Table Of Contents
Title
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1
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1. Introduction
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3
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2. Aboriginal And Torres Strait Islander
(ATSI) And Health Services
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3
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3. Maternity
Related Problems to Aboriginal And Torres Strait Islanders
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4
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4.
Difficulties In Offering Proper Maternity Care
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6
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5. Recommendations: How maternity services and care can be improved for women of ATSI?
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6
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6. Conclusion
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8
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7. References
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9
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Introduction
A theory of
social determinants identifies that health and inequality in population is
established by several interrelated social factors. Similarly, it is a
fundamental principle of human rights decree that all rights are integrated and
that influencing on the pleasure of one right will influence the enjoyment of
others. Due to this synergy, human rights discussion offers a framework for
evaluating the likely health impacts of government programs and policies on
Indigenous peoples. The social determinants affect the health status of the
population indirectly and directly through lifestyle risk factors and access
to, or/and utilisation of the health care system. In Australia, providing
improvement and easy access to the health of the indigenous
people is still a big challenge for the government of Australia.
Aboriginal And Torres Strait Islander (ATSI) And
Health Services
Aboriginal and
Torres Strait Islander (ATSI) are the indigenous people of Australia with
distinct histories, identities, and cultural practices. The national
statistics for them may mask significant geographic disparities in their health
and social wellbeing. The health construct of ATSI is not merely regarding the
physical wellbeing of the person. It is the cultural, emotional and social
wellbeing of the whole community, a notion that is generally overlooked by
conventional health services. It is thus expected that conventional health
services suffer from added challenges in an attempt to gain the trust of Torres
Strait Islander and Aboriginal people. The most prominent area suffering in
this regard is the maternity. Aboriginal and Torres Strait Islander females
and children persist to experience greater rates of morbidity and mortality in
comparison to non-Indigenous females and children (Kildea & Wardaguga,
2009). About delivery of such maternal care, ATSI health services put emphasis
on the value of a holistic approach towards their health care, where mental,
ethical and social wellbeing is associated with its cultural and historical context.
Nevertheless, there is an uneven burden of unfavourable perinatal effects for mothers
and their children of Aboriginal and Torres Strait Islander, including high
maternal mortality rate. And
this rate is four fold high compared to Australian females. In ATSI there is
wide difference in pre-term birth percentage (13.5% against 8.0%), perinatal
deaths rates (17.1 percent against 8.8 percent per one thousands births) and
low birth weight percentage (12.0 percent against 6.0 percent) ( Jongen, McCalman , Bainbridge & Tsey, 2014; Australian Bureau of
Statistics, 2015).
The causes
behind the sobering inequality are diverse and multifaceted. This paper will critical analysis the maternity issue among ATSI women, difficulty to use maternity services for them
owing to their culture and social determinant and will also present the
recommendation to improve the current situation.
Maternity
Related Problems to Aboriginal And Torres Strait Islanders
The maternity period is a unique stage of life for women since it may
bring lots of challenges as well as opportunities with it. Since the
reproductive health outcomes for mothers and infants of Aboriginal and Torres
Strait Islander are considerably poorer; they even deteriorate with growing distance
where the provision of such services becomes more difficult
(Murphey & Best, 2012). In fact, a lot of Aboriginal and Torres Strait
Islander women at present do not have access to quality primary maternity care.
Even in rural and distant areas such
women in particular are being deprived of access to first-class care from the
complete variety of health expertise. They can only receive such a care that is
inconsistent and does not meet their social and cultural requirements.
At present the provision of maternity services to women of Aboriginal and
Torres Strait Islander is greatly inadequate. The pregnant women of ATSI often face
seclusion from a partner, friends, family, and culture and society for the
birth of their babies and this may cause a great impact on their wellbeing. Too much stress, separation from familiar and
fostering people, environment and cultural ways, brings about apprehension,
sorrow and loneliness at a vital phase. While several urban promotes the values
of family-friendly birth settings and offer choices for community midwifery
services, a lot of female in remote areas and of Aboriginal and Torres Strait
Islander face dislocation from the families (Hancock, 2009) and this serves as
risk factors for causing high stress levels . The use of alcohol tobacco and other drugs
pregnancy in the women of this community is also found to be high which lack
their proper health education and awareness. Due to cultural difference women of ATSI feel
uncomfortable for regular medical checkups and suffer from such unhealthy
activities.
Difficulties
In Offering Proper Maternity Care
The magnitude and lasting nature of disparity in provision of maternity
care to Aboriginal and Torres Strait Islander women is partially due to
cultural and traditional values of these people. The notion of gender specific
scaffolds among ATSI people conveys that women and men have dissimilar needs,
life experiences, degrees of authority, access to information from diverse
sources to help decision making and approaches of expressing sickness(Kildea,
Kruske, Barclay, & Tracy, 2010). Those dissimilarities impact on the manner
that women and men of ATSI interact with the health services. Furthermore, culturally, it is not easy for
women of Aboriginal and Torres Strait Islander to seek medical help early in
their pregnancy. For a large number of Indigenous women, their primary visit to
a medical centre or hospital is on the day of labour. As a result it becomes difficult to recognise
antenatal complications in such women as early as possible and likewise,
premature birth rates and mortality rates rise in them.
As with the Indigenous Australian population, family violence is an unseen
concern. A study demonstrated that family violence causes major influence on
the health of Indigenous women compared to women of other Australian groups. Due to the family fear, they avoid consulting
a health service and therefore escape those issues which can be prevented if
detected earlier. Early and ongoing maternity care facilitates a plan of care
to be made in the first trimester. Lack of care and late visiting to get the
antenatal care increases the rates of perinatal morbidity and mortality
(Rumbold et al, 2012). This also
affects their reproductive health outcomes and presents challenges to
healthcare provider to identify them and offer them with pertinent treatment
accordingly. The ATSI women have least awareness regarding how to be cautious
in pregnancy because they lack a proper health education due to less exposure
to it. Women with comorbidities
need to be conscious of the effect of their diseases on pregnancy, in addition
to, the effect of pregnancy on their existing health comorbidity.
Additionally, social, financial and psychological problems which generate
stress, a lack of control over situations and unproductive self-management are
believed to be the greater determinants
(Whiteside, Tsey & Cadet, 2009). Their financial resources are less which also
prevent them for undergoing proper medical advice and help.
Recommendations:
How maternity services and care can be improved for women of ATSI?
In spite of cultural and social resistance, it is the duty of the health
care provider to provide culturally safe maternity health care. A policy should
be developed which tackle such issues and endorses education of not only
indigenous women but also of practitioners regarding delivery of maternity
services to challenging patients. Since
cultural, spiritual, and social wellbeing is very important to the people of Aboriginal
and Torres Strait Islander it is imperative that their
health needs be considered in this background. Cultural safety offers a
practical framework to improve the provision of maternity services to ATSI
women and their families (Reibel & Walker, 2010). This can be offered by developing a
multi-agency move towards service delivery in line with the fact that maternity
services for indigenous people cannot address health inequalities singly.
“The Council of Australian Governments (COAG)
recognises that strategies aimed at achieving improvements in any particular
area will not work in isolation – the building blocks must fit together through
the integration of policy ideas and an agreed approach to their implementation” (Aboriginal Health Council of Western
Australia, 2011)
It is the duty
of the government as well as health practitioner to make sure that Aboriginal
and Torres Strait Islander women should have access to first-rate maternity
services. And, these services must be culturally safe, offer continuous care
and access to the greatest expertise (Australian Government, 2009). Nurses can
help filled the gap by enhancing communication, by addressing social, cultural
and emotional health needs of and Aboriginal and Torres Strait Islander
women. Considering the disparity in
health services to indigenous community, the nurses can play a role in
improving the care of Aboriginal and Torres Strait Islander pregnant women by
removing those disparities and giving equal treatment opportunities. They
can encourage women living in rural or remote areas to get an early maternal
care and can work to get them access to such services. Early access to
maternity service is a sign of the victory of this approach (Bar-Zeev, Barclay,
Farrington & Kildea, 2012).
Conclusion
In conclusion,
there are growing rather than declining challenges to the provision of safe
maternity services to Aboriginal and Torres Strait Islander women. Transforming
the approach care is delivered could endorse significant improvements. The
cultural aspect should be considered because it is from within the community
and culture that actual optimistic changes in the people’s health commence.
References
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