Opinion
Closing the gap begins before a baby is born
Professor Rhonda Marriott AM explains a key limiting factor to addressing Aboriginal health inequities, and what we're doing to address it.
Healthy mothers, on the whole, give birth to healthy children. And healthy mothers are supported physically and mentally by not only their communities, but their health practitioners and the health systems they deliver.
But what happens when the health system, which has been designed as a ‘one size fits all’ approach, doesn’t fit?
At the Ngangk Yira Institute for Change, we have been working with Aboriginal communities throughout Western Australia to identify the needs of Aboriginal women giving birth in metropolitan and regional centres for more than a decade.
We had many goals when we set out, some of which included identifying the cultural needs of women birthing in urban areas and recognising the gaps in service delivery.
What we found was that existing healthcare didn’t recognise the potential issues and unique barriers faced by Aboriginal women. The service delivery of maternal health systems and processes was not culturally sensitive or culturally secure.
What we needed was more Aboriginal midwives and culturally secure models of care in hospitals. These are critical to closing the gap in maternity care and childbirth outcomes for Aboriginal women and families.
When we took this to the Minister for Health of Western Australia at the time and now Premier, the Hon Roger Cook, he recognised the problem and saw merit in our solution.
In that role, Mr Cook funded the establishment of an Aboriginal Maternity Group Practice at the Women and Newborn Health Service at King Edward Memorial Hospital, which became operational this year.
This is the realisation of what feels like a lifetime’s work for me and a big step towards changing the Government’s ethos in relation to maternity care, changing the ethos of the WA maternity health workforce, and changing the ethos of education relevant to maternity care in WA.
This is also a step towards further Closing the Gap in Aboriginal health outcomes.
When this is done well, with cultural safety of service delivery at the forefront, the potential is created for positive engagement by Aboriginal families with health services.
The new practice at King Edward Memorial Hospital will advance that, by creating a culturally secure maternity services pathway for Aboriginal women that is being co-designed with key stakeholders and Aboriginal community experts.
We know this is what works. Research has shown us time and again that a strong start in life is fundamental for healthy and resilient Aboriginal people and communities, so fostering this is absolutely critical.
It is heartening to see that one Closing the Gap target that is on track to meet the 2031 deadline is healthy birth weight. This has a tremendous flow-on effect, but we must keep working to maintain that.
There are many terrific projects happening across the country focussed on achieving this and contributing to the health, social and emotional wellbeing, empowerment and self-determination of Aboriginal families, and communities.
I am proud to work alongside amazingly passionate staff who share and build our shared vision to make a difference. But to affect real change – to close the gaps we see in Aboriginal life outcomes – researchers, clinicians and the community all need to be working together.
Learn how the Ngangk Yira Institute for Change is providing a strong start for healthy and resilient Aboriginal people and communities.But what happens when the health system, which has been designed as a ‘one size fits all’ approach, doesn’t fit?
At the Ngangk Yira Institute for Change, we have been working with Aboriginal communities throughout Western Australia to identify the needs of Aboriginal women giving birth in metropolitan and regional centres for more than a decade.
We had many goals when we set out, some of which included identifying the cultural needs of women birthing in urban areas and recognising the gaps in service delivery.
We asked ourselves, what do healthcare professionals and midwives need to know and do in order to better support these women?
What we found was that existing healthcare didn’t recognise the potential issues and unique barriers faced by Aboriginal women. The service delivery of maternal health systems and processes was not culturally sensitive or culturally secure.
What we needed was more Aboriginal midwives and culturally secure models of care in hospitals. These are critical to closing the gap in maternity care and childbirth outcomes for Aboriginal women and families.
When we took this to the Minister for Health of Western Australia at the time and now Premier, the Hon Roger Cook, he recognised the problem and saw merit in our solution.
In that role, Mr Cook funded the establishment of an Aboriginal Maternity Group Practice at the Women and Newborn Health Service at King Edward Memorial Hospital, which became operational this year.
This is the realisation of what feels like a lifetime’s work for me and a big step towards changing the Government’s ethos in relation to maternity care, changing the ethos of the WA maternity health workforce, and changing the ethos of education relevant to maternity care in WA.
This is also a step towards further Closing the Gap in Aboriginal health outcomes.
Pregnancy presents an ideal opportunity for midwives and other health professionals to build respectful and authentic relationships with Aboriginal women and their families.
When this is done well, with cultural safety of service delivery at the forefront, the potential is created for positive engagement by Aboriginal families with health services.
The new practice at King Edward Memorial Hospital will advance that, by creating a culturally secure maternity services pathway for Aboriginal women that is being co-designed with key stakeholders and Aboriginal community experts.
We know this is what works. Research has shown us time and again that a strong start in life is fundamental for healthy and resilient Aboriginal people and communities, so fostering this is absolutely critical.
It is heartening to see that one Closing the Gap target that is on track to meet the 2031 deadline is healthy birth weight. This has a tremendous flow-on effect, but we must keep working to maintain that.
There are many terrific projects happening across the country focussed on achieving this and contributing to the health, social and emotional wellbeing, empowerment and self-determination of Aboriginal families, and communities.
I am proud to work alongside amazingly passionate staff who share and build our shared vision to make a difference. But to affect real change – to close the gaps we see in Aboriginal life outcomes – researchers, clinicians and the community all need to be working together.
I challenge everyone to do something of meaning towards Closing the Gap.
I challenge everyone to go that extra distance because while individually it may only be a small thing, cumulatively it is powerful and really does make a difference.
Everyone can and should be part of this journey.