Indigenous Australian perspectives in Social Marketing

Recent reports suggest that program evaluation in the area of Indigenous health is at best problematic. The Australian Productivity Commission in 2016, for example, noted a lack of evidence of effectiveness in this area, and the need to carefully design programs and systematically evaluate them. There is thus a need to consider the policies and implementation of health programs for Australia’s first peoples. Often these programs can be thought of as social marketing aimed at individual and community level behavioural change. It is the argument of this thesis that the inherent structural power relationship between Indigenous peoples and change agents (government, authorities and service providers) affects the success of social marketing in this area.

The way the power structures affect social marketing is covered by three case studies. The first encompasses, downstream social marketing from government and authorities to Indigenous peoples (The Northern Territory Emergency Response Intervention). The second, a midstream social marketing approach, which uses an Indigenous health agency (The Birthing on Country Project). Whilst the third (The Narrandera Community Health Program), examines an upstream, community lead approach, to social marketing in health. A Foucauldian analysis was used to critically evaluate, from an Indigenous perspective, each social marketing program.

The findings demonstrate that power affects social marketing effectiveness for Indigenous peoples. Downstream approaches were seen as the most expensive and largest in scale but provided only partial evidence of success and exhibited unintended consequences of both ethical and societal outcomes. Upstream approaches to social marketing, whilst empowering Indigenous Australian people, was found to challenge power structures and to be successful required significant cross-cultural and community leadership skills. Midstream approaches, whilst not addressing historical and present-day power imbalances were found to be the most effective of the three. Provided that the midstream service providers had some autonomy, control and consulted with and sought approval from their clients and key stakeholder communities. It is thus vital to consider the situational context and power relationship between those advocating change and those effected by change. Also, social interventions which are best for Indigenous health and identify must be informed by their voices. Though this can only occur now, through midstream approaches, as they don’t overtly challenge authorities and established power structures. More negative factors of health programs can also occur for Indigenous peoples when their voices are not heard, or the power structure cannot accommodate them.