Leanne Coombe

Community governed health services in Cape York: Does the evidence point to a model of service delivery?

Health service delivery model reforms are currently underway in Cape York in an effort to improve health outcomes for the Aboriginal and Torres Strait Islander communities. These reforms include the transition of the Apunipima Cape York Health Council from an advocacy agency to a community-controlled health service provider. This paper investigates the literature on existing community governance models and community-controlled health service delivery models, to guide the choice of the most appropriate model for the Cape York health reforms. The evidence collected suggests a new innovative health service delivery model is emerging that will not only improve Indigenous health status, but may also present a more appropriate model for the health care sector than the existing mainstream health service delivery model provided for other sections of the collective Australian population.

Building capacity through action research curricula reviews

In Australia, graduates of Master of Public Health (MPH) programmes are expected to achieve a set of core competencies, including a subset that is specifically related to Indigenous health. This paper reports on the methods utilised in a project which was designed using action research to strengthen Indigenous public health curricula within MPH programmes at Australian universities. This aim is achieved through the use of three interlinked ‘action–reflection’ cycles, involving individual Indigenous public health academics who, through their membership in a scholarly network, have undertaken a series of curriculum reviews, which have in turn influenced organisational change in universities. The project results demonstrated how action research can successfully strengthen Indigenous public health curricula.

Integration models for indigenous public health curricula

ABSTRACT All graduates of Master of Public Health (MPH) programmes in Australia are expected to achieve a core set of Indigenous public health competencies designed to train ‘judgement safe practitioners’. A curriculum framework document was developed alongside the competencies to assist programme providers to integrate appropriate Indigenous content, but it does not describe the intended integration model. A review of MPH programmes was undertaken to determine the extent of integration, identify examples of best practice and explore how integration can be improved. Data from the consolidated review findings were analysed using a staged approach. Several models of curricula integration were identified, building on known models, and definitions developed that differentiate features according to the extent of integration achieved. The model recommended in the literature as best practice, known to promote deep learning, was found in only one of the reviewed programmes. This combination model supports development of reflexive practitioners who can operate across different disciplines and ways of knowing. Enablers and barriers were explored to explain why some integration models were more commonly found. Implications for curriculum reform are outlined with strategies to assist implementation of a combined integration model, a necessary learning approach to enhance student cultural competence.

Aboriginal and Torres Strait Islander Public Health: Online and Integrated into Core Master of Public Health Subjects.

The Master of Public Health (MPH) is an internationally recognised post-graduate qualification for building the public health workforce. In Australia, MPH graduate attributes include six Indigenous public health (IPH) competencies. The University of Melbourne MPH program includes five core subjects and ten specialisation streams, of which one is Indigenous health. Unless students complete this specialisation or electives in Indigenous health, it is possible for students to graduate without attaining the IPH competencies. To address this issue in a crowded and competitive curriculum an innovative approach to integrating the IPH competencies in core MPH subjects was developed. Five online modules that corresponded with the learning outcomes of the core public health subjects were developed, implemented and evaluated in 2015. This brief report outlines the conceptualisation, development, and description of the curriculum content; it also provides preliminary student evaluation and staff feedback on the integration project. Significance for public health This approach to a comprehensive, online, integrated Indigenous public health (IPH) curriculum is significant, as it ensures that all University of Melbourne Master of Public Health (MPH) graduates will have the competencies to positively contribute to Indigenous health status. A workforce that is attuned not only to the challenges of IPH, but also to the principles of self-determination, Indigenous agency and collaboration is better equipped to be comprised of ethical and judgment-safe practitioners. Additionally, the outlined approach of utilizing IPH content and examples into core MPH subjects ensures both the Australian relevance for an Australian-based health professional course and international appeal through the modules inclusion of International Indigenous case-studies and content. Furthermore, approaches learned in a challenging Indigenous Australian context are transferable and applicable to other IPH challenges in a local, national and global context.

Models of Interuniversity Collaboration in Higher Education--How Do Their Features Act as Barriers and Enablers to Sustainability?.

This study combines conceptual and empirical review of the literature around interuniversity collaborations to identify known models and applications, and enablers and barriers impacting on their sustainability, to inform development of a collaborative public health teaching programme in Australia. A range of literature was explored in this study, including commentary on appropriate theoretical frameworks, exploratory studies, descriptive analyses and specific case study investigations. There was a dearth of literature that compares the factors that ultimately lead to success or failure of the models of collaboration identified. Further research investigating how different types of collaboration affect particular barriers and enablers, and how certain types of collaborations are more sustainable than others, is required.

Australian Higher Education Reforms--Unification or Diversification?.

The higher education policy of the previous Australian government aimed to achieve an internationally competitive higher education sector while expanding access opportunities to all Australians. This policy agenda closely reflects global trends that focus on achieving both quality and equity objectives. In this paper, the formulation and implementation of the policy are examined according to the policy cycle approach, drawing on additional theories and analytic frameworks as applicable. The analysis explores why such an ambitious policy approach was taken, how it was implemented and factors affecting its achievability. Indicators suggest the policy was not delivered successfully within the term of the Labor administration. It also highlights an ongoing policy trend to unify the higher education sector, despite evident divisions within the sector and between levels of government administration. The paper concludes with recommendations to diversify the system so that the equity and quality policy agendas can be implemented concurrently.