Hypothesis: improving literacy about health workforce will improve rural health workforce recruitment, retention and capability

Background One of the key barriers to health in rural areas is health workforce. Poor understanding and communication about health workforce across all stakeholder groups (including the broad community) is very common and can negatively affect the health workforce, recruitment, experiences and outcomes. Hypothesis In this paper, we propose the concept of literacy about health workforce. We propose this as a specific, actionable extension of the existing and well accepted health literacy concept. We hypothesise that improving literacy about health workforce will improve, in particular, rural health workforce recruitment, retention and capability. Implications of the hypothesis We propose that literacy about health workforce is important for all members of the health and broader system (e.g. local GP, mayor, workforce agency, health manager, Aboriginal health worker, carers, community health facilitators, patients, schools, local businesses, cultural and recreation groups) because we hypothesise their literacy about health workforce affects their capacity to make informed decisions and take action to manage their health workforce needs in direct synchrony with the community’s health needs. We hypothesise that improving literacy about health workforce will improve the effectiveness and efficiency of attracting, recruiting, training, and retaining a high quality, capable, health workforce, and further, will support the development and acceptance of innovative solutions to health workforce crises such as new models of care. This hypothesis is action orientated, is testable and includes the consideration of methods to engage and improve literacy of those within and external to the health workforce.

Aboriginal health worker screening for sexually transmissible infections and blood-borne viruses in a rural Australian juvenile correctional facility

Introduction: In Australia, Aboriginal youth are disproportionately represented in juvenile detention centres. We assessed the prevalence of sexually transmissible infections (STIs) and blood-borne viruses (BBVs) identified by an Aboriginal Health Worker (AHW)-led screening program delivered to male detainees of a rural juvenile detention centre. Methods: A retrospective review of first screening visit data was performed. Demographic and behavioural data were collected and the prevalence of STI/BBV was assessed. Results: Over a 4-year period to November 2004, 101 screens on new medium-to-long-term detainees were performed. The median age of participants was 17 years (range 14–20) and 87% were Aboriginal. Most reported multiple lifetime sexual partners (mean 14, range 0–60) and a minority had used a condom for the last episode of vaginal intercourse. Injecting drug use and non-professional tattoos or piercings were both reported by over one-third of participants, with over 80% reporting previous incarceration. One-quarter of those screened were newly diagnosed with one or more STI/BBV. The most common infection identified was urethral chlamydia (prevalence 16.3%, 95% confidence interval 10.0–25.5%), although the prevalence of newly diagnosed syphilis, hepatitis B and hepatitis C were each over 5%. Many participants remained susceptible to hepatitis B. Conclusion: An AHW-led STI/BBV screening program identified a large number of asymptomatic and previously undiagnosed infections in this group of young male detainees. Such an education and screening program using skilled Aboriginal staff not affiliated with the correctional system could have a substantial impact on the prevalence of STI/BBV among juvenile detainees.

Exploring the impact of an Aboriginal Health Worker on hospitalised Aboriginal experiences: lessons from cardiology

To enhance Aboriginal inpatient care and improve outpatient cardiac rehabilitation utilisation, a tertiary hospital in Western Australia recruited an Aboriginal Health Worker (AHW). Interviews were undertaken with the cardiology AHW, other hospital staff including another AHW, and recent Aboriginal cardiac patients to assess the impact of this position. The impact of the AHW included facilitating culturally appropriate care, bridging communication divides, reducing discharges against medical advice, providing cultural education, increasing inpatient contact time, improving follow-up practices and enhancing patient referral linkages. Challenges included poor job role definition, clinical restrictions and limitations in AHW training for hospital settings. This study demonstrates that AHWs can have significant impacts on Aboriginal cardiac inpatient experiences and outpatient care. Although this study was undertaken in cardiology, the lessons are transferable across the hospital setting.

Keepin Ya Mob Healthy: Aboriginal Community Participation and Aboriginal Health Worker Training in Victoria

This article outlines the development of accredited Aboriginal Health Worker training in Victoria. The processes of community consultation are presented as the primary reason for the successful implementation of the training program in its first year of delivery. The most important community consultation processes involved the active input of Elders and Aboriginal Health Workers. The training was seen as more credible by other Koorie people because of the input of these groups. The supportive role played by both the State and Commonwealth governments as well as industry groups are also explored. The successful implementation of the Aboriginal Health Worker training program demonstrates that Aboriginal people know what is best for them and can effectively initiate, organise and deliver their own culturally appropriate training programs.

Lake Mungo

Lake Mungo, in New South Wales, is the home of the first known people in this country. Here, the oldest known evidence of Aboriginal people in Australia has been found. Because of its importance, it is a site which everyone should know about. To give us a feeling for Lake Mungo, Billy Reid, the illustrator of The Aboriginal Health Worker and The Aboriginal Child at School, came with me on a trip. We travelled west to the Darling River (whose Aboriginal name is Calewatta), and then south-east to Lake Mungo itself. Billy made wonderful drawings to represent the deeds and everyday life of those people. This can be reconstructed from the fossil evidence found at Lake Mungo. He has also drawn some scenes of life along the banks of the Calewatta - the river which is Billy’s own home. He hails from Bourke.

Meet Billy Reid – Aboriginal Artist

Billy Reid, whose photograph appears on the front cover of this issue, is the illustrator for this journal, and its sister journal The Aboriginal Health Worker. Before becoming a professional artist, Billy had a varied experience of Aboriginal life which he can now draw upon in his work as illustrator. He was born in 1948 in the town of Warren in north-west New South Wales, thirteen miles off the Great Western Highway. Dad, known as Bill Reid, was a drover then. Billy remembers, as a child, driving along the outback roads with the horses and the stock. His mother, who died last year, used to drive the wagonette behind Dad, the twenty-odd horses and the cattle or sheep.Billy spent much of his early life moving between towns in outback Australia. As a child he lived for two years with his aunt at Coonamble while his parents kept working and on the move. Back and forth between Bourke, Coonamble, Brewarrina and Walgett gave him little chance to settle down to schooling. This meant Billy didn’t get going with his education till fairly late. Then, due to constant middle ear infections, which have left him partially deaf, he couldn’t hear his lessons. A good part of Billy’s childhood was spent at the Far West Home in Manly, Sydney. He left school at thirteen.Billy taught himself to draw whiling away time absent from school, on the Bourke Reserve. His artistic gift clearly runs in the family. Bill Reid Senior, who was later to become Pastor Reid, specialises in intaglio art: he carves emu eggs. As the shell is scraped away different colours are revealed, allowing beautiful pictures and textures to be formed about the shape of the egg.