Leading the way: the contribution of Aboriginal community controlled health organisations to community health in Australia.

Abstract

Background The Aboriginal community controlled health sector has been a leader in community health in Australia. We sought to understand the influence this sector has had on the non-Indigenous community health movement in Australia since the 1970s. Methods We interviewed 87 key informants on the history of community health in Australia, including policy makers, researchers, medical doctors, allied health, social workers, nurses and politicians. Five were Aboriginal, and 11 had particular experience in Aboriginal community health. A team approach was taken to qualitative analysis using a codebook. We interrogated data to seek evidence for the influence of Aboriginal community health on non-Indigenous community health, and the relationship between the two sectors. This was complemented by construction of a policy timeline. Results Aboriginal community health services were regarded as best practice community health, and informed and influenced practice in non-Indigenous community health services. Non-Indigenous community health was sometimes more of a competitor than an ally. The respect for the Aboriginal community health sector, particularly community controlled, was seen to have grown over time, acknowledging the strengths of the model. Although establishing Aboriginal community health services was a struggle, the resulting model has better resisted managerialist control compared with non-Indigenous community health. Conclusions The Aboriginal health sector developed a vision and practice of community health that went on to inform generalist non-Indigenous community health sector in Australia. The sector continues to remain strong today as an example model of community health that is relevant to all Australians.