Working in Indigenous primary health care
: a continuous, interconnected and multifaceted journey for health professionals

  • Robyn Lynette Williams

    Student thesis: Doctor of Philosophy (PhD) - CDU


    A consistent, culturally safe and effective workforce is crucial to enabling equity
    and access to health care and improving health outcomes for Indigenous
    peoples in Australia. This issue is linked to health workforce recruitment and
    retention in Australia and is an ongoing problem particularly in rural and remote
    areas, and more markedly in Indigenous primary health care contexts. Failure to
    attract and retain qualified staff, along with high staff-turnover, significantly
    impacts on the delivery and effectiveness of health care. The literature reveals
    reasons including a lack of appropriate work-place orientation and professional
    development opportunities, and limited government intervention in terms of
    health workforce policy or strategy. This results in compromised access to a
    stable service that meets Indigenous peoples’ needs, exacerbation of
    Indigenous health inequities, and reduction of community confidence in the
    provision of culturally safe health care.

    The inquiry at the centre of this thesis is to ask what kind of preparation health
    professionals need to work effectively in Indigenous primary health care
    contexts? This was explored using a qualitative study involving 22 health
    workforce participants, including nurses, doctors, and allied health professionals
    who are (or have been) working in Indigenous urban, rural and remote locations
    in Australia.

    Using a Constructivist Grounded Theory approach, four themes were found
    (Foundation of effective practice, Education, Engagement with the practice
    context, and Negotiation of culturally safe practice). The themes come together
    to form an emerging theory of preparation for practice that is ongoing, cyclical,
    and affected or influenced by a number of intrinsic and extrinsic factors. It is
    intended that the research will contribute to a stronger understanding of the
    people who choose to work in Indigenous primary health care, and what can
    support their need to continuously ‘prepare for practice’ in these settings.
    Date of AwardNov 2019
    Original languageEnglish
    SupervisorGretchen Ennis (Supervisor)

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