Beyond policy and planning and into practice: getting sexual health on the agenda in Aboriginal communities in Western Australia

Abstract

Background: Indigenous Australians have significantly poorer status on a large range of health,educational and socioeconomic measures and successive Australian governments at state andfederal level have committed to redressing these disparities. Despite this, improvements inAboriginal health status have been modest, and Australia has much greater disparities in the healthof its Indigenous people compared to countries that share a history characterised by colonisationand the dispossession of indigenous populations such as New Zealand, Canada and the UnitedStates of America. Efforts at policy and planning must ultimately be translated into practicalstrategies. This article outlines an approach that was effective in Western Australia in increasingthe engagement and concern of Aboriginal people about high rates of sexually transmissibleinfections and sexual health issues. Many aspects of the approach are relevant for other healthissues. Results: The complexity of Indigenous sexual health necessitates inter-agency and crossgovernmental collaboration, in addition to Aboriginal leadership, accurate data, and communitysupport. A recent approach covering all these areas is described. This has resulted in Aboriginalsexual health being more actively discussed within Aboriginal health settings than it once was andadditional resources for Indigenous sexual health being available, with better communication andpartnership across different health service providers and sectors. The valuable lessons in capacitybuilding, collaboration and community engagement are readily transferable to other health issues, and may be useful for other health professionals working in the challenging area of Aboriginal health.Conclusion: Health service planners and providers grapple with achieving Aboriginal ownershipand leadership regarding their particular health issue, despite sincere concern and commitment toaddressing Aboriginal health issues. This highlights the need to secure genuine Aboriginalengagement. Building capacity that enables Indigenous people and communities to fulfill their owngoals is a long-term strategy and requires sustained commitment, but we argue is a prerequisite for better Indigenous health outcomes.