Promoting women's health in remote Aboriginal settings: Midwifery students' insights for practice

Abstract

OBJECTIVE: To describe midwifery students' insights on promoting health to Aboriginal women in remote Australia following a supervised clinical placement. DESIGN: Semistructured, in-depth interviews were conducted with all midwifery students who undertook the placement between 2010 and 2013. SETTING: Aboriginal communities on the Ngaanyatjarra Lands, Western Australia. PARTICIPANTS: Undergraduate and postgraduate midwifery students from a Western Australian university. INTERVENTIONS: Remote cultural immersion clinical placement. MAIN OUTCOME MEASURES: Student learning related to culturally respectful health care delivery and promotion of health. RESULTS: Students observed that, despite vast distances, high rates of participation in a breast screening program were achieved due to the informal provision of culturally relevant information and support. Opportunistic encounters in communities also enabled sexual health messages to be delivered more widely and in less formal settings. The role played by Aboriginal Health Workers and female family members was vital. The importance of culturally respectful approaches to sensitive women's business, including discretion, the use of local language and pictorial representations of information, was recognised as was the socio-cultural context and its impact on the health and well-being of the community. CONCLUSIONS: Although short in duration, the Ngaanyatjarra Lands clinical placement provided midwifery students with a rare opportunity to observe the importance of local contexts and cultural protocols in Aboriginal communities, and to adapt health promotion strategies to meet local needs and ways of doing things. These strategies embraced the strengths, assets and capacities of communities, yet students also witnessed challenges associated with access, delivery and acceptance of health care in remote settings.

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