Working in Indigenous primary health care

: a continuous, interconnected and multifaceted journey for health professionals

Abstract

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 Award	Nov 2019
Original language	English
Supervisor	Gretchen Ennis (Supervisor)