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Writer's pictureDr Sarah Ireland

Weaving stories and knowledge into service redesign

Yolŋu Country, Northern Territory. 18 October, 2024.

Our current work in the research project To be Born Upon a Pandanus Mat: Yothuw gayatha dhäwal’ guyaŋa’ nharaw uses participatory action research to inform maternity service redesign. We are working to increase continuity and quality of maternity care as Yolŋu women move through services in Galiwin’ku, Nhulunbuy and Darwin. Our main focus is on embedding the djäkamirr (doula) role into the health system and improving the quality of Western midwifery care. All up it's a big and very ambitious project!

It means research and service delivery are not separate but woven together like a pandanus mat.

The participatory action research approach centres Yolŋu in our collaborative work and empowers stakeholders to guide and contribute to the research process. The approach uses iterative cycles of data collection to inform the next steps in service redesign. Stakeholders include djäkamirr, consumers, clinicians, service managers, Cultural Authorities and Elders. It means the research and service delivery are not separate but woven together like a pandanus mat.


Photo credit: Res McCalman. Researchers (L to R) - Virginia Rripa, Joan Malku Dhamarrandj and Sarah Khaw discussing research activities.


We have been building the research team so we can better collect the important stories necessary to informing service redesign. Recently Yolŋu researchers, Joan Malku Dhamarrandji and Virginia Rripa, began working alongside Balanda researchers Dr Emily Armstrong and Sarah Khaw, to commence data collection with Yolŋu stakeholders. Joan Malku is an experienced senior Yolŋu researcher, whereas Virginia Rripa is new to doing community research. We are so happy to be supporting Virginia in developing Yolŋu research knowledge, experience and skills. Virginia says 'I am looking forward to learning more about research and working together'.


Photo credit: Sarah Khaw. (L to R): Virginia Rripa (Yolŋu Researcher) and Sarah Khaw (Research Fellow) after a day of djäma (work).


They have also commenced interviews with djäkamirr about their work in the program

Joan Malku, Virginia, Emily and Sarah.K. started talking with Yolŋu women about their experiences of pregnancy care with a focus on decision-making, informed consent and concepts of risk. They have also commenced interviews with djäkamirr about their work in the program. Yolŋu researchers are continuing with Galiwin’ku data collection and the Darwin-based researchers plan to visit again soon. Working collaboratively, our team will weave the stories shared by participants and use that collective knowledge to achieve the goals of women in Galiwin’ku.


Photo credit: Emily Armstrong. (L to R):  Djandi Ganambarr (Gumurr’ dhangiyunamirr Board member), Joan Malku Dhamarrandj (Senior Yolŋu Researcher) and Emily Armstrong (Postdoc Researcher)


Senior Yolŋu researcher Joan Malku talked with Emily about the aims of participatory action research and working with Yolŋu values:  


We’ve been finding out new stories. … People we’re working with, they’ll get yuwalk (real) understanding. It’s about thinking and then mala djarr’yun (sorting out) and then doing the practical thing. You need to know what you’re learning so you do it in a way that’s helpful for yourself and for the people involved in the djäma (work). …


Passing the knowledge – to make it more practical so everyone’s feeling comfortable and something’s been achieved. We want achievement with that knowledge - we’ve got power to help Yolŋu and all people involved.  …


The goal is to have a strong mother, family and yothu (baby) growing up in a manymak (good) environment – safe and with support and getting knowledge. The mother is happy and the child and all the family. Sharing knowledge between the djäkamirr [mala] (caretakers/Yolŋu doulas,) and yothumirr miyalk [mala] (pregnant woman), and doctors and nurses, and Yolŋu mala ŋaḻapaḻmirr (Yolŋu Elders).


One day they’ll become grandmothers and pass that knowledge to the new generation of women.

They will pass that knowledge to the young generations, to the young mothers in the future. One day they’ll become grandmothers and pass that knowledge to the new generation of women. It’s a cycle, like that. … the aim is to have that djäkamirr that know their role and are proud of their djäma (work). Researchers will be proud too. We will be exchanging knowledge. And older people will be getting their ancient knowledge and bringing it here to the modern day.


We have also grown our higher degree by research student group.

We have also grown our higher degree by research student group and are very fortunate to welcome Balanda PhD student Angela Rees to our team. Angela is a registered midwife with a keen interest in remote areas and providing quality midwifery care for First Nations women.

Photo credit: Supplied by Angela Rees. New PhD student Angela Rees joins our team.


Angela explains:

My project will be exploring and measuring the workload of very remote midwives working to an extended scope of practice in a very remote Birthing on Country service. I’d like to express a huge thank you to all of the staff and fellow PhD students who have welcomed and supported me already in these early days!


With our research team growing we are excited to be collaborating with stakeholders and weaving the research stories into maternity service redesign!


With acknowledgement and gratitude to Dr Emily Armstrong and Sarah Khaw for their contributions to the blog.


Learn more with these links


Our project website To be born upon a pandanus mat


Colleagues


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