Kununurra : Lily Creek Lagoon by Peter Connolly

I first blogged about the Ord Valley Aboriginal Health Service FASD program back in January 2011 (see the post Getting Fathers Involved). Last week, an article called Ord Valley Aboriginal Health Service’s fetal alcohol spectrum disorders program: Big steps, solid outcome was published in the Australian Indigenous HealthBulletin. The author, Bridge, provides an overview of the program and reflects on successes and challenges as the first year draws to a close.

An FASD prevention program was initiated in August 2009 through the Ord Valley Aboriginal Health Service (OVAHS). OVAHS is a comprehensive primary health care (PHC) facility servicing Aboriginal people in the remote township of Kununurra and the surrounding communities. (Kununurra is situated in the far north east Kimberley region of Western Australia). The town has a population of approximately 7,500 people, and of those, approximately 50% are Aboriginal.

The program was developed to take a broad, holistic approach to working with women and their families. It also recognized the links between prenatal alcohol use, other drug taking behaviours and teenage sex/contraception issues. The program they developed targeted five groups:

  1. All Aboriginal women receiving prenatal care at OVAHS
  2. All Aboriginal women between the ages of 13 to 45
  3. OVAHS staff
  4. Local Aboriginal men
  5. Local, national and international interest groups and organisations.

The primary focus of the program is working with pregnant women. As part of their prenatal care, women receive FASD education, alcohol and other drug assessment and one-to-one counseling. Brief intervention, motivational interviewing and a three part antenatal assessment are key features of the program. When appropriate, these interventions are extended to include partners, families and the community as a whole. Information is also provided on contraception.

Contraception is viewed in the program as a cornerstone of FASD prevention. The author comments:

Dialogue with young women in the community revealed that their knowledge of puberty, menstruation, pregnancy and contraception varied, with a significant number reporting little knowledge of contraception in particular. Given the incidence of early alcohol use among young women (and its resultant impairment of judgement), and their attitudes and norms around consumption, the program has placed considerable emphasis on the promotion of alcohol awareness, contraception and safe sexual practices as part of all brief interventions.

One of the unique features of this program, I think, is the clear attempt to involve men in FASD prevention. Bridge says that men appear interested in  FASD education for a variety of reasons. “The men also believe that Aboriginal culture, knowledge and stories rely heavily on oral tradition, and therefore memory, and that this is potentially lost if many of the next generation suffer neurological damage as a result of pre-natal alcohol exposure. Men within the local community are also aware that too many of their young men are leaving school early and with only basic education, and that rates of imprisonment are high among Aboriginal men. As such the local men have voiced concern that FASD could be a contributing factor, especially as Aboriginal people currently make up 21% of the total number of Australian prisoners, yet only comprise 2.5% of Australia’s population.”

Results from the program clearly demonstrate the role that men/fathers have in supporting women to make alcohol-free choices:

In some families, women report that men hold the power-base and as such strongly influence the choices made regarding alcohol use in their pregnancies. Through conversation with antenatal clients, a number of women identified pressure from their partners as being significant in determining drinking behaviours during pregnancy. The women reported they would like to stop drinking, but were often pressured to stay with their partners in the ‘drinking circle as a show of family loyalty and their commitment and faithfulness to the relationship. Some female clients also report that to remove themselves from this social circle and ‘sit’ with non-drinking family members or friends, or spend time doing activities such as fishing potentially results in relationship problems, arguments or even violence. The role men play in the decision making of some clients was not initially anticipated, but it was recognised early on that the success of the program lay in part in the inclusion and education of men.

You can read the full-text of the article here.

Read more on FASD prevention in Western Australia:

Bridge, P. (2011). Ord Valley Aboriginal Health Service’s fetal alcohol spectrum disorders program: Big steps, solid outcome. Australian Indigenous HealthBulletin 11 (4). Free full-text.

GG makes historic visit to Kimberley town (The West Australian, August 11, 2011)

Ch. 3: From community crisis to community control in the Fitzroy Valley. In The Aboriginal and Torres Strait Islander Social Justice Commissioner. (2011). Social Justice Report 2010. Australian Human Rights Commission.

CTIS applauds new efforts to prevent FASD in rural Australia (December 15, 2010)

Marulu: The Liliwan Project (The George Institute for Global Health)