This report explores strengths-based, bottom-up approaches to delivering Aboriginal health and wellbeing services.1 It focuses on three case study organisations across two sites, all of which have reputations for maintaining highly positive relationships with their communities. The case studies look at organisations Laynhapuy Health; an Aboriginal Community Controlled Health Service (ACCHS) operating in East Arnhem Land, Northern Territory (NT). Waminda; an ACCHS in the Shoalhaven region of New South Wales (NSW) and beyond. Waminda provides health and wellbeing services to Aboriginal women and their families, and Noah’s, s a community-based, not-for-profit organisation catering to children and young people with special needs and their families across the Shoalhaven area.
Despite the substantial differences between the two field sites and the scope of the three organisations, there were strong commonalities between them in the approaches and challenges they raised
- From the wide range of health and wellbeing practitioners the researchers spoke to – which included nurses, midwives, Aboriginal health workers, therapists, caseworkers and more – there was clear sentiment that in a context of postcolonial power imbalance, Aboriginal people often experience inappropriate treatment in mainstream services.
- For all three organisations, strengths-based approaches are inseparable from their community-driven, holistic design. The linking elements are their understandings of power structures and neo-liberal trends in a cross-cultural context in the Australian health and wellbeing sector.
- Community-driven program design is fundamental to ensuring success. This requires building longterm relationships with communities that go well beyond superficial consultation. Relationship building goes hand-in-hand with long-term learning based on local histories, culture and socio-economic dynamics.
- Much of the health sector treats illness in Aboriginal people, rather than promoting health and wellbeing. Holistic health that addresses social determinants is preventative and protective. It can include supporting culture and language, connection to Country, spirituality, belonging and identity, strength of community and family, and empowerment and control.
- Much top-down intervention in the health care sector and beyond relies on externally identifying and seeking to fix problems. Often systems operate based on practitioners’ ‘expert’ values and terms. Person-centred care shifts the power balance and places clients’ needs, desires, goals, values and circumstances at the centre of the care process.
This report explores these dynamics, and, in the process, details the three organisations’ approaches and successes. This brings us back to many of the core issues that are well documented in relation to Aboriginal health and wellbeing, including the importance of community-driven design, holism, the social determinants of health, and person- and family-centred approaches. This allows us to celebrate the organisations’ strengths and successes – highlighting ‘beautiful, big, positive’ stories, as one of our interviewees put it.