The Essay Explores The Role Of ACCHS, Hospitals, Nurses, And Midwives In Reducing Health Inequality Among Aboriginal And Torres Strait Islander Australians.

Part A: 
In Part A you are required to discuss the role Aboriginal Community Controlled Health Services (ACCHS) play in reducing the health inequality experienced by Aboriginal and Torres Strait Islander Australians.
1. Discuss the importance of self-determination to Indigenous Australians using ACCHS as an example of local communities exercising self-determination.
2. Discuss how the ACCHS model of comprehensive primary health care reflects Indigenous understandings of health and wellbeing. 
3. Choose one program provided by your local ACCHS* and discuss how it contributes to the health and wellbeing of the local Indigenous community 
4. Discuss the role of Aboriginal Health Workers (AHWs) and Aboriginal Health Practitioners (AHPs) in ACCHS in improving health outcomes for their local communities

Part B: 
In Part B you are required to discuss the role hospitals play in reducing the health inequality experienced by Aboriginal and Torres Strait Islander Australians.
1. What are the National Safety and Quality Health Service (NSQHS) Standards and how do these standards contribute to better health outcomes for Aboriginal and Torres Strait Islander patients.
2. Identify and discuss two (2) examples of programs or strategies hospitals can implement to improve patient outcomes for Indigenous Australians .

Part C: 
In Part C you are required to discuss the role nurses and midwives can play in reducing the health inequality experienced by Aboriginal and Torres Strait Islander Australians.
1. What are the Nursing and Midwifery Board of Australia (NMBA) Nursing and Midwifery Codes of Conduct and how do these codes contribute to better health outcomes for Aboriginal and Torres Strait Islander patients. 
2. Identify and discuss two (2) examples of how individual nurses and midwives can provide culturally-safe care and contribute to reducing health inequality for Indigenous Australians

The importance of self-determination for Indigenous Australians using ACCHS as an example

Part A

1).Self-determination is an important aspects of individual in relating and identifying oneself in the society. It provides the people the right to be in control of their destiny in the society. United Human Rights Committee defines it as a tool of a guarantee of human right being exercised among the people in a social group. In the indigenous groups of the Aboriginal Torres Strait Islanders it is necessary to define various socio cultural hindrances that they may face in the balancing of the rights in the society (Ahmrc.org.au, 2018). It can help them put forward their issues in the country they live in to forge a sustainable relationship.

2). Contrary to the global definition of the Primary health care in the case of the aboriginals in the society relates to maintaining their overall emotional and social security in the society. One of the important issue in providing the healthcare to the aboriginals is their identification issue with the healthcare providers who they feel are biased against them (Ahmrc.org.au, 2018). The improvement of the overall health and living conditions of the individuals in the aboriginals societies help in establishing the fact that sanitation and healthcare are important aspects in establishing overall health of individuals in society (de Dassel, Ralph & Cass, 2017). This will help in improving the social determinants of health among the Torres Strait Islanders improving their identification with the country.

3). The use of the Healthcare Homes in Australia to provide Healthcare facilities to the individuals in the society is one of the important healthcare facilities to be provided to the individuals in the society (Health.gov.au, 2018). The various services that are being provide by the Healthcare facilities caters to the healthcare issues related to conditions like diabetes, heart and lung conditions and arthritis. The healthcare homes focus on treating the conditions that need long term treatment for condition that might need long term care.  They are funded by the government focusing on providing medicine and healthcare for the aboriginals who cannot afford it (Nattabi et al., 2017). This let the aboriginals relate to their countries and socially relate to their nation.

4). Aboriginal Health Workers (AHWs) and Aboriginal Health Practitioners (AHPs) have a major role to play in the providing to the healthcare among the Torres Strait Islander and forging a strong relationship between aboriginals and the society. They are the communication channels between the policies to be implemented by the government and the people in the aboriginal society. The AHWs and AHPs focus on the providing of the healthcare to people in the Torres Strait Island and other aboriginal areas (Ahmrc.org.au, 2018). Moreover, they have a major role to play in forging relation between people in Aboriginal society and the government in Australia. The role of Aboriginal Health Workers (AHWs) and Aboriginal Health Practitioners (AHPs) in the society focus on the development of the relation between the Torres State Islander and improving ideals between the people in the society and their identity between them and the society (Topp, Edelman & Taylor, 2018). AHWs and AHPs also help in the proper implementation of policies of people in the society.

ACCHS model of comprehensive primary health care reflects Indigenous understandings of health and wellbeing

Part B

1). The main objectives of National Safety and Quality Health Service Standards are:

• Defending the people from harm
• Ameliorate the qualities of services providing for improvement of health.
• Give assurance mechanisms about the qualities of the services that are being provided to the people in the society.
• The standard of the qualities that are to be met and safety measures are to be in place for the people in the society.
• The quality improvement standards are to be provided to the people in society for meeting developmental requirements of sustainable future.

These standards helped in the improvement of overall heath in the society of Torres State Islanders. The policies help in even distribution of healthcare policies throughout the society. The policies help in the proper implementation of the healthcare strategies and policies put in place by the government for the people in the Aboriginal society (Gardner et al., 2018). The maintenance of the standards helps in the assurance of the fact that the people get proper treatment irrespective of their social situation. These policies help in the uplifting of overall living conditions in the society (Qip.com.au, 2018). The improvement of the quality of healthcare being provided to the people helps in assuring them of their identity and merging them with the mainstream society in the country. The assurance to the people in the society helps in the improvement of relation between the people in the urban society in Australia and the Torres Strait Islanders.

2). There are a number of examples that can be cited for the instances of improving the relations between the Aboriginals and Australian society.

Example 1: One of the major issues faced by the people in the society is in the fact that they fear to approach the hospitals for the fear of being victim of Stereotyping. One of the major issues that the people face is that they are bound not to use the help of the health care offidcials as they are denied medicine on the basis of them being substance abusers. One of the major issue in this context is that the people are frequently biased against as there was a case where a a cancer patient was denied painkillers for the suspicion of substance abuse. This greatly affects the mentality of the person affecting their overall healthcare development.

Example 2: There are many other issues related to the racism which affects the relation of the healthcare providers and the people in the society of the Torres Strait Islanders in Australia. One Such case is that they are thought to be stronger that the general population of other social groups leading to a major issue in their treatment patters. There have been cases of amputations and operations of the patients without the administration of anesthetics leading to a number of infections and often much displeasure to the patients.

Such activities are not conducive for the healthy relationship growth among aboriginals and the healthcare professionals affecting the overall effectiveness of the policy.

Part C

1). The Code of Conduct focusses on the behavior of the Nurses and Midwives with the people in the society that they are interacting with. The Code of Conduct guiding their overall behaviour include:

• Inculcation of Safety and Competency in the modes of practice in the society affecting their contribution in the providing of healthcare in the society.
• They should respect the race culture and ethnicity of the person and not be biased because of any stereotype about the person.
• Any personal information that is received about the patient should kept confidential at all costs helping in the improvement of relationships between healthcare personell and the people of the society.
• They should provide proper and accurate information to the patients about the overall healthcare practice and policies that are there to benefit them.
• Give proper information to the patients helping them in taking informed decisions about their condition.
• Building a relationship of trust and mutual respect among the people in the society affecting the relations between the aboriginals and people in the Torres Strait Islanders.

These policies help in the improvement of the relation between the Torres Strait islander aboriginals and help in forming a long lasting sustainable relationship in the society. The trust of the people and their ability to make informed decisions about their diseases will help in improving their overall condition in the society and working towards their overall welfare (Nursingmidwiferyboard.gov.au, 2018). The nurses and midwives relations with people are also exceptionally important as they are in constant communication with the people in the society affecting their overall development.

2). There are a number of cases where nurses and mid wives can intervene and improve the healthcare of the people in the society.

Example 1:  One of the major roles that the nurse can play is in improving the communication channel between the patient and the healthcare providers helping in their overall health conditions. The proper communication channels help in the open communication channels between patients and healthcare providers which helps in the patients sharing their issues and getting proper treatment. Moreover, the nature of the interaction of the nurse will also help in improving the faith of the person on the healthcare professionals who are treating those getting proper results and improvement of the healthcare in the society. The communication channels also help in the treatment of the diseases in a better way with proper knowledge of symptoms.

Example 2: Midwives too play a major role in the improvement of the healthcare among the people in the society and reducing the neonatal death rates. One of the major issues in this context is that midwives can build a proper communication channel and convince aboriginal women to take help of proper healthcare facilities in case of any situational problems. The midwives can also understand the health of the children and get them proper medical attention improving the overall rate of death of the children in the society.  

References:

Ahmrc.org.au. (2018). ABORIGINAL COMMUNITIES IMPROVING ABORIGINAL HEALTH. Retrieved from https://www.ahmrc.org.au/media/resources/research/298-aboriginal-communities-improving-aboriginal-health/file.html

de Dassel, J. L., Ralph, A. P., & Cass, A. (2017). A systematic review of adherence in Indigenous Australians: an opportunity to improve chronic condition management. BMC health services research, 17(1), 845.

Gardner, K., Sibthorpe, B., Chan, M., Sargent, G., Dowden, M., & McAullay, D. (2018). Implementation of continuous quality improvement in Aboriginal and Torres Strait Islander primary health care in Australia: a scoping systematic review. BMC health services research, 18(1), 541.

Health.gov.au. (2018). Department of Health | Resources for practices and ACCHS. Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/content/health-care-homes-resources

Nattabi, B., Matthews, V., Bailie, J., Rumbold, A., Scrimgeour, D., Schierhout, G., ... & Bailie, R. (2017). Wide variation in sexually transmitted infection testing and counselling at Aboriginal primary health care centres in Australia: analysis of longitudinal continuous quality improvement data. BMC infectious diseases, 17(1), 148.

Nursingmidwiferyboard.gov.au. (2018). Nursing and Midwifery Board of Australia - Professional standards. Retrieved from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx

Qip.com.au. (2018). National Safety and Quality Health Service (NSQHS) Standards - QIP - Quality Innovation Performance Limited. Retrieved from https://www.qip.com.au/standards/national-safety-and-quality-health-service-nsqhs-standards/

Topp, S. M., Edelman, A., & Taylor, S. (2018). “We are everything to everyone”: a systematic review of factors influencing the accountability relationships of Aboriginal and Torres Strait Islander health workers (AHWs) in the Australian health system. International journal for equity in health, 17(1), 67.