Dr Jon Hunt commented on a recent post that asked for suggestions for news stories in Aboriginal health. He suggested the Anangu Bibi birthing project would be worth a story. Croakey asked him to elaborate:
“It was based in Port Augusta and Whyalla which are two medium sized towns in South Australia which have a high proportion of Aboriginal people.
I wasn’t directly involved with the project, however being a GP working in Aboriginal Health the problem of pregnancy reared its ugly head quite often.
As I am sure you know, the engagement of Aboriginal people with mainstream health services is usually quite poor. The aim of the project was to improve this in an important area by strongly involving Aboriginal people with the antenatal, intrapartum and postnatal care of these patients.
Aboriginal Health Workers played key roles in community antenatal care at the clinic and antenatal clinics at the hospital. As well as these clinics they could also do home visits where difficulties arose with compliance (or whatever the polite term is these days). Indeed they performed any role that was required to improve their care.
Just as important was the support the AHW provided to the patient whilst they were admitted in hospital for the birth, as well as being directly involved with their care.
As I see it, there are many positives to this approach. The AHW gains knowledge and improved self esteem through empowerment and responsibility. The hospital gains a cultural mediator and an extra worker. The patient has increased satisfaction and better care by improved engagement with a process which is usually very clinical and often culturally naive. There does not appear to be any negatives to this approach that I can see.
For me though the main bonus was that once I referred a patient to them I knew that there was nothing more I needed to do.
I think an important lesson that could be learned from this is that this sort of shared approach should be used with mainstream services wherever possible. For instance there is no reason why this model couldn’t be used for general hospital patients. A large proportion of inpatients at Port Augusta hospital are Aboriginal, yet there are no Aboriginal staff employed to perform these liaison or shared duties. Unfortunately the mindset of the health administration does not appear to be flexible enough to adapt to differing circumstances.”
