通过提供主流服务实施 "缩小差距 "政策:南澳大利亚案例研究。

IF 1.4 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Health Promotion Journal of Australia Pub Date : 2024-06-02 DOI:10.1002/hpja.884
Emma George, Matt Fisher, Tamara Mackean, Fran Baum
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引用次数: 0

摘要

解决的问题:澳大利亚政府通过多种战略实施了 "缩小差距"(CTG)战略。我们研究了南阿德莱德在实施 "缩小差距 "战略第一个十年(2008-2018 年)期间的幼儿政策,并对旨在促进原住民和托雷斯海峡岛民儿童的健康和福祉但缺乏原住民控制的政策的复杂性和挑战进行了批评:我们在南阿德莱德开展了一项定性案例研究,采访了来自卫生和幼儿教育部门的 16 名政策参与者。专题分析揭示了关键主题,以说明政策是如何通过主流结构实施的:CTG 战略的快速推出、短期资金的限制、原住民医疗服务的削减、象征性的咨询以及服务提供的主流化是政策实施的主要特征。在不同的实施背景下,原住民领袖的影响力各不相同。参与者倡导提供文化上安全的健康和教育服务,以改善儿童、家庭和社区的健康状况:结论:在南阿德莱德实施 CTG 战略的过程匆忙而复杂,缺乏原住民的控制。这导致了原住民领袖的边缘化,以及家庭和社区的脱离。一个更具协作性、由原住民主导的政策实施过程对于改革政策实施和解决健康不公平问题至关重要。所以呢?这项研究的结果表明,政策的实施方式仍然反映了殖民地权力的不平衡。如果我们要实现 CTG 战略中设定的目标,就必须考虑促进承认原住民权利的替代进程。
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Implementing 'Closing the Gap' policy through mainstream service provision: A South Australian case study.

Issue addressed: The Australian government's 'Closing the Gap' (CTG) strategy has been implemented via multiple strategies. We examined CTG policy in early childhood within Southern Adelaide during the first decade of implementation (2008-2018) and critiqued the complexity and challenges of policy that is designed to promote health and well-being of Aboriginal and Torres Strait Islander children but lacked Aboriginal control.

Methods: A qualitative case study was conducted in Southern Adelaide, and we interviewed 16 policy actors from health and early childhood education sectors. Thematic analysis revealed key themes to show how policy had been implemented through mainstream structures.

Results: The rapid roll out of the CTG strategy, the limitations of short-term funding, cuts to Aboriginal health services, tokenistic consultation, and the mainstreaming of service provision were key features of policy implementation. The influence of Aboriginal leaders varied across implementation contexts. Participants advocated for services in health and education that are culturally safe to improve health of children, families, and communities.

Conclusions: The implementation of the CTG strategy in Southern Adelaide was rushed, complex, and lacking Aboriginal control. This contributed to the marginalisation of Aboriginal leaders, and disengagement of families and communities. A more collaborative and Aboriginal led process for policy implementation is essential to reform policy implementation and address health inequity. SO WHAT?: Findings from this study suggest that policy has continued to be implemented I ways that reflect colonial power imbalances. Alternative processes that promote the recognition of Indigenous rights must be considered if we are to achieve the targets set within the CTG strategy.

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来源期刊
Health Promotion Journal of Australia
Health Promotion Journal of Australia PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
3.10
自引率
10.50%
发文量
115
期刊介绍: The purpose of the Health Promotion Journal of Australia is to facilitate communication between researchers, practitioners, and policymakers involved in health promotion activities. Preference for publication is given to practical examples of policies, theories, strategies and programs which utilise educational, organisational, economic and/or environmental approaches to health promotion. The journal also publishes brief reports discussing programs, professional viewpoints, and guidelines for practice or evaluation methodology. The journal features articles, brief reports, editorials, perspectives, "of interest", viewpoints, book reviews and letters.
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