“Milbulgali Bagili”: A systematic scoping review of the history of Aboriginal and Torres Strait Islander advocacy 1940-1970

Although there is a recognised literature on the importance of community participation and intersectoral action to address inequitable rates of preventable diseases, few studies have reported effectiveness of linkages between health systems and community resources (e.g. individuals in governance roles, health and community-based organisations, regional forums) on quality of preventive healthcare. In this longitudinal cross-sectional study, data gathered from 90 Indigenous primary health care services participating in the Audit and Best Practice for Chronic Disease National Program (2010-2014) were analysed to examine linkages between Indigenous primary healthcare centres and community resources on delivery of best practice preventive healthcare for Aboriginal and Torres Strait Islander peoples. This study revealed that there is substantial room to improve the delivery of preventive health care in areas of obesity, alcohol and social and emotional wellbeing by strengthening links between PHC and community resources. Systems and processes considered necessary for linking with community were not well established, nor designed to support early intervention for clients identified at risk for chronic diseases. Our findings suggest that factors influencing primary healthcare centre linkages with community resources are varied and present at the community, health centre and policy levels. There remains unexplored potential of continuous quality improvement approaches to engage community and cross-sectoral partners to overcome the systematic issues in the delivery of preventive healthcare and to reduce health disparities experienced by Aboriginal and Torres Strait Islander Australians. What do we know? The health system must be linked to and engaged with community and a range of other services that address the wider social and cultural determinants of health to effectively reduce inequitable rates of preventable diseases experienced by Aboriginal and Torres Strait Islander Australians. What does this study add? Strengthening health system linkages with community resources requires human effort and additional resource input. Supporting implementation of integrated quality improvement methods provides opportunities to engage and leverage community resources and improve preventive healthcare for Indigenous people.