 life histories of Indigenous women with addictions and who have involvement with the child welfare system, as children or adults. Wanda's life story exemplifies the impact of government policies that is characteristic of vulnerable Indigenous women and draws attention to the lack of ethical standards in government policymaking in child welfare, public health and mental health/addictions. The path to recovery for Canadian Indigenous women in need of treatment for co-occurring mental disorders and substance addiction is too frequently characterized by an inadequate and ever shifting continuum of care. For those who feel intimidated, suspicious or have simply given up on seeking supports, a profound invisibility or forgetting of their struggle exists in areas of government policy and programming provision. Living outside the scope of mental health and addiction priorities, they become visible to the human service sector only if they become pregnant, their parenting draws the attention of child and family services (CFS), they need emergency health care, or are in trouble with the law. The intergenerational cycle of substance abuse, mental illness and poverty is commonly associated with child welfare involvement

Socio-demographic factors and psychological distress in Indigenous and non-Indigenous Australian adults aged 18-64 years: analysis of national survey data

Directory of Open Access Journals (Sweden)

Cunningham Joan

2012-02-01

Full Text Available Abstract Background Indigenous Australians are known to be at greater risk of morbidity and mortality from mental health related conditions, but most available data relate to the use of mental health services, and little is known about other aspects of social and emotional wellbeing. Using the first available nationally representative data, we examined the prevalence and patterning of psychological distress among Indigenous Australian adults and compared these with corresponding data from the non-Indigenous population. Methods The analysis used weighted data on psychological distress, as measured by a modified Kessler Psychological Distress score (K5, and a range of socio-demographic measures for 5,417 Indigenous and 15,432 non-Indigenous adults aged 18-64 years from two nationally representative surveys. Very high psychological distress (VHPD was defined as a K5 score ≥ 15 (possible range = 5-25. Results Indigenous adults were about three times more likely than non-Indigenous adults to be classified with VHPD: 14.5% (95% confidence interval (CI 12.9-16.0% versus 5.5% (95% CI 5.0-5.9%. After adjusting for age, most socio-demographic variables were significantly associated with VHPD in both populations, although the relative odds were generally larger among non-Indigenous people. Indigenous people in remote areas had a lower prevalence of VHPD than their non-remote counterparts, and only marital status, main language, and food insecurity were significantly associated with VHPD in remote areas. Conclusions Higher absolute levels of VHPD combined with smaller socio-demographic gradients in the Indigenous population suggest the importance of risk factors such as interpersonal racism, marginalization and dispossession, chronic stress and exposure to violence that are experienced by Indigenous Australians with common and/or cross-cutting effects across the socioeconomic spectrum. The lower prevalence of VHPD and lack of association with many socio