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Critical Analysis of VAHS - Victorian Aboriginal Health Service
  • 6

  • Course Code: NSG2204
  • University: Holmesglen
  • Country: Australia

Task :  

Critical analysis of a public/primary health care initiative or program: Advocacy and social justice for improved access to health outcomes for Indigenous Australians.

Critical Analysis Directions: You are required to write a critical analysis of an Aboriginal Community Controlled Health Organisation (ACCHO).

A list of ACCHOs that you can choose from is below. You must choose one organization from this list:

•    Victorian Aboriginal Health Service (Fitzroy, Victoria) https://www.vahs.org.au/
•    Miwatj Health Aboriginal Coorperation (Arnhem Land, Northern Territory) https://www.miwatj.com.au/
•    Yadu Health Aboriginal Corporation (Ceduna, South Australia) https://www.yadu.org.au/
•    Tasmanian Aboriginal Centre (Hobart, Tasmania) https://tacinc.com.au/

The critical analysis must be written in third-person academic language, with referencing (minimum of 10) in APA7th style to support statements. References should be less than 10 years old (less than 5 years if possible), except when referencing to historical information (original information/source may be referenced).

Your critical analysis should be written in three parts. Please use the headings below (which are not included in the word count). You do not need to include an introduction or conclusion.

Description - Identify the ACCHO you are analyzing.

Where is it located? Who is the community it serves? Which services does it offer, and what is the role of the nurse within the ACCHO? Provide context / background to the community (such as demographics and health needs) – relate these to determinants of health inequalities and the impact of history and colonisation specific to that community.

Analysis 

Analyse how the ACCHO addresses the determinants of health (identified in the ‘Description’– above) for the specific community it serves.

How does this support the Close the Gap campaign targets and outcomes? (you may choose to focus on 1 or 2 targets/outcomes that are especially applicable to the community the ACCHO is in).

How do nurses working within the ACCHO participate in advocacy and social justice? Relate these to the Close the Gap Campaign and how the ACCHO addresses determinants of health inequalities and the impact of history and colonisation.

Evaluation 

Evaluate the effectiveness of the ACCHO – have health outcomes (through addressing determinants of health) for Indigenous people within the community improved or decreased since the ACCHO was established? Are Close the Gap targets/outcomes being met?

Explore and evaluate factors that have impacted the effectiveness of the ACCHO, such as local, state or federal factors and the role of the nurse – what (if anything) needs to change to improve health outcomes and social justice?

ANSWERS

Description

In the context of this critical analysis, under examination is the Aboriginal Community Controlled Health Organisation (ACCHO), which is the Victorian Aboriginal Health Service (VAHS).

The Fitzroy, Victoria-based VAHS mostly serves the local Aboriginal population with its services. Prominent community members including Uncle Bruce McGuiness and Aunty Alma Thorpe started VAHS in 1973.

The organisation offers a broad range of social, dental, and medical services that are tailored to the particular needs of the neighbourhood (VAHS, 2023).

The nurse plays a crucial role in VAHS by aiding with procedures, teaching patients about their health, and acting as a patient-physician liaison in addition to providing front-line care. They play a critical role in ensuring that the services are comprehensive, culturally sensitive, and clinically successful.

VAHS serves a community that has long been beset by a number of health inequities rooted in the broader determinants of health. Wallace et al. (2019) includes socioeconomic position, educational level, and accessibility to healthcare as some of these determinants.

These are all closely related to history and the colonial heritage. The indigenous community's health challenges are, to a significant extent, a manifestation of the repercussions of colonisation, including land dispossession, cultural disruption, and social marginalisation (Shmerling et al., 2020).

These historical injustices have perpetuated health disparities, making services like those offered by VAHS crucial in bridging the health gap.

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Analysis

The Victorian Aboriginal Health Service (VAHS), as a leading Aboriginal Community Controlled Health Organisation (ACCHO), plays a crucial role in addressing the determinants of health for the indigenous community it serves in Fitzroy, Victoria.

Central to the mission of ACCHOs is the understanding that health is multifaceted; it is a synergy of physical, social, emotional, and cultural well-being (Kirby, 2015). Thus, the approach VAHS takes goes beyond mere clinical interventions, delving into the broader determinants that influence health outcomes (VAHS, 2023).

One of the primary determinants VAHS addresses is the issue of access to healthcare. Historically, indigenous communities have been marginalised, with limited access to healthcare services.

VAHS, being community-controlled, not only ensures that medical services are accessible but also tailors them to be culturally appropriate (Adams, 2014). This approach tackles both the tangible (physical access) and intangible (cultural barriers) determinants that have hindered indigenous health.

Furthermore, the socio-economic challenges that the community faces, such as unemployment and lower educational attainment, have direct repercussions on their health (Munari et al., 2021).

VAHS addresses these by integrating social services alongside medical ones, recognising that health cannot be viewed in isolation from other aspects of life (VAHS, 2023).

The 'Close the Gap' campaign, initiated to address health disparities faced by Aboriginal and Torres Strait Islander peoples, has set various targets. One of the primary targets is to achieve health equity within a generation.

The services offered by VAHS directly contribute to this target by providing holistic, community-driven healthcare that addresses the root causes of health disparities, rather than merely the symptoms (Altman et al., 2018).

Additionally, considering the higher prevalence of chronic diseases such as diabetes among indigenous communities, another relevant 'Close the Gap' target is the reduction of these diseases (Griffiths et al., 2016).

Nurses, as frontline healthcare professionals within VAHS, are not mere medical practitioners; they are advocates and champions of social justice. Their role goes beyond clinical care, encompassing education, community engagement, and advocacy.

They ensure that the care provided is culturally sensitive, respecting and understanding the traditions and values of the indigenous community. This advocacy, rooted in the principles of social justice, directly aligns with the 'Close the Gap' campaign.

By ensuring that healthcare is both accessible and appropriate, nurses contribute significantly to bridging the health disparity (Labonte et al., 2014).

Furthermore, nurses at VAHS play an instrumental role in addressing the scars of history and colonisation. Understanding that the health challenges faced by the indigenous community are deeply rooted in historical injustices, nurses adopt a trauma-informed approach to care.

This entails acknowledging the influence of past occurrences on people's health, such as the forcible relocation of children and the confiscation of property (Poirier et al., 2022). By addressing these past traumas, nurses make sure that patients receive holistic care that attends to their emotional and psychological needs in addition to their physical needs.

The Fitzroy indigenous community's many health factors are addressed by the Victorian Aboriginal Health Service thanks to its all-encompassing and community-centric approach. VAHS is making great progress in closing the gap in health inequalities, and its goals and results align with the 'Close the Gap' campaign (Griffiths et al., 2016).

With their dual roles as medical professionals and advocates, nurses are at the forefront of this mission. They make sure that the community receives care that is culturally sensitive and clinically effective, addressing health disparities caused by historical influences and colonisation.

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Evaluation

In order to meet the particular health requirements of the indigenous population in Fitzroy, Victoria, the Victorian Aboriginal Health Service (VAHS) was established as an Aboriginal population Controlled Health Organisation (ACCHO).

Ever since its establishment, VAHS has endeavoured to comprehensively tackle the elements that influence health, ranging from socioeconomic variables to healthcare accessibility (VAHS, 2023).

When assessing the efficacy of VAHS, data points to improved health outcomes for Indigenous members of the community. Better health outcomes result from the combination of culturally responsive medical, dental, and social care, which guarantees that the larger determinants of health are addressed (Wallace et al., 2019).

Additionally, the launch of specific activities like the Diabetes Club suggests a proactive strategy to treat common health issues in the community (VAHS, 2023).

Even though VAHS has accomplished some of its goals, there is still more to be done, as seen by the larger national "Close the Gap" targets. There is no denying that the ACCHO has enhanced community health services and access, but there is still cause for worry over the differences in health outcomes between Indigenous and non-Indigenous Australians.

A number of variables affect how effective ACCHOs, such as VAHS, are (Shmerling et al., 2020). Local factors, such as community engagement and participation, play a vital role in the success of such organisations.

State and federal policies, funding, and recognition also significantly influence their efficacy. Furthermore, the role of nurses, as frontline healthcare providers and advocates, is paramount.

Their continuous professional development and the integration of trauma-informed care approaches can further enhance the effectiveness of the ACCHO (Kirby, 2015).

While VAHS has made commendable progress in improving health outcomes for the Indigenous community in Fitzroy, achieving the 'Close the Gap' targets requires sustained effort (Shmerling et al., 2020).

There's a need for greater collaboration between local, state, and federal entities, and a continuous evaluation of the roles and training of healthcare professionals, especially nurses, to ensure that the determinants of health are addressed holistically, thereby championing both improved health outcomes and social justice. 

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References

Adams, K., Halacas, C., Cincotta, M., & Pesich, C. (2014). Mental health and Victorian Aboriginal people: what can data mining tell us?. Australian Journal of Primary Health, 20(4), 350-355. https://sci-hub.se/https://doi.org/10.1071/PY14036 
Altman, J., Hunter, B., & Biddle, N. (2018). How realistic are the prospects for'closing the gaps' in socioeconomic outcomes for Indigenous Australians?. Canberra, ACT: Centre for Aboriginal Economic Policy Research (CAEPR), The Australian National University. https://openresearch-repository.anu.edu.au/handle/1885/147387
Griffiths, K., Coleman, C., Lee, V., & Madden, R. (2016). How colonisation determines social justice and Indigenous health—a review of the literature. Journal of Population Research, 33, 9-30. https://www.academia.edu/download/85663884/s12546-016-9164-120220508-1-eeeoxj.pdf 
Kirby, T. (2015). Ian Anderson: transforming Indigenous medicine and education. The Lancet, 385(9975), 1285. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60671-7/fulltext
Labonte, R., Sanders, D., Packer, C., & Schaay, N. (2014). Is the Alma Ata vision of comprehensive primary health care viable? Findings from an international project. Global health action, 7(1), 24997. https://www.tandfonline.com/doi/pdf/10.3402/gha.v7.24997 
Munari, S. C., Wilson, A. N., Blow, N. J., Homer, C. S., & Ward, J. E. (2021). Rethinking the use of ‘vulnerable’. Australian and New Zealand Journal of Public Health, 45(3), 197. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9968560/
Poirier, B. F., Hedges, J., Soares, G., & Jamieson, L. M. (2022). Aboriginal community controlled health services: an act of resistance against Australia’s neoliberal ideologies. International Journal of Environmental Research and Public Health, 19(16), 10058. https://www.mdpi.com/1660-4601/19/16/10058/pdf 
Shmerling, E., Creati, M., Belfrage, M., & Hedges, S. (2020). The health needs of Aboriginal and Torres Strait Islander children in out‐of‐home care. Journal of Paediatrics and Child Health, 56(3), 384-388. https://sci-hub.se/https://doi.org/10.1111/jpc.14624 
VAHS (2023). About. Retrieved from: https://www.vahs.org.au/about/ 
Wallace, J., Hanley, B., Belfrage, M., Gregson, S., Quiery, N., & Lucke, J. (2019). Delivering the hepatitis C cure to Aboriginal people: documenting the perspectives of one Aboriginal Health Service. Australian journal of primary health, 24(6), 491-495. https://www.researchgate.net/profile/Jack-Wallace-3/publication/328387865_Delivering_the_hepatitis_C_cure_to_Aboriginal_people_Documenting_the_perspectives_of_one_Aboriginal_Health_Service/links/5c08528c92851c39ebd61655/Delivering-the-hepatitis-C-cure-to-Aboriginal-people-Documenting-the-perspectives-of-one-Aboriginal-Health-Service.pdf

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