Comprehensive primary health care at Central Australian Aboriginal Congress: Bringing together health care and action on social determinants of health — Agentur Pty Ltd
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Comprehensive primary health care at Central Australian Aboriginal Congress: Bringing together health care and action on social determinants of health (100)

Donna Ah Chee 1 , John Boffa 1 , Fran Baum 2 , Toby Freeman 2 , Angela Lawless 2 , Tahnia Edwards 1 , David Scrimgeour 3
  1. Central Australian Aboriginal Congress Aboriginal Corporation, Alice Springs, NT
  2. Southgate Institute, Flinders University, Adelaide, SA
  3. Aboriginal Health Council of South Australia, Adelaide, SA

Background:

Comprehensive primary health care encompasses rehabilitation, treatment, prevention, and promotion. However, in Australia and globally, implementation of primary health care has typically been selective, largely focusing on treatment of certain diseases, with less focus on the promotive element of the spectrum in particular. Promotive action to address the social determinants of health is crucial reducing health equities.

Methods:

The Southgate Institute conducted a five year NHMRC funded project in partnership with six primary health care services, five in South Australia (four state government, and one non-government), and one community controlled service in Alice Springs, Central Australian Aboriginal Congress. Over a five year period (2009-2013), we conducted interviews, workshops, and surveys with staff and clients, documented patient journeys and case studies of intersectoral action, and collected indicator data.

Results/Discussions:

 The project documented considerable change in primary health care over the five years, with the introduction of Medicare Locals, and in South Australia, significant budget cuts and reorientation of services. Congress, in contrast to the South Australian services, were able to retain the full spectrum of comprehensive primary health care, including health promotion and action on the social determinants of health. This included collective and collaborative advocacy on issues including alcohol, housing, and primary health care. There are a number of factors that may contribute to Congress’ ability to act on social determinants, including having an Aboriginal community controlled health board, an organisational and leadership commitment to comprehensiveness, and a less constraining political and financial environment than in South Australia.

Conclusions/implications:

These findings suggest the importance of a) community controlled health services in the improvement of Aboriginal and Torres Strait Islanders’ social determinants of health, and b) continued advocacy for adequate support and funding to allow implementation of the full comprehensive primary health care mandate, including action on the social determinants of health.

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