ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 229
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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‘Gurruṯu’ and the value of relationships in primary
healthcare: A case study from north-east Arnhem
Land, Australia
Dr Sarah Gelbart1,2, Jeff Cook1, Minitja Marawili1
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Laynhapuy Homelands Aboriginal Health Service, 2University of Tasmania
Trusting relationships are difficult to measure in standardised performance metrics. However, they
are essential to the provision of high-quality primary healthcare. Drawing on Aboriginal health and
wellbeing principles, this presentation demonstrates the value of relationship-based care, particularly
when working in cross-cultural settings.
The Yolŋu term ‘gurruṯu’, translated as ‘kinship relationships’ provides a framework for understanding
and valuing these connections. As an Aboriginal community-controlled organisation, Laynhapuy
delivers culturally appropriate primary healthcare to residents in Homelands across a 6500-km2
geographic area in north-east Arnhem Land, Australia. Gurruṯu or relationship-based care, including
two-way learning and reflective practice, allows the Laynhapuy team to engage with community and
respond to their healthcare needs.
This region has some of the highest rates of rheumatic heart disease (RHD) in the world. Using the
RHD program as a case study, this presentation demonstrates the value of trusting longitudinal
relationships to improve health and wellbeing outcomes for individuals and communities. Using an
outreach model, the team engages in prevention and education activities, ensuring early detection
and treatment of skin sores and sore throats, as well as prompt recognition and management of
acute rheumatic fever (ARF). For patients diagnosed with ARF, secondary prophylaxis with monthly
intramuscular penicillin injections can prevent the development of RHD. The model works because
communities trust and can access their primary healthcare team.
A key element of the program is the team-based approach, including recognition and involvement of
Aboriginal health workers, families and community members. Recent innovations to improve access
to echocardiography for screening and monitoring in community are having an impact too. However,
their benefits are realised because they are embedded within existing relationships and responding to
community need. This presentation reminds us of the essential value of relationships as we reconnect
and revive primary healthcare.
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