The Marulu Strategy 2008-2012: overcoming Fetal Alcohol Spectrum Disorder (FASD) in the Fitzroy Valley

Aust N Z J Public Health. 2017 Oct;41(5):467-473. doi: 10.1111/1753-6405.12689. Epub 2017 Jul 27.

Abstract

Objective: Aboriginal leaders concerned about high rates of Fetal Alcohol Spectrum Disorder (FASD) in the Fitzroy Valley, remote north-western Australia, introduced restrictions on access to take-away full-strength alcohol. Following this, Aboriginal leaders engaged strategic partners in a broader strategy to address FASD in the region. The aim of this study was to develop and implement a community-led, researcher-supported, FASD strategy.

Methods: A review of literature focusing on community-led FASD strategies identified key components that informed the Marulu FASD strategy. These included strategy ownership, leadership, and governance by participating communities, and a research framework.

Results: Community meetings and workshops led to the development of The Marulu FASD Strategy (2008). Feasibility and community consent to conduct a FASD prevalence study (the Lililwan Project) was confirmed, and implementation was progressed (2010-2013). Concurrent FASD prevention activities were conducted. In 2012, the Marulu FASD Unit was established within a local Aboriginal organisation to sustain and coordinate ongoing strategy activities.

Conclusions: Community control of public health initiatives can be achieved when Aboriginal communities prioritise issues of significant concern, and engage strategic partners to overcome them. Implications for public health: The Marulu Strategy forms a template for action to address FASD and other public health issues in Aboriginal communities in Australia and internationally.

Keywords: Australian Aboriginal; Fetal Alcohol Spectrum Disorder (FASD); prenatal alcohol exposure; prevention; social change.

MeSH terms

  • Alcohol Drinking / epidemiology
  • Alcohol Drinking / ethnology
  • Australia / epidemiology
  • Cross-Sectional Studies
  • Female
  • Fetal Alcohol Spectrum Disorders / diagnosis
  • Fetal Alcohol Spectrum Disorders / ethnology*
  • Fetal Alcohol Spectrum Disorders / prevention & control*
  • Humans
  • Male
  • Native Hawaiian or Other Pacific Islander*
  • Pregnancy