Closing the (service) gap: exploring partnerships between Aboriginal and mainstream health servicesKate P. Taylor A B C and Sandra C. Thompson A B
A Combined Universities Centre for Rural Health (CUCRH), University of Western Australia, PO Box 109 Geraldton, WA 6531, Australia. Email: firstname.lastname@example.org
B Centre for International Health and Curtin Health Innovation Research Institute, Curtin University, PO Box U1987, Perth, WA 6845, Australia.
C Corresponding author. Email: email@example.com
Australian Health Review 35(3) 297-308 https://doi.org/10.1071/AH10936
Submitted: 17 June 2010 Accepted: 21 October 2010 Published: 25 August 2011
Background. Although effective partnerships between Aboriginal and mainstream health services are critical to improve Aboriginal health outcomes, many factors can cause these partnerships to be tenuous and unproductive. Understanding the elements of best practice for successful partnerships is essential.
Methods. A literature review was conducted in 2009 using keyword searches of electronic databases. Sourced literature was assessed for relevance regarding the benefits, challenges, lessons learnt and factors contributing to successful Aboriginal and mainstream partnerships. Key themes were collated.
Results. Although there is much literature regarding general partnerships generally, few specifically examine Aboriginal and mainstream health service partnerships. Twenty-four sources were reviewed in detail. Benefits include broadening service capacity and improving the cultural security of healthcare. Challenges include the legacy of Australia’s colonial history, different approaches to servicing clients and resource limitations. Recommendations for success include workshopping tensions early, building trust and leadership.
Conclusion. Although successful partnerships are crucial to optimise Aboriginal health outcomes, failed collaborations risk inflaming sensitive Aboriginal–non-Aboriginal relationships. Factors supporting successful partnerships remind us to develop genuine, trusting relationships that are tangibly linked to the Aboriginal community. Failure to invest in this relational process and push forward with ‘business as usual’ can ultimately have negative ramifications on client outcomes.
What is known about the topic? Partnerships between different health services have long been recognised as beneficial for broadening service capacity and using resources more effectively to improve client care. The current policy climate particularly recognises partnerships between Aboriginal and mainstream services as offering multiple benefits for improving the cultural and clinical capacity of health service delivery to Aboriginal clients. Yet many challenges face these arrangements, including tensions stemming from historical and current race relations, different ways of working and ongoing Aboriginal disadvantage.
What does this paper add? Although partnerships between Aboriginal and mainstream services are strongly advocated for, there is a paucity of research on the challenges in these arrangements and practical suggestions on how to make such partnerships genuinely successful. This paper analyses the results from research, case studies, reports and reviews to identify the factors that challenge and enhance partnerships between Aboriginal and mainstream health services. The collation of this information also enables indicators of best practice to be presented.
What are the implications for practitioners? Although there are considerable challenges for Aboriginal and mainstream health services entering into partnerships, this paper offers health service practitioners and managers a summary of lessons learnt and a ‘checklist’ of best practice indicators to assist them in developing, implementing and sustaining a successful collaborative arrangement.
References Mattesich PW, Murray-Close. M, Monsey M. Collaboration: what makes it work. 2nd edition. A Review of Research Literature on Factors Influencing Successful Collaboration. Nashville, TN: Fieldstone Alliance; 2001.
 Social Justice Report 2005. Sydney: Human Rights and Equal Opportunity Commission Aboriginal and Torres Strait Islander Social Justice Commissioner (HREOC); 2005.
 Social and Emotional Well Being Framework: A national strategic framework for Aboriginal and Torres Strait Islander Mental Health and Social and Emotional Well Being (2004–2009). Canberra: Australian Health Ministers Advisory Council; 2004.
 Aboriginal Health Promotion and Chronic Care (AHPACC) Partnership. Aboriginal Health Promotion and chronic care partnership: interim program guidelines. Available at http://www.health.vic.gov.au/communityhealth/aboriginal_health.htm [verified 10 August 2010].
 NSW Aboriginal Chronic Conditions Area Health Service Standards. Sydney: NSW Department of Health; 2005.
 South Australian Aboriginal Health Partnership. Agreement of South Australian Aboriginal health and wellbeing. 2005. Available at http://www.ahcsa.org.au/media/docs/2005_2010_framework_agreement.pdf [verified 10 August 2010].
 Sydney Consensus Statement. Principles for better practice in Aboriginal health promotion. Sydney: NSW Health; 2002.
 The Power of Partnership. Geneva: World Health Organization; 2003.
 Hooper K, Thomas Y, Clarke M. Health professional partnerships and their impact on Aboriginal Health: an occupational therapist’s and Aboriginal health worker’s perspective. Aust J Rural Health 2007; 15 46–51.
| Health professional partnerships and their impact on Aboriginal Health: an occupational therapist’s and Aboriginal health worker’s perspective.CrossRef |
 Eslick S, Gevers L Intersectoral collaboration: critical success factors. Perth: Leslie Gevers Community Management Services; 2000.
 Gillies P. Effectiveness of alliances and partnerships for health promotion. Health Promot Int 1998; 13 99–120.
| Effectiveness of alliances and partnerships for health promotion.CrossRef |
 Lasker RD, Weiss ES, Miller R. Partnership synergy: a practical framework for studying and strengthening the collaborative advantage. Milbank Q 2001; 79 179–205.
| Partnership synergy: a practical framework for studying and strengthening the collaborative advantage.CrossRef | 1:STN:280:DC%2BD3Mzos1ajsg%3D%3D&md5=5bd6f619d72718d55928975ac7ce6eceCAS |
 McWilliam CL, Coleman S, Melito C, Sweetland D, Saidak J, Smit J, et al Building empowering partnerships for interprofessional care. J Interprof Care 2003; 17 363–76.
| Building empowering partnerships for interprofessional care.CrossRef |
 Walker R, Smith P, Adam J. Making partnerships work: issues of risk, trust and control for managers and service providers. Health Care Anal 2009; 17 47–67.
| Making partnerships work: issues of risk, trust and control for managers and service providers.CrossRef |
 Hailey J. NGO partners: the characteristics of effective development partnerships. In: Osbourne S, editor. Public–Private Partnerships. London: Routledge; 2000.
 Buse K, Harmer A. Seven habits of highly effective global public-private health partnerships: practice and potential. Soc Sci Med 2007; 64 259–71.
| Seven habits of highly effective global public-private health partnerships: practice and potential.CrossRef |
 Mitchell SM, Shortell SM. The governance and management of effective community health partnerships: a typology for research, policy, and practice. Milbank Q 2000; 78 241–89.
| The governance and management of effective community health partnerships: a typology for research, policy, and practice.CrossRef | 1:STN:280:DC%2BD3cvhsVOisA%3D%3D&md5=fc0e679decaec173afe1da8659302828CAS |
 Pope C, Ziebland S, Mays N. Qualitative research in health care: analysing qualitative data. BMJ 2000; 320 114–6.
| Qualitative research in health care: analysing qualitative data.CrossRef | 1:STN:280:DC%2BD3c%2FptVOgug%3D%3D&md5=9bde8d53d6962b9e5c3f2c60740269fcCAS |
 Waples-Crowe P, Pyett P. Learning from a successful partnership between mainstream and Indigenous organisations. Aborig Isl Health Work J 2006; 30 4–5, 33.
 Voyle J, Simmons D. Community development through partnership: promoting health in an urban indigenous community in New Zealand. Soc Sci Med 1999; 49 1035–50.
| Community development through partnership: promoting health in an urban indigenous community in New Zealand.CrossRef | 1:STN:280:DyaK1Mvgt1KmsQ%3D%3D&md5=c0fa6b4656222461cc91041b05813926CAS |
 Carriage C, Harris E, Kristensen E. Evaluation of the first strategic plan for Aboriginal Health in South Western Sydney. 1993–98. Aust Health Rev 2000; 23 20–7.
| Evaluation of the first strategic plan for Aboriginal Health in South Western Sydney. 1993–98.CrossRef | 1:STN:280:DC%2BD3M%2Fmtleqtg%3D%3D&md5=8e469365b5f1f0e660147f7a510a2e8cCAS |
 Jackson D, Brady W, Stein I. Towards (re)conciliation: (re)constructing relationships between Indigenous health workers and nurses. J Adv Nurs 1999; 29 97–103.
| Towards (re)conciliation: (re)constructing relationships between Indigenous health workers and nurses.CrossRef | 1:STN:280:DyaK1M7mt1Smsg%3D%3D&md5=a5c9b4c8605cd20f462419fa42807d1dCAS |
 Dollard J, Stewart T, Fuller J, Blue I. Aboriginal health worker status in South Australia. Aborig Isl Health Work J 2001; 25 28–30.
 Fuller J, Hermeston W, Passey M, Fallon T. Mapping Aboriginal Health Partnerships (MAHP E T): Report to the Diabetes site. Lismore: University Department of Rural Health (Northern Rivers) and University of Sydney and Southern Cross University: 2008.
 Waples-Crowe P, Pyett P. The making of a great relationship: a review of a healthy partnership between mainstream and Indigenous organisations. Melbourne: Victoria Aboriginal Community Controlled Health Organisation; 2005.
 Strempel P, Saggers S, Gray D, Stearne A. Indigenous drug and alcohol projects: elements of best practice. Research Paper. Canberra: Australian National Council on Drugs; 2003.
 Cooper J, Moore S, Palmer L, Reinhardt J, Roberts M, Soloman A, et al Partnership approach to Indigenous primary health care and diabetes: a case study from regional NSW. Aust J Rural Health 2007; 15 67–70.
| Partnership approach to Indigenous primary health care and diabetes: a case study from regional NSW.CrossRef |
 Fuller JD, Martinez L, Muyambi K, Varron K, Ryan B, Klee R. Sustaining an Aboriginal mental health service partnership. Med J Aust 2005; 183 S69–72.
 Cleworth S, Smith W, Sealey R. Grief and courage in a river town: a pilot project in the Aboriginal community or Kempsey, New South Wales. Australas Psychiatry 2006; 14 390–4.
 Hampton MR, McKay-McNabb K, Jeffrey B, McWatters B. Building research partnerships to strengthen sexual health of Aboriginal youth in Canada. Aust Comm Psyc 2007; 19 28–38.
 Nossar V, Houston S, Gale L. ‘From little things, big things grow’: a history of the development of cooperation between Aboriginal health services and the South Western Sydney Area Health Service. Aust Health Rev 1993; 16 346–52.
| 1:STN:280:DyaK2M%2FntFSisw%3D%3D&md5=978c7442bc35a56d1d953c87209ac06cCAS |
 Taylor J, Dollard J, Weetra C, Wilkinson D. Contemporary management issues for Aboriginal Community Controlled Health Services. Aust Health Rev 2001; 24 125–32.
| Contemporary management issues for Aboriginal Community Controlled Health Services.CrossRef | 1:STN:280:DC%2BD3Mrms1amsw%3D%3D&md5=6b6287cfe03d3115df7e62e7a96f918bCAS |
 Salisbury C. A health service and Aboriginal and Torres Strait Islander partnership to develop and plan mental health services. Aust J Prim Health Interchange 1998; 4 18–30.
| A health service and Aboriginal and Torres Strait Islander partnership to develop and plan mental health services.CrossRef |
 Pyett P. Working together to reduce health inequalities: reflections on a collaborative participatory approach to health research. Aust N Z J Public Health 2002; 26 332–6.
| Working together to reduce health inequalities: reflections on a collaborative participatory approach to health research.CrossRef |
 Aboriginal Health Plan. 2001–2006. Planning Report no: 01/02. Sydney: South Western Sydney Area Health Service; 2001.
 Dobson I, Darling K. Aboriginal Youth Mental Health Partnership Project. Evaluation Report August 2003. Aboriginal Youth Mental Health Partnership Project Advisory Group and Department of Human Services Mental Health Unit and Aboriginal Services Division; 2003. Available at http://www.sapo.org.au/binary/binary323/MAYT.pdf [verified 28 June 2011].
 Perino J. Supporting wellness in the bush. 9th National Rural Health Conference: standing up for rural health: learning from the past, action in the future; 7–10 March 2007; Albury, NSW. 2007.
 Bradford M, Nancarrow H, Viti P, Weazel A. Cross-cultural Partnerships in Violence Prevention. Queensland Centre for Domestic and Family Violence Research. Available at http://www.vplabrador.ca/home/files/women/cross_cultural_partnerships_violence_prevention.pdf [verified 31 July 2011].
 Dwyer J, Silburn K, Wilson G. National Strategies for Improving Indigenous Health and Health Care, Vol. 1. Canberra: Commonwealth of Australia: 2004.
 Making the Connections. Guidelines for effective approaches to Aboriginal and Torres Strait Islander public health. Melbourne: National Public Health Partnership; 2006.
 Zaheer A, McEvily B, Perrone V. Does trust matter? Exploring the effects of interorganizational and interpersonal trust on performance. Organ Sci 1998; 9 141–59.
| Does trust matter? Exploring the effects of interorganizational and interpersonal trust on performance.CrossRef |
 The health of the people of New South Wales – Report of the Chief Health Officer. Sydney: Population Health Division; 2004.
 Hayman NE, Wenitong M, Zangger JA, Hall ME. Strengthening cardiac rehabilitation and secondary prevention for Aboriginal and Torres Strait Islander peoples. Med J Aust 2006; 184 485–6.
 Thompson SC, Taylor KP. Are we really committed to making a difference? Reflections on Indigenous health research and dissemination Aust N Z J Public Health 2009; 33 403–4. [Editorial]
| Are we really committed to making a difference? Reflections on Indigenous health research and disseminationCrossRef |
 Genat B. Aboriginal Health Workers: primary health care at the margins. Crawley, WA: University of Western Australia Press; 2006.
 Hazlehurst KM. A healing place: Indigenous visions for personal empowerment and community recovery. Rockhampton, QLD: Central Queensland University Press: 1994.
 Henry B, Houston S, Mooney G. Institutional Racism: A plea for decency. Med J Aust 2004; 180 517–20.
 Coffin J. Rising to the challenge in Aboriginal Health by creating cultural security. Aborig Isl Health Work J 2007; 31 22–4.
 Thomson N. Cultural respect and related concepts: a brief summary of the literature. Aust Indig Health Bull 2005; 5 1–22.
 Reconciliation Action Plans. Turning good intentions into actions. Kingston, ACT: Reconciliation Australia; 2006.
 Council for Aboriginal Reconciliation. Partnerships in Reconciliation: it’s up to us. Kingston, ACT: Reconciliation Australia; 1999.
 Center for the Advancement of Collaborative Strategies in Health. Partnership Self-Assessment Tool: 2002. Available at http://www.cacsh.org/psat.html [updated 21 August 2007, verified].
 Victorian Health Promotion Foundation. The Partnerships Analysis Tool for Partners in Health Promotion. Available at http://www.health.vic.gov.au/healthpromotion/stakeholders/partnerships.htm [verified 18 August 2010].