Background: Indigenous community controlled health services have been developed in the Americas, Australia and New Zealand as a way of increasing health care coverage, accessibility and appropriateness for Indigenous communities. Models of Indigenous community controlled health care also aim to improve cultural identity and retention and reflect ideals of human rights and self-sovereignty. However, despite being founded on similar principles, these systems manifest in unique ways, being influenced by local, national and political contexts. The current research aims to understand the opportunities and constraints for Australian policy in drawing lessons from the Latin American context in order to improve the provision of culturally appropriate and safe health care to Indigenous Australians, particularly with regards to Indigenous community control.
Methods: The research combines case studies of Indigenous community controlled health services and interviews with Ministry of Health staff in Latin America and interviews with Australian practitioners and policymakers. The Latin American case studies and interviews explore the influence of community control on the provision of health services and the perspectives and roles of State institutions regarding Indigenous community participation in health. The Australian interviews serve to guide analysis regarding the suitability of strategies employed in these models for adoption within Australia.
Results: In recent decades, there has been an increasing call for global collaboration in Indigenous health, as given contextual similarities, there is scope to learn from what has and has not worked well in other countries. However, the processes of Indigenous community participation in health are highly context-dependent, reflecting the effects of historical and ongoing interactions between the State and Indigenous communities; the diverse, complex and fluid nature of Indigenous communities; and differences in the conceptualisation of ‘community’ and ‘participation’. There is therefore a need to balance examples provided from overseas with local knowledge and experience.
Conclusions: While consideration of local context is crucial, reflection on the experiences of international Indigenous communities may serve to provide some additional perspective. Ensuring that lessons from overseas are balanced with practical considerations for local implementation necessitates strong ties between communities, research and practice in the area of comparative Indigenous health research.