Meaningful Aboriginal community engagement
Aboriginal people driving healthcare improvements
Health inequity for First Nations People in Australia remains a serious concern with Indigenous lives, on average, being 8 years shorter than those of non-Indigenous Australians. Closing this gap to health inequity requires acknowledgment of the ongoing wisdom, strength and resilience of Aboriginal and Torres Strait Islander people, as they sustain the world’s oldest living cultures.
When Aboriginal people have a genuine say in the design and delivery of programs and services that affect them, better life outcomes are achieved. Amy Graham and Janet Kelly describe how meaningful engagement can be experienced using the Aboriginal preferred ways of Dadirri, Yarning and Ganma.
Dadirri- look and listen- describes a quiet form of listening which is intentionally adopted to increase awareness and understanding. It involves deeply listening to what the person says, whilst also noticing body cues. Practically, it means turning off the computer, mirroring eye contact and letting quiet some space exist in conversation.
Yarning- think and discuss- is a process of building human connection. It represents a culturally safe way of talking for Indigenous people. As a clinician, yarning helps us learn about this person’s priorities.
Finally, Ganma- take action together- describes coming together of Indigenous and non-Indigenous ideas and creating new knowledge to move forward with. It describes a partnership and collaborative action.
Amy and Janet share applying the Dadirri-Yarning-Ganma process to Health Journey Mapping in a South Australian kidney care health service. This increasingly adopted approach works to share critical information between providers to plan, support, and evaluate care; aiming to enhance cultural safety right across healthcare experiences.
While the concepts explored are undoubtably universally valuable, working well in collaborations with Aboriginal people is intentionally centred here. The presentation itself demonstrates a snapshot of yarning as plenty of space is given to thinking and discussing. The pace, shape and content unfold in its own unique and unexpected way.
Amy Graham is a Kaurna, Narungga woman. Her world is centred on her family, community and culture. Her experiences as a patient and as an Aboriginal Health Practitioner exposed her to the inequity within Australia's systems for First Nations people. Amy’s research with the University of Adelaide aims to inform meaningful change and see a real-life, real-time impact on the way Aboriginal people are observed, assessed and portrayed
Associate Professor Janet Kelly is a nurse researcher and course coordinator focused on improving health care and outcomes for and with Aboriginal people. She has co-designed flexible and adaptable health journey mapping tools that identify barriers and enablers, gaps and strategies in care. These tools are increasing being used for quality improvement, reflective practice, education and training in renal care, cardiac care, nursing, midwifery and medicine. In 2019 Janet led the AKction – Aboriginal Kidney Care Together – Improving Outcomes Now Project, funded through Health Translation SA, bringing together Aboriginal kidney patients and their families, health professionals, academics, researchers and other key stakeholders to identify strengths and gaps and improve care. Janet now co-leads AKction2, a 5 year NHMRC Ideas grant with Dr Kim O'Donnell. This project positions Aboriginal people with lived experience of kidney disease as patient experts and chief investigators, and hasfour nested sub studies: Indigenous governance, Kidney journey mapping, Peer support and navigation, and Cultural safety.