The barriers and enablers of primary healthcare service transition from government to community control in Yarrabah_A grounded theory study.pdf (1.11 MB)
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The barriers and enablers of primary healthcare service transition from government to community control in Yarrabah: A grounded theory study

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journal contribution
posted on 22.03.2022, 23:49 by Janya MccalmanJanya Mccalman, Crystal Sky Jongen, Sandra CampbellSandra Campbell, Ruth Fagan, Kingsley Pearson, Suzanne Andrews
Introduction: Consistent with the aspirations of First Nations Australians for community control of healthcare services, 123/196 (63%) of Australia's First Nations-specific primary health care services are community-controlled. Yet despite policy commitment over 30 years, the transition of government-run First Nations' primary healthcare services to First Nations community control has been slow. This paper identifies the barriers and enablers to transitioning the delivery of primary healthcare services from Queensland Health to Gurriny Yealamucka community-controlled health service in Yarrabah. Methods: Grounded theory methods were used to select 14 Gurriny and Queensland Health (QH) personnel involved in the transition for interview and to analyse these interview transcripts and 88 Gurriny organisational documents. Results: Barriers and enablers to transition were identified at three levels: those internal factors within Gurriny, external factors directly related to the government handover, and broader structural and policy factors outside the control of either Gurriny or QH. Barriers at the Gurriny organisational level were an internal lack of experience and capacity, and varying levels of community confidence; enablers were leadership stability and capacity, community mandate, relationships with partner organisations, and ability to provide service continuity. Barriers in Gurriny's relationship with QH were a lack of certainty, transparency and prioritisation of the transition process; systemic racism; difficulties obtaining and maintaining the necessary workforce; limited resources including insufficient, unstable and inappropriate funding support; and problems with information sharing; enablers were performance frameworks to keep transition progress on track. Barriers in broad policy environment were an unsupportive Queensland government policy environment; government bureaucracy; and delays, conflicts and divisions; enablers were high-level government support and commitment. Conclusions: The evaluation of Yarrabah's transition process suggests that future such transitions will require planning and commitment to a long-term, multi-faceted and complex process, encompassing the required level of authorisation and resourcing. This case example of a transition from government to community control of PHC highlighted the ongoing power issues that are faced every day by community-controlled organisations that co-exist with mainstream health systems within a colonial power structure.

Funding

Category 2 - Other Public Sector Grants Category

History

Volume

9

Start Page

1

End Page

15

Number of Pages

15

eISSN

2296-2565

ISSN

2296-2565

Publisher

Frontiers Media

Publisher License

CC BY

Additional Rights

CC BY 4.0

Language

eng

Peer Reviewed

Yes

Open Access

Yes

Cultural Warning

This research output may contain the names and images of Aboriginal and Torres Strait Islander people now deceased. We apologize for any distress that may occur.

Acceptance Date

10/09/2021

External Author Affiliations

Charles Darwin University; Gurriny Yealamucka Health Service, Yarrabah, QLD

Author Research Institute

Centre for Indigenous Health Equity Research

Era Eligible

Yes

Medium

Electronic-eCollection

Journal

Frontiers in Public Health

Article Number

616742