Enabling prosperity: success factors in Indigenous economic development

Public discussion about ‘closing the gap’ between Indigenous and non-Indigenous Australians tends to focus on measures such as life expectancy, child mortality, early childhood education, literacy and numeracy, and employment.  These are, rightly, essential markers of health and well-being for all people, and for decades they have provided evidence that Australia’s health and social systems have not met the needs of Indigenous Australians. However, there is another story, one that focuses on the measures of success, as evident in the many thriving Indigenous businesses and corporations around the country.  Across Australia, there is a growing story of economic security and success, in which Indigenous Australians are creating enterprises combining sound business principles with strong cultural and social foundations for the benefit of individuals, families and communities. Urbis was commissioned by Westpac to undertake research into Indigenous business development, to provide an evidence base to support the work of the Empowered Communities group. The report, Enabling Prosperity: Success Factors in Indigenous Economic Development, suggests that these factors are much the same as for any other businesses: human capital, access to capital and markets, infrastructure, location and an authorising environment created through government policy and regulation. In practice, businesses succeed because of more than one factor, and multiple factors can strengthen the capacity of a business to grow and develop.  For instance, access to capital often relies on the development of successful partnerships, while ownership of land and resources requires human capital to realise its potential. Indigenous culture can be both a support and a resource. Individual attitude and vision are also essential ingredients in business success, while government plays an important role in ensuring the regulatory environment enables rather than hinders business efforts. Much can be learned by examining successful Indigenous businesses both in Australia and internationally. Businesses are the key driver for wealth creation, helping to provide job opportunities and improve social and economic conditions. Fostering business success, therefore, has the potential to increase employment, improve living standards, and contribute to stable and nurturing communities. Current government policy frameworks, such as the Indigenous Economic Development Strategy, are largely focused on increasing education and training and generating opportunities for private sector employment and enterprise.  This is important. Just as important is the contribution that successful community or non-profit enterprises can make in providing employment, generating business investment for growth, building partnerships and demonstrating positive role models. The Empowered Communities group is such a national initiative. Formed in 2013, the group brings together Indigenous leaders from eight communities across Australia and seeks to strengthen Indigenous individuals and communities through a range of activities (see https://empoweredcomms.wordpress.com for more information). Strategies that strengthen both individual and community business initiatives will help to ensure that more Indigenous Australians have the opportunity to live successful and productive lives.  Everyone has a contribution to make in this regard. Governments can create an enabling regulatory environment. Banks can enable access to capital. Local chambers of commerce can foster business development through support and networks for new entrepreneurs. Communities and individuals can purchase goods and services from Indigenous businesses. Building a strong and vibrant Indigenous business and social enterprise sector can then contribute to improving many of the health and social indicators, such as improving nutrition and healthy lifestyle choices, and increasing employment and education.  Efforts to improve Indigenous outcomes really are everyone’s business

Views on and experiences of electronic cigarettes: a qualitative study of women who are pregnant or have recently given birth.

Background Electronic cigarettes (ECs) are increasingly used for reducing or stopping smoking, with some studies showing positive outcomes. However, little is known about views on ECs during pregnancy or postpartum and previous studies have nearly all been conducted in the US and have methodological limitations, such as not distinguishing between smokers and ex/non-smokers. A greater understanding of this topic will help to inform both clinicians and EC interventions. We elicited views and experiences of ECs among UK pregnant or recently pregnant women. Methods We conducted semi-structured telephone interviews, using topic guides, with pregnant or recently pregnant women, who were current or recent ex-smokers. To ensure broad views of ECs were obtained, recruitment was from several geographical locations and via various avenues of recruitment. This included stop smoking services, antenatal and health visitor clinics, a pregnancy website and an informal network. Participants were 15 pregnant and 15 postpartum women, including nine current EC users, 11 ex-users, and 10 never-users. Five women who were interviewed in pregnancy were later interviewed in postpartum to explore if their views had changed. Audio data was transcribed verbatim and framework analysis was applied. Results Five main themes emerged: motivations for use (e.g., for stopping or reducing smoking), social stigma (e.g., avoiding use in public, preferring ‘discrete’ NRT), using the EC (e.g., mostly used at home); consumer aspects (e.g., limited advice available), and harm perceptions (e.g., viewed as less harmful than smoking; concerns about safety and addiction). Conclusions ECs were viewed positively by some pregnant and postpartum women and seen as less harmful than smoking and useful as aids for reducing and stopping smoking. However, due to perceived social stigma, some women feel uncomfortable using ECs in public, especially during pregnancy, and had concerns about safety and nicotine dependence. Health professionals and designers of EC interventions need to provide women with up-to-date and consistent information and advice about safety and dependence, as well as considering the influence of social stigma

Making space to breathe : values, identity and accountability in a faith-based NGO

This project examines the impact on a Christian mission organisation of thedecision to accept government funding and add an explicit internationaldevelopment focus to its work. During the 1980s the Anglican Board of Mission(ABM), the national mission agency of the Anglican Church of Australia, enteredinto a contractual relationship with the Australian Government which ultimatelyled to accreditation as a development agency and involvement with the Australianinternational development sector. This process has significantly influenced ABMboth structurally and philosophically, bringing a creative tension within theorganisation between two related but distinct approaches to Christian witness.A cooperative inquiry method was chosen with the aim of fostering organisationallearning within ABM. The researcher became a participant in a team of fivewhich conducted three cycles of inquiry over a year. This team of staff membersand the researcher explored the influence of the growing relationship withgovernment on their faith-based NGO and its implications within the context ofChristian mission. Notions of intentionality, accountability and legitimacy withinthe relationships with their stakeholders emerged as significant foundations forthe work of the organisation. The cycles of inquiry generated a body of co-createdknowledge which, it is argued, have pointed the way to managing ABMs dualroles. Its multiple accountabilities - to government, to its Anglican constituency,and to overseas church partners - are understood as offering a framework throughwhich it can continually assess its organisational integrity and fidelity to its valuebase. Articulating intentionality of purpose and a clear theological understandingof mission and development were identified as crucial if ABM is to maintain itslegitimacy as derived from the mandate of the Anglican Church to undertakeChristian mission and development on its behalf. Making space to breathebecame a metaphor to describe the task of the organisation in creating both a reflective space which opens possibilities for transformed praxis, and a liminalspace between the two Programs of the organisation in which a unifyingphilosophical ground can be discovered

Correction to: Supporting Aboriginal and Torres Strait islander cultural educators and cultural mentors in Australian general practice education

Following publication of the original article [1], the author reported that Fig. 1 was missing

Barriers to obtaining a driver licence in regional and remote areas of Western NSW

This study examined factors impeding young people in Western NSW from entering the licensing system. The findings can be used to inform strategies to increase licensing rates for this population, to enable greater access to essential services and socio - cultural opportunities, while at the same time either maintaining or improving current levels of road safety for these young drivers . A mixed-method study was undertaken in 2014, involving interviews, focus groups and telephone surveys with 364 young people and 32 road safety stakeholders in Western NSW. Participants were asked for their views on the importance of young people having a driver licence and the effect of barriers to obtaining a driver licence identified in prior research. The qualitative data were thematically analysed and triangulated with descriptive statistics from the survey data to uncover key findings. Participants reported that a driver licence provides young people with a sense of independence and facilitates access to employment, education, sport and social events. Commonly reported barriers to obtaining a licence included: the process of obtaining a learner licence; proof of identify requirements; literacy and numeracy skills; legal issues and supervised driving requirements. The study results show that barriers to licensing span structural, practical, financial, legal and attitudinal issues that need to be accounted for when designing policy initiatives to increase licensing rates, while maintaining or improving the current level of road safety

Supporting Aboriginal and Torres Strait Islander cultural educators and cultural mentors in Australian general practice education

Background: Promoting cultural competence of health professionals working with Aboriginal and Torres Strait Islander communities is key to improving health outcomes. Cultural Educators and Cultural Mentors (CE/ CMs) have critical roles in Australian general practice training, yet these are not well understood. Methods: Guided by a CE/CM Network, our research team including experienced CE/CMs, used surveys and semi-structured interviews to explore these roles and investigate best practice in employment and support. Participants sampled from stakeholders involved in general practice education across Australia included CE/CMs, Medical Educators, General Practice Supervisors and Registrars, and representatives of Regional Training Organisations, Indigenous Health Training Posts and other key organisations. We undertook thematic analysis using a framework approach, refined further in team discussions that privileged views of CE/ CM members. Results: Participants comprised 95 interviewees and 55 survey respondents. We organised our findings under three overarching themes: understandings about cultural education and mentoring; employment and support of CE/CMs; and delivery and evaluation of cultural education and mentoring. Our findings supported a central role for Aboriginal and Torres Strait Islander CE/CMs in face-to-face Registrar education about culture and history and related impacts on health and healthcare. Cultural education was reported to provide base-line learning as preparation for clinical practice whilst cultural mentoring was seen as longitudinal, relationship-based learning. Mentoring was particularly valued by Registrars working in Aboriginal and Torres Strait Islander communities. Challenges described with employment and support included difficulties in finding people with skills and authority to undertake this demanding work. Remuneration was problematic, particularly for CMs whose work-time is difficult to quantify, and who are often employed in other roles and sometimes not paid. Other improved support recommended included appropriate employment terms and conditions, flexibility in role definitions, and professional development. Recommendations concerning implementation and evaluation included valuing of cultural education, greater provision of mentoring, partnerships with Medical Educators, and engagement of CE/CMs in rigorous evaluation and assessment processes. Conclusions: Our research highlights the importance of the unique CE/CM roles and describes challenges in sustaining them. Professional and organisational support is needed to ensure delivery of respectful and effective cultural education within general practitioner training

Building Aboriginal and Torres Strait Islander Cultural Education and Cultural Mentoring Capacity

In 2012 General Practice Education and Training commissioned the University of Western Sydney, who subcontracted with Urbis, to conduct research aimed at developing the evidence base to support training in cultural competence for doctors working with Aboriginal and Torres Strait Islander people. This research is aimed to inform a proposed National Framework for Cultural Competence in Prevocational and Vocational General Practice Training. Letters of support for the research were provided by the National Aboriginal Community Controlled Health Organisation and its affiliate organisations and ethics approval was received from the Human Research Ethics Committees of the University of Western Sydney, New South Wales Aboriginal Health and Medical Research Council, Northern Territory Department of Health and the Menzies School of Health Research as well as the Central Australia Human Research Ethics Committee, Aboriginal Health Council of South Australia Aboriginal Health Research Ethics Committee and Western Australian Aboriginal Health Ethics Committee. The research was framed at all times by the research outcomes and research questions developed by General Practice Education and Training Cultural Educators and Cultural Mentors and reflected in the contract between General Practice Education and Training and the University of Western Sydney