"We're on the ground, we know what needs to be done": Exploring the role of Aboriginal Health Workers in primary health care

Ragavi Jeyakumar; Bindu Patel; Julieann Coombes; Ty Madden; Rohina Joshi

doi:10.3389/fpubh.2022.1010301

"We're on the ground, we know what needs to be done": Exploring the role of Aboriginal Health Workers in primary health care

Front Public Health. 2023 Jan 19:10:1010301. doi: 10.3389/fpubh.2022.1010301. eCollection 2022.

Authors

Ragavi Jeyakumar^{1

2}, Bindu Patel¹, Julieann Coombes¹, Ty Madden¹, Rohina Joshi^{1

3

4}

Affiliations

¹ The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
² Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
³ School of Population Health, University of New South Wales, Sydney, NSW, Australia.
⁴ The George Institute for Global Health, New Delhi, India.

Abstract

Background: Aboriginal Health Workers (AHWs) are core providers of primary health care (PHC) for First Nations peoples in Australia. However, the national AHW workforce is aging and in short supply. There is a poor understanding of the factors contributing to this attrition from the perspectives of AHWs themselves. This study aimed to systematically explore the current functioning and sustainability of AHWs in NSW PHC by amplifying AHW voices.

Materials and methods: This study was co-designed with three Aboriginal health services in NSW. It included a literature review exploring the role of AHWs in NSW, and yarns with AHWs and their supervisors at participating services. Yarning is an Indigenous approach to knowledge generation centered upon storytelling. The yarns were guided by the USAID-developed Community Health Worker Assessment and Improvement Matrix. Yarn transcripts were analyzed using cyclical thematic analysis to identify key facilitators and challenges for AHW practice.

Results: The yarns highlighted five categories of change that are required to ensure AHW sustainability: community connection, recognition, value, support, and an inclusive health system. The yarns revealed that there are both service- and system-level factors influencing each of these categories of change.

Conclusions: The lived experiences of AHWs in NSW emphasize five key categories of change that are required to ensure workforce sustainability. It is evident that a system-wide paradigm shift to better include holistic approaches to health is necessary to truly ensure sustainability. Co-designing similar studies with ACCHOs across NSW can help inform this change.

Keywords: Aboriginal Health Worker; community health worker; primary health care; sustainability; workforce.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Australia
Australian Aboriginal and Torres Strait Islander Peoples
Health Personnel
Health Services, Indigenous*
Humans
Primary Health Care

Grants and funding

RJo is funded by the National Heart Foundation of Australia (Grant Number: 102059) and the University of New South Wales Scientia Fellowship. This project was funded through RJo's Fellowship.