Janya McCalman1, Marlene Longbottom2, Sara Fagan3, Ruth Fagan4, Suzanne Andrews4, Adrian Miller3. 1. Centre for Health Equity Research, School of Health, Medical and Applied Sciences, CQUniversity Australia, Lvl 2 Cairns Square, Cnr Abbott & Shields St, Qld, 4870, Cairns, Australia. j.mccalman@cqu.edu.au. 2. Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, NSW, 2522, Australia. 3. Centre for Health Equity Research, School of Health, Medical and Applied Sciences, CQUniversity Australia, Lvl 2 Cairns Square, Cnr Abbott & Shields St, Qld, 4870, Cairns, Australia. 4. Gurriny Yealamucka Health Service Aboriginal Corporation, 1 Bukki Rd, Yarrabah, QLD, 4871, Australia.
Abstract
BACKGROUND: Pandemics such as COVID-19 are a serious public health risk for Australian Aboriginal and Torres Strait Islander communities, yet primary healthcare systems are not well resourced to respond to such urgent events. At the start of the COVID-19 pandemic, a federal government advisory group recommended a rapid, tailored Indigenous response to prevent predicted high morbidity and mortality rates. This paper examines the efforts of one ACCHO, which in the absence of dedicated funding, pivoted its operations in response to COVID-19. Gurriny Yealamucka Health Service (Gurriny) is the only primary healthcare service in the discrete Indigenous community of Yarrabah, Far North Queensland. METHODS: The research was conducted at the request of the Chief Executive Officer of Gurriny. Using grounded theory methods, thirteen Gurriny staff and five Yarrabah and government leaders and community members were interviewed, transcripts of these interviews and 59 documents were imported into NVIVO-12 and coded, and key concepts were compared, organised into higher order constructs, then structured into a theoretical framework. RESULTS: Gurriny responded to COVID-19 by leading with local solutions to keep Yarrabah safe. Four key strategies were implemented: managing the health service operations, realigning services, educating and supporting community, and working across agencies. These strategies were enabled or hindered by five conditions: the governance and leadership capacity of Gurriny, relying on the health taskforce, locking the door, "copping it", and (not) having resources. A year after the first case was experienced in Australia and on the eve of vaccine rollout to Indigenous communities, there have been no COVID-19 cases in Yarrabah. DISCUSSION: The success of the locally led, holistic, comprehensive and culturally safe response of Gurriny suggests that such tailored place-based approaches to pandemics (and other health issues) are appropriate, but require dedicated resourcing. Key challenges were the fragmented and rapidly changing government processes, poorly coordinated communication and resource allocation channels, and bottlenecks in hierarchical funding approval processes. CONCLUSIONS: The COVID-19 response in Yarrabah demonstrates the need for governance reform towards greater resourcing and support for local decision making by Aboriginal community-controlled health organisations.
BACKGROUND: Pandemics such as COVID-19 are a serious public health risk for Australian Aboriginal and Torres Strait Islander communities, yet primary healthcare systems are not well resourced to respond to such urgent events. At the start of the COVID-19 pandemic, a federal government advisory group recommended a rapid, tailored Indigenous response to prevent predicted high morbidity and mortality rates. This paper examines the efforts of one ACCHO, which in the absence of dedicated funding, pivoted its operations in response to COVID-19. Gurriny Yealamucka Health Service (Gurriny) is the only primary healthcare service in the discrete Indigenous community of Yarrabah, Far North Queensland. METHODS: The research was conducted at the request of the Chief Executive Officer of Gurriny. Using grounded theory methods, thirteen Gurriny staff and five Yarrabah and government leaders and community members were interviewed, transcripts of these interviews and 59 documents were imported into NVIVO-12 and coded, and key concepts were compared, organised into higher order constructs, then structured into a theoretical framework. RESULTS:Gurriny responded to COVID-19 by leading with local solutions to keep Yarrabah safe. Four key strategies were implemented: managing the health service operations, realigning services, educating and supporting community, and working across agencies. These strategies were enabled or hindered by five conditions: the governance and leadership capacity of Gurriny, relying on the health taskforce, locking the door, "copping it", and (not) having resources. A year after the first case was experienced in Australia and on the eve of vaccine rollout to Indigenous communities, there have been no COVID-19 cases in Yarrabah. DISCUSSION: The success of the locally led, holistic, comprehensive and culturally safe response of Gurriny suggests that such tailored place-based approaches to pandemics (and other health issues) are appropriate, but require dedicated resourcing. Key challenges were the fragmented and rapidly changing government processes, poorly coordinated communication and resource allocation channels, and bottlenecks in hierarchical funding approval processes. CONCLUSIONS: The COVID-19 response in Yarrabah demonstrates the need for governance reform towards greater resourcing and support for local decision making by Aboriginal community-controlled health organisations.
Authors: Shaun M Flint; Joshua S Davis; Jiunn-Yih Su; Erin P Oliver-Landry; Benjamin A Rogers; Aaron Goldstein; Jane H Thomas; Uma Parameswaran; Colin Bigham; Kevin Freeman; Paul Goldrick; Steven Y C Tong Journal: Med J Aust Date: 2010-05-17 Impact factor: 7.738
Authors: Peter D Massey; Adrian Miller; Sherry Saggers; David N Durrheim; Richard Speare; Kylie Taylor; Glenn Pearce; Travis Odo; Jennifer Broome; Jenni Judd; Jenny Kelly; Magdalena Blackley; Alan Clough Journal: Health Policy Date: 2011-08-24 Impact factor: 2.980