A case study in the use of evidence in a changing political context: an Aboriginal and Torres Strait Islander health service re-examines practice models, governance and financing
Deepa Gajjar A , Anthony B. Zwi B , Peter S. Hill A D and Cindy Shannon CA School of Population Health, The University of Queensland, Public Health Building, Herston, Qld 4006, Australia. Email: d.gajjar@uq.edu.au
B Department of Global Health and Development, The University of New South Wales, School of Social Sciences, Morven Brown Building (Rm G25), Sydney, NSW 2052, Australia. Email: a.zwi@unsw.edu.au
C Office of the Pro-Vice-Chancellor (Indigenous Education), The University of Queensland Brisbane, JD Story Building (Rm 444), St Lucia, Qld 4072, Australia. Email: pvcie@uq.edu.au
D Corresponding author. Email: p.hill@sph.uq.edu.au
Australian Health Review 38(4) 383-386 https://doi.org/10.1071/AH13221
Submitted: 2 October 2013 Accepted: 14 March 2014 Published: 30 June 2014
Journal Compilation © AHHA 2014
Abstract
This paper examines the response of a regional body, the Institute for Urban Indigenous Health (IUIH), coordinating Aboriginal community controlled health organisations (ACCHOs) in south-east Queensland, to research evidence as they prioritise and plan services in response to internal economic and organisational factors, as well as external policy change. An event-based analysis of a quarterly management meeting of the IUIH allowed an exploration of how the IUIH uses a range of evidence to respond to the challenges faced within the Aboriginal community controlled health sector. The study identified three distinct but interconnected processes: (1) identifying evidence for change; (2) exploring and reframing this evidence; and (3) the application of this evidence at different levels of policy and practice. These processes were evident in each of the three major agendas addressed during the meeting, namely navigating current political change, reforming the ACCHO business model and reframing the available evidence for advocacy. The result has been the emergence of a new service delivery model, in which evidence supports accountability, change management, self-sufficiency and attempts to redefine community control.
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