Community-Based Sexual and Reproductive Health Promotion and Services for First Nations People in Urban Australia

Sophie Hickey; Yvette Roe; Caroline Harvey; Sue Kruske; Anton Clifford-Motopi; Ike Fisher; Brenna Bernardino; Sue Kildea

doi:10.2147/IJWH.S297479

Community-Based Sexual and Reproductive Health Promotion and Services for First Nations People in Urban Australia

Int J Womens Health. 2021 May 18:13:467-478. doi: 10.2147/IJWH.S297479. eCollection 2021.

Authors

Sophie Hickey^#¹, Yvette Roe^#¹, Caroline Harvey², Sue Kruske^{1

2}, Anton Clifford-Motopi², Ike Fisher², Brenna Bernardino^{3

4}, Sue Kildea¹

Affiliations

¹ Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Queensland, Australia.
² Institute for Urban Indigenous Health, Brisbane, Queensland, Australia.
³ School of Population Health, University of Queensland, Brisbane, Queensland, Australia.
⁴ Poche Centre for Indigenous Health, University of Queensland, Brisbane, Queensland, Australia.

^# Contributed equally.

Abstract

Context: Little is known about sexual and reproductive health (SRH) access and health promotion for First Nations peoples in Australia. This study aimed to better understand community preferences, knowledge and access to contraception and SRH services, and use this understanding to make recommendations which support approaches led by local Aboriginal community-controlled health organisations (ACCHOs).

Methods: Qualitative First Nations-led yarning circles were conducted with 55 community members and health service providers using and/or working at ACCHOs in urban South East Queensland. Cultural protocols ensured women's and men's interviews were separately collected and analysed. Thematic analysis was conducted by multiple coders, privileging interpretations by First Nations researchers.

Results: Family, kin and friends were described as key knowledge holders and ACCHOs as knowledge spaces for sharing information about maintaining positive SRH and wellbeing for First Nations people. Interviewees wanted accurate and timely information in an accessible, culturally appropriate way. Making informed choices about family planning was described as an important process of agency and self-determination for First Nations people, and contextualized within broader aspirations for growing strong families and healthy relationships.

Conclusion: Understanding SRH through the concept of "knowledge spaces" and "knowledge holders" highlights the collective importance of community relationality to support individual agency and informed SRH decision-making. ACCHOs appear to be acceptable knowledge spaces for SRH information; and evidence-based recommendations may increase their reach. Health services should consider upskilling community SRH knowledge holders to share consistent, accurate and accessible SRH information.

Keywords: Indigenous; community-based health promotion; contraception; sexual and reproductive health; strength-based.

Grants and funding

Sophie Hickey and Yvette Roe’s salaries during this period were funded by a National Health and Medical Research Council Partnership Grant for the Indigenous Birthing in an Urban Setting Study. Brenna Bernardino received a summer student scholarship from the University of Queensland’s Poche Centre for Urban Indigenous Health to undertake research placement with the research team to assist with data collection. The research team received in-kind funding support from our partner organisation the Institute for Urban Indigenous Health who covered all additional incidental costs (ie catering for yarning circles, participant reimbursements). The authors would like to acknowledge the collegiality and critical comments provided by Sarah Ireland on an earlier draft of the manuscript.