“ Closing the Gap is a number one priority for the Government, and we know that the most successful programs, the ones achieving outcomes, are those developed and driven by the community themselves,
Providing the right care from the very beginning, from the health of mothers before they conceive, to caring, supportive and appropriate care through pregnancy, to postnatal care, and through to the early days of school – this Framework is about ensuring that Aboriginal and Torres Strait Islander children and their families have the services, and information they need to set children up for better health outcomes for the rest of their lives.
The social and cultural determinants of health are one of our key priorities in Closing the Gap, and this means addressing the range of factors that impact on health, such as racism, cultural exclusion and economic status.
“The holistic and consultative approach is the way forward.”
Assistant Minister for Health and Aged Care, Ken Wyatt AM, MP today launched the new Framework, which is part of the Implementation Plan for the Aboriginal and Torres Strait Islander Health Plan 2013-2023.
The National Framework for Health Services for Aboriginal and Torres Strait Islander Children and Families will help Aboriginal and Torres Strait Islander children to get a better start in life.
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It provides a guide for culturally appropriate maternal health care, pregnancy care and early childhood – setting children and families up for better health throughout their lives.
“This work was developed in collaboration with community leaders and a cultural advisory group. We also have consulted widely with Aboriginal and Torres Strait Islander communities across the country, listening to what they need, so we can deliver the services that they require in the way that best suits different communities,” said Assistant Minister Wyatt.
“We needed to ensure this Framework spells out how to provide the right care at the most critical time of life for our children – from pre-conception and maternity care services through to eight years of age and the family unit that supports those children,” he said.
The focus of the Framework is on bringing a more holistic approach to health and wellbeing that draws on the strengths of Aboriginal and Torres Strait Islander peoples and cultures to inform how high quality, evidence-based child and family health services are delivered.
A number of structural factors underpin the Framework, and are required to enable health services to meet the needs of Aboriginal and Torres Strait Islander children and families.
These system enablers include:
- a culturally respectful and non-discriminatory health system (which is also a priority of the National Aboriginal and Torres Strait Islander Health Plan 2013 – 2023);
- access to care based on proportionate universalism;
- commitment to health equity, and addressing the social determinants of health. Strong and sustainable health outcomes cannot be achieved without recognition of the impact of colonisation, interpersonal and institutional racism, and the resulting health and social impacts of poverty, trauma, addiction, housing shortages, poor education, unemployment, and the lack of social supports;
- evidence-based practice that is informed by researchers and the experience of Aboriginal and Torres Strait Islander families;
- a focus on the cultural safety and development of the Aboriginal and Torres Strait Islander health workforce at all levels of governance and service delivery;
- governance structures that support Aboriginal and Torres Strait Islander people in leadership roles and ensure the participation of Aboriginal and Torres Strait Islander people in planning, delivery and review of child and family health services; and
- supportive Government policy and funding. The vast majority of child and family health services are funded by governments. Government policy directly and indirectly affects the implementation of programs and services. It is vital that funded programs are built upon strong program logic, and that there is joint accountability and funding continuity (where possible) across the service system, irrespective of how existing programs are funded and managed. Funding must align with the principles of proportionate universalism with an expectation of delivering equitable health outcomes for Aboriginal and Torres Strait Islander peoples.
The Framework also identifies key approaches that support culturally safe and appropriate care for Aboriginal and Torres Strait Islander people. Other approaches to care identified in the Framework include:
Central to these approaches is the importance of cultural competence, and the need for individuals and organisations to develop the capacity to work effectively within the cultural context of each client.
- family-centred care to identify and respond to the needs and structures of individual families;
- relationship-based care;
- a focus on social and emotional wellbeing; and
- strengths-based approaches.
It is acknowledged that many Aboriginal and Torres Strait Islander people have complex systems of family relationships. Children are often the responsibility of the entire extended family, rather than the biological parents alone. As such, the term family, as used in this Framework, is inclusive of carers as well as parents.
Similarly, this Framework covers all families where a child or children are of Aboriginal and/or Torres Strait Islander descent, regardless of either of their parents’ heritage.
In this sense, it places the child and their needs at the centre of the family.
The Framework will be embedded at the Commonwealth level in Funding Agreements, raising awareness through Aboriginal Health Partnership forums and including the principles in our policy design and program implementation.
For example, the Department of Education and Training has agreed to incorporate the Framework into the implementation of Connected Beginnings, building the same principles and shared vision for Aboriginal and Torres Strait Islander children’s health across disciplines and jurisdictions.