NACCHO Aboriginal Health and #Racism : Download Report : Confronting racism to improve healthcare for Aboriginal and Torres Strait Islander patients with kidney disease

Action is urgently needed to confront the immense health disparities in kidney disease outcomes suffered by Aboriginal and Torres Strait Islander peoples.

‘There is some encouraging work being done—especially by the Queensland and South Australian governments, and in some individual agencies—but much more is needed.’

Australian Healthcare and Hospitals Association Strategic Programs Director, Dr Chris Bourke.

Read the 120 Aboriginal Health and racism published by NACCHO over past 8 years

Read the 12 Aboriginal Kidney Health published by NACCHO over past 8 years

Dr Bourke, who is Australia’s first Aboriginal dentist, has co-authored a Perspectives Brief published by the AHHA’s Deeble Institute for Health Policy Research—Addressing racism to improve healthcare outcomes for Aboriginal and Torres Strait Islander people: a case study in kidney care.

‘The raw facts are that Indigenous Australians have at least 6 times—in some age groups up to 15 times— the incidence of end-stage kidney disease as non-Indigenous Australians.

‘Yet we have one-quarter of the chance of receiving home-based dialysis, and one-third of the chance of receiving a kidney transplant.

‘We believe that many of the answers to solving this problem lie in addressing racism—mostly unintentional—particularly at the institutional level, but also at the individual level’.

‘There is documented evidence of Aboriginal and Torres Strait Islander peoples receiving poorer healthcare outcomes when treated by non-Indigenous healthcare organisations and health professionals’.

‘My fellow authors and I feel that equity in kidney care should come from concerted action in four interconnected areas:

Cultural safety: Boards, accreditation agencies, and education and training providers can do more to promote self-reflection in non-Indigenous healthcare professionals about providing accessible and responsive care that is safe and free of racism, as judged by Indigenous individuals, families and communities.

Institutional racism: Healthcare organisations can actively work within the health system to reverse the exclusion of Aboriginal and Torres Strait Islander people from governance, control, and accountability of healthcare organisations, and to employ more Indigenous health workers.

National safety and quality health service standards: The Australian Commission on Safety and Quality in Healthcare’s triennial accreditation processes for hospitals set out how healthcare organisations can improve service delivery to Aboriginal and Torres Strait Islander people.

Race discrimination law: The existing laws tend to focus on individual rather than systemic discrimination, with racism being hard to prove, even though intention to discriminate does not have to be proven.

The laws also focus on equality of opportunity rather than equality of outcomes. Nevertheless, it is important for healthcare organisations to ensure that the need to avoid discrimination is factored into their governance and operations and to be aware that the laws do provide for “positive discrimination” in removing barriers to care and bringing about better outcomes.’

Addressing racism to improve healthcare outcomes for Aboriginal and Torres Strait Islander people: a case study in kidney care is available here. More information on the Deeble Institute for Health Policy Research is available here.

 

 

 

Aboriginal #CoronaVirus News Alert No 45 : April 23 #KeepOurMobSafe : #OurJobProtectOurMob : Will new #COVID19 laws increase risk to Aboriginal people already facing discrimination and racial profiling by the justice sector.

” The COVID 19 Pandemic has seen a raft of laws passed across all Australian states aimed at reducing the serious risk the virus poses, and while these new laws limit personal freedoms to protect health and safety, they also increase risk to Aboriginal people already face discrimination and racial profiling by the justice sector.

The UN Permanent Forum for Indigenous Issues also urges Member States and the international community to include the specific needs and priorities of indigenous peoples in addressing the global outbreak of COVID 19.

It should be remembered that ‘Indigenous peoples can contribute to seeking solutions.’

This is especially so in relation to the criminal justice system, which continues to have a major impact on the health and wellbeing of Aboriginal people in Australia and across the world.” 

Dr. Hannah McGlade is a Noongar human rights law researcher and social justice activist. She is a member of the United Nations Permanent Forum for Indigenous Issues and the Senior Indigenous Research Fellow at Curtin University.

Originally published IndigenousX to support see link HERE 

This issue is a national one and especially relevant to Western Australia as it records the highest rates of Aboriginal deaths in custody. Recent cases include the 2019 police shooting of Joyce Clarke in Geraldton, and the death of Cherdeena Wynne in Perth.

In WA, Aboriginal children and youth are also incarcerated at double the national average, being 50 times more likely to be in detention and Aboriginal women have been described as ‘the most incarcerated group of people in the world’. This state was also the first to disband the Aboriginal Justice Advisory Council (AJAC) established in the wake of the Royal Commission into Aboriginal Deaths in Custody more than 25 years ago.

In 2018 Australian Law Reform Commission in the Pathways to Justice Inquiry, called for the re-establishment of the AJAC’s to drive reforms and reduce Aboriginal imprisonment rates. There has been a lack of response to the Inquiry at the state and federal level, which is difficult to understand in WA where the Minister for Indigenous Affairs has promised to reduce Indigenous incarceration by one third.

And while WA’s Attorney General promised to stop incarcerating Aboriginal people for fines, the bill is not yet law as it hasn’t passed both houses of parliament. Police are also now issuing COVID fines and move on notices to homeless Aboriginal people and their advocates, increasing the likelihood of incarceration as a result.

Prison is the most unsafe place that Aboriginal people can be in a pandemic as there is no ability for prisoners to self isolate and protect themselves. Many Aboriginal prisoners also have chronic health conditions placing them at high risk of serious outcomes, including death, in the event of COVID.

Last month over 300 academics, lawyers and concerned citizens issued an Open Letter supporting immediate actions to protect prisoner’s safety. All states should begin to release low risk prisoners, consistent with approach adopted in many countries including the US, Turkey and Ireland. Releasing Aboriginal prisoners at this time will prevent Aboriginal deaths in custody, argues Cheryl Axelby, chair of the NATSILS:

“With the over-representation of our people in prison, our lives are on the line,”

“We are calling for immediate early release, particularly of people who are on remand, women who are victims of family violence and sentenced for lesser offences like fines and public order offences, young people and those most at risk of transmitting Covid-19, like elderly and people with health conditions.

Risk to Aboriginal prisoners is a national and international human rights issue. In British Columbia Canada the Assembly of First Nations has also demanded proactive responses from governments. This should include developing release plans for as many Aboriginal prisoners as possible, prioritizing those with health conditions, and providing immediate release for low risk prisoners with a home they can self isolate.

Several United Nations bodies including the World Health Organisation, the Office of Drug Control and the High Commissioner for Human Rights have given clear advice that there is no time to lose. Prisoner health is a public health matter and prisoners must not be forgotten. The risks to prisoners, and also staff, are imminent and must be urgently addressed.  Incarceration should only be a matter of last resort and states should release prisons who do not pose a risk to society. Disappointingly the advice is not being followed by WA government, who instead appear to be adopting a ‘tough on crime’ approach.

A punitive approach fails to recognise that many Aboriginal prisoners haven’t been found guilty of a crime and are on remand, and that many, including women, have experienced significant trauma and also discrimination which has played a role in their incarceration. The children and youth detained are very young, as the state imposes liability on children from 10 years of age, and they may be incarcerated in country far from their families.

NACCHO Aboriginal Health and #CulturalSafety : Download National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025 focusing on #Indigenous patient clinical and cultural safety.

When we talk about patient safety it’s important to understand that for Aboriginal and Torres Strait Islander people, this is inextricably linked with cultural safety.
This means that cultural safety is not an ‘add on’ or ‘nice to’. It’s something all registered health practitioners and health regulators need to understand and apply’,

National Aboriginal and Torres Strait Islander Health Worker Association CEO, incoming Strategy Group Co-chair Mr Karl Briscoe 

Photo above : Prof Gregory Phillips, Karl Briscoe, Martin Fletcher & Gill Callister launching The National Scheme’s Aboriginal & Torres Strait Islander Health & Cultural Safety Strategy 2020-2025. Source

February 27 marked the release of a new strategy prioritising cultural safety in the health system brought forward by First Nations health experts, regulators and health organisations.

The National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025 focuses on Indigenous patient clinical and cultural safety.

Download the Strategy 2020-2025

Aboriginal-and-Torres-Strait-Islander-cultural-health-and-safety-strategy-2020-2025 (1)

Presented by Ahpra (Australian Health Practitioner Regulation Agency) and National Boards, the strategy was endorsed by 43 organisations, academics and individuals.

With the four objectives of cultural safety, increased participation, greater access and influence, the strategy has already achieved some of its targets, including:

  • Partnering with the National Health Leadership Forum to develop a baseline definition of cultural safety
  • Commissioning a high-quality cultural safety training
  • Recommending and advocating for changes to the Health Practitioner Regulation National Law.

Established by the Aboriginal and Torres Strait Islander Health Strategy Group, the strategy was led by First Nations organisations and individuals.

The Strategy focuses on achieving patient safety for Aboriginal and Torres Strait Islander Peoples as the norm and the inextricably linked elements of clinical and cultural safety.
A key feature is that the Strategy was led by Aboriginal and Torres Strait Islander organisations and individuals via the Aboriginal and Torres Strait Islander Health Strategy Group that represents all signatories to the Strategy (see below).
Inaugural Co-chair of the Strategy Group Prof Gregory Phillips said this work has been a long time in the making and marks an important milestone for addressing health equity.
‘The Aboriginal and Torres Strait Islander Health Strategy Group has already instigated and progressed significant reform to help achieve health equity and address racism in the health system.
We are proud of our achievements to date and the launch of the Strategy.
We have much work to do, but together we can have a broad-reaching effect that will help embed cultural safety into the health system across Australia.
This is a significant step in the right direction to address Aboriginal and Torres Strait Islander People’s health, and the national priority of a health system free of racism,’ said Prof Phillips.
Ahpra Chair Ms Gil Callister PSM said ‘self-determination has underpinned this work. The Strategy Group was guided by a caucus of Aboriginal and Torres Strait Islander members to lead this work and reach a clear definition of cultural safety.
As we saw in the recent 10-year Closing the Gap report – our health system must embrace this strategy to fundamentally improve the health of our Aboriginal and Torres Strait Islander people.’
Strategy Group Co-chair and Chair of the Occupational Therapy Board of Australia Ms Julie Brayshaw said ‘cultural safety needs to become the norm in order for patient outcomes to become equal between Aboriginal and Torres Strait Islander Peoples and other Australians. Without cultural safety, there is no patient safety for Aboriginal and Torres Strait Islander patients.’
CEO of the Dental Council of Australia Ms Narelle Mills said the collaboration of the signatories and Aboriginal and Torres Strait Islander leadership means the Strategy is an opportunity to demonstrate strength and commitment in this vitally important area.
‘With this Strategy, 43 entities have a clear way forward to support cultural safety, work in a culturally safe way and deliver to clear strategic objectives that seek to embed cultural safety across the registered health workforce, education providers, students and the entities regulating health practitioners’, said Ms Mills.
 The vision
Patient safety for Aboriginal and Torres Strait Islander Peoples is the norm. We recognise that patient safety includes the inextricably linked elements of clinical and cultural safety, and that this link must be defined by Aboriginal and Torres Strait Islander Peoples.

 

 The objectives
 Cultural Safety A culturally safe health workforce through nationally consistent standards, codes and guidelines across all registered health practitioners in Australia.
 Increased participation Increased Aboriginal and Torres Strait Islander participation in the registered health workforce and across all levels of the scheme regulating registered practitioners nationally.
 Greater access Greater access for Aboriginal and Torres Strait Islander Peoples to culturally safe services from registered health practitioners.
 Influence Using the Strategy Group’s leadership and influence to achieve reciprocal goals. This includes developing a nationally consistent baseline definition to be used across the scheme regulating registered practitioners nationally, which has already been achieved in partnership with the National Health Leadership Forum.

As part of the Strategy, some key achievements have already been delivered:

  • partnering with the National Health Leadership Forum (the forum for national Aboriginal and Torres Strait Islander health peak organisations) to develop, consult and finalise a baseline definition of cultural safety for the scheme for regulating health practitioners
  • commissioning high-quality cultural safety training to ensure that the regulation of health practitioners, including the development of standards practitioners must meet and the handling of notifications (concerns about registered health practitioners), is culturally safe
  • recommending and advocating for changes to the Health Practitioner Regulation National Law to ensure consistency in cultural safety for Aboriginal and Torres Strait Islander people.

Signatories to the Strategy

The Strategy was developed with the leadership of Aboriginal and Torres Strait Islander health organisations and individuals, and is proudly endorsed by:

 

  • Aboriginal and Torres Strait Islander Health Practice Accreditation Committee
  • Dental Board of Australia
  • Aboriginal and Torres Strait Islander Health Practice Board of Australia
  • Indigenous Allied Health Australia
  • Ahpra (Australian Health Practitioner Regulation Agency)
  • Medical Board of Australia
  • Australasian Osteopathic Accreditation Council
  • Medical Radiation Practice Accreditation Committee
  • Australian and New Zealand Podiatry Accreditation Council
  • Medical Radiation Practice Board of Australia
  • Australian Commission on Safety and Quality in Health Care
  • National Aboriginal and Torres Strait Islander Health Worker Association
  • Australian Dental Council
  • National Aboriginal Community Controlled Health Organisation
  • Australian Indigenous Doctors’ Association
  • Nursing and Midwifery Board of Australia
  • Australian Indigenous Psychologists Association
  • Occupational Therapy Board of Australia
  • Australian Medical Council
  • Optometry Board of Australia
  • Australian Nursing and Midwifery Accreditation Council
  • Optometry Council of Australia and New Zealand
  • Australian Pharmacy Council
  • Osteopathy Board of Australia
  • Australian Physiotherapy Council
  • Paramedicine Board of Australia
  • Australian Psychology Council
  • Pharmacy Board of Australia
  • Chair, Occupational Therapy Council of Australia Ltd
  • Physiotherapy Board of Australia
  • Chinese Medicine Accreditation Committee
  • Podiatry Board of Australia
  • Chinese Medicine Board of Australia
  • Prof Mark Wenitong
  • Chiropractic Board of Australia
  • Prof Noel Hayman
  • Congress of Aboriginal and Torres Strait Islander Nurses and Midwives
  • Prof Pat Dudgeon (represented by Dr Sabine Hammond)
  • Council of Chiropractic Education Australasia
  • Prof Roianne West, Dean First Peoples Health
  • Councils Presidents Forums (NSW)
  • Psychology Board of Australia


Please note this list includes organisations that have provided endorsement and interim endorsement.

For more information

NACCHO Aboriginal cultural safety in health care: New @AIHW monitoring framework assesses progress in achieving cultural safety in the health system for Indigenous Australians

” For the purpose of developing a monitoring framework cultural safety is defined with reference to the experience of the Indigenous health care consumer, of the care they are given, their ability to access services and to raise concerns.

Some of the essential features of cultural safety include an understanding of one’s culture; an acknowledgment of difference, and a requirement that caregivers are actively mindful and respectful of this difference.

The presence or absence of cultural safety is determined by the experience of the recipient of care and is not defined by the caregiver (AHMAC 2016).” 

AIHW Online Report HERE

Or Download Summary

Cultural safety in health care_ monitoring framework

1.Culturally respectful health care services

Cultural respect is achieved when the health system is a safe environment for Indigenous Australians, and where cultural differences are respected. This module reports on how health care is provided, and whether cultural respect is reflected in structures, policies and programs.

The 2017–18 Online Services Report data showed that among Indigenous primary health care providers:

  • 95% had a formal commitment to providing culturally safe health care
  • 84% had mechanisms to gain advice on cultural matters
  • over 70% of organisations  with a formal board had over half of Board members who were Indigenous
  • nearly 4 in 10 provided interpreter services; while around one third offered culturally appropriate services such as bush tucker, bush medicine and traditional healing.
  • 41% of health staff employed in these organisations were Indigenous
  • almost all (99%) provided cultural orientation for non-Indigenous staff.

National health workforce data showed that from 2013 to 2017:

  • the number of Aboriginal and Torres Strait Islander medical practitioners employed in Australia increased from 234 to 363
  • the number of Indigenous nurses and midwives employed in Australia increased from 2,434 to 3,540.

See more info PART 2 Below for modules 2 and 3

Part 1 Cultural Safety Background

The concept of cultural safety has been around for some time, with the notion originally defined and applied in the cultural context of New Zealand. It originated there in response to the harmful effects of colonisation and the ongoing legacy of colonisation on the health and healthcare of Maori people—in particular in mainstream health care services.

A commonly accepted definition of cultural safety from the Nursing Council of New Zealand (2002:7) is the ‘effective nursing or midwifery practice of a person or family from another culture, and is determined by that person or family… Unsafe cultural practice comprises any action which diminishes, demeans or disempowers the cultural identity and wellbeing of an individual.’

A distinctive feature of this definition of cultural safety is its emphasis on the provision of culturally safe health care services as defined by the end users of those services, notably, the Maori people of Aotearoa New Zealand, not by the (non-Maori) providers of care.

The National Collaboration Centre for Indigenous Health in Canada (2013) notes that culturally safe health care systems and environments are established by a continuum of building blocks:

Cultural awareness ⟹ Cultural sensitivity ⟹ Cultural competency ⟹ Cultural safety

The centre states that cultural safety ‘…requires practitioners to be aware of their own cultural values, beliefs, attitudes and outlooks that consciously or unconsciously affect their behaviours. Certain behaviours can intentionally or unintentionally cause clients to feel accepted and safe, or rejected and unsafe. Additionally cultural safety is a systemic outcome that requires organizations to review and reflect on their own policies, procedures, and practices in order to remove barriers to appropriate care.’

In Australia, there has been increasing recognition that improving cultural safety for Aboriginal and Torres Strait Islander health care users can improve access to, and the quality of health care. This means a health system where Indigenous cultural values, strengths and differences are respected; and racism and inequality is addressed.

There are difficulties in both defining and measuring generalised concepts such as cultural respect and cultural safety. They include lack of conceptual clarity and agreement on terms, the qualitative nature of the concepts, and the diversity of Indigenous Australians and their perceptions.

The Australian literature uses various definitions of cultural safety, and related concepts such as cultural respect and cultural competency, and what these mean in relation to the provision of health care.

For the purpose of developing a monitoring framework cultural safety is defined with reference to the experience of the Indigenous health care consumer, of the care they are given, their ability to access services and to raise concerns. Some of the essential features of cultural safety include an understanding of one’s culture; an acknowledgment of difference, and a requirement that caregivers are actively mindful and respectful of this difference. The presence or absence of cultural safety is determined by the experience of the recipient of care and is not defined by the caregiver (AHMAC 2016).

Two important aspects of culturally safe health care across the literature are, how it is provided and how it is experienced, and these form the basis for the monitoring framework (see AHMAC 2016; CATSINAM 2014; AIDA 2014; DHHS 2016; NACCHO 2011; Department of Health 2015).

How health care is provided

  • behaviour, attitude and culture of providers: respects and understands Indigenous culture and people
  • defined with reference to the provision of care, including governance structures, policies and practices

How health care is experienced  by Indigenous people

  • feeling safe, connected to culture and cultural identity is respected
  • can only be defined by those who receive health care

The importance of cultural respect and cultural safety is outlined in Australian government documents such as the Cultural Respect Framework 2016–26 for Aboriginal and Torres Strait Islander Health, and the National Aboriginal and Torres Strait Islander Health Plan 2013–23.

The Australian Commission on Safety and Quality in Healthcare (ACSQHC) also included six Aboriginal and Torres Strait Islander specific actions in the National Safety and Quality Health Service Standards to improve care for Aboriginal and Torres Strait Islander people in mainstream health services.

 Part 2 Summary

The cultural safety monitoring framework covers three domains: the first focusing on how health care services are provided, the second on Indigenous patients’ experience of health care, and the third on measures regarding access to health care.

Data are reported from a wide range of available national and state and territory level sources to provide a picture of cultural safety, though there are significant data gaps. Sources include both national administrative data collections and surveys of Indigenous health care users.

2.Patient experience of health care

The experiences of Indigenous health care users, including having their cultural identity respected, is critical for assessing cultural safety. Aspects of cultural safety include good communication, respectful treatment, empowerment in decision making and the inclusion of family members.

National survey data show that:

  • in 2014–15, an estimated 80% of Indigenous Australians who consulted a doctor/specialist in the last 12 months said that their doctor always/often listened carefully, while an estimated 85% said that their doctor always/often showed respect for what was said.
  • in 2012–13, an estimated 20% of Indigenous Australians reported being treated unfairly by health care staff in the last 12 months.

The differences in rates of Indigenous and non-Indigenous hospital patients who choose to leave prior to commencing or completing treatment are frequently used as indirect measures of cultural safety. Among:

  • emergency department presentations in 2015–16, around 8% of Indigenous patients and 5% of non-Indigenous patients took own leave or did not wait
  • hospitalisations in 2013–15, around 3% of Indigenous and 0.5% of non-Indigenous patients left against medical advice or were discharged at their own risk.

3.Access to health care services

Indigenous Australians experience poorer health than non-Indigenous Australians’, but they do not always have the same level of access to health services. This is due to a range of different reasons, including remoteness and affordability. Selected measures of access to health care services for Indigenous and non-Indigenous Australians are used to monitor disparities in access.

  • BreastScreen participation rates for the two year period 2016–2017 for Indigenous women were 27% compared with 34% for non-Indigenous women.
  • Indigenous Australians waited longer to be admitted for elective surgery in 2017–18 than non-Indigenous Australians (median waiting time of 48 days and 40 days, respectively).
  • In 2015, the potentially avoidable mortality rate for Indigenous Australians was over 3 times the rate for non-Indigenous Australians (345 and 105 per 100,000 respectively).

Data gaps

Monitoring cultural safety and cultural respect in the health system, and the impact it has on access to appropriate health care, are limited by a lack of national and state level data. This is particularly the case in relation to reporting on the policies and practices of mainstream health services, such as hospitals and primary health care services.

There is also limited data on the experiences of Indigenous health care users. Most jurisdictions undertake surveys about patients’ experiences in public hospitals, but there was  not a lot of available data on Indigenous patient experience. A high proportion of Indigenous Australians use mainstream health services, so further data developments in this area are required to allow for more comprehensive reporting across the health sector.

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NACCHO Aboriginal and Torres Strait Islander Health Workforce : Donnella Mills @NACCHOChair Keynote Address at #CATSINaM19 Building a workforce and embedding #CulturalSafety : Connecting care through culture

” I’m keen to hear your ideas on how we can cooperate across the sector to develop a better workforce with cultural safety embedded throughout the hundreds of clinics and hospitals across the country.

I was impressed by the theme you chose for your conference: ‘connecting care through culture’. That simple phrase captures so much of what we do in our sector each and every day.

Cultural safety, I believe, is what makes us unique and what represents our greatest strength.

In the Aboriginal community-controlled health organisations – the ACCHOs – you have this reinforced through the operating model.

Community control’ is not just a term – it is a 48-year-old model – forged at Redern in 1971 – and now exercised in 144 local Aboriginal and Torres Strait Islander communities across the country.” 

Donnella Mills Acting Chair, NACCHO Keynote address at the CATSINaM National Professional Development Conference Sydney 26 September 

I would like to acknowledge that this conference is being held on Aboriginal land. I recognise the strength, resilience and capacity of the Gadigal people of the Eora Nation who are the traditional custodians of this place we now call Sydney. I pay my respects to their elders.

For those of you who don’t know me, I am a Torres Strait Islander woman with ancestral and family links to Masig and Nagir. I am the Acting Chair of NACCHO, which stands for the National Aboriginal Community Controlled Health Organisation.

I thank the CATSINaM Board for inviting me to deliver this address. It is a privilege to be talking with you today and a special pleasure to be among so many hard-working and dedicated healthcare professionals.

Without you, the Health gap would be so much wider than it is now. Without you, there would be little cultural safety in our hospitals and medical services. I have seen how important your work is on the ground at Wuchopperen and in the other services I have visited. You are the backbone of Aboriginal health.

I plan to speak for about 25 minutes. That will leave us about 20 minutes for yarning at the end. I’m keen to hear your ideas on how we can cooperate across the sector to develop a better workforce with cultural safety embedded throughout the hundreds of clinics and hospitals across the country.

Community control

Our people trust us with their health. We build ongoing relationships to give continuity of care so that chronic conditions are managed and preventative health care is effectively targeted.

Studies have shown that Aboriginal controlled health services are 23% better at attracting and retaining Aboriginal clients than mainstream providers.

Through local engagement and a proven service delivery model, our clients ‘stick’. The cultural safety in which we provide our services is a key factor of our success. In this way, ACCHOs are already ‘leading the way’.

We also build partnerships that make things work. Leadership is not all about the strength to stand up on your own, it is about being smart enough to stand shoulder-to-shoulder with one another. It is about galvanising support on the ground. It is about forging alliances in the sector and building strategic partnerships at the national level.

Employment

Another strength – one that we tend to overlook – is the sheer size of our sector. Let’s have a look at the ACCHO part of it alone. It is not widely known, but the 144 ACCHOs, collectively, are the single largest employer of Aboriginal and Torres Strait Islander people in Australia. That means that one in every 44 Indigenous jobs in Australia is at one of our health services.

If we add the Aboriginal health workers in the mainstream and the rest of the sector, these numbers become all the more impressive.

Our sector is doing more to close the employment gap than any of the employment measures dreamed up by Government agencies.

If the Government really wants to get people off welfare, don’t punish vulnerable people with cashless welfare cards, robo-debts or by sending them off to meaningless Work for the Dole activities.

Work with our sector and grow the Aboriginal workforce together. We have real jobs located in real communities. That is where the investment needs to go.

We should remind our politicians of this when they visit us.

They may see a small clinic somewhere with a few staff, but if they understood that we are part of a huge national network of Aboriginal professionals, they might take more notice of us and realise what we have to offer.

Comprehensive primary health care

Another challenge for us is continuing the development of a comprehensive primary health care model. I think we have been hearing this since the release of the National Aboriginal Health Strategy way back in 1989.

Twenty-one years later, a study concluded that ACCHOs are one of a very few settings where ‘comprehensive primary health care’ is delivered. If we keep offering a comprehensive approach for primary health care across the nation, our people will be much less likely to fall between the cracks.

We can do this through colocation of services or forming partnerships at the local level. This can include clinical care, immunisation and environmental health programs, on-site pharmaceutical dispensing and partnerships with family violence, child protection counselling and legal services.

We can also develop links with sports programs, homelessness services, dental services, aged care and disability support. None of these elements can fully succeed when they stand alone. The voluminous literature on the social determinants of health tell us that. But more importantly, it is what we all know from our own personal experiences.

You don’t need an academic to tell you that comprehensive primary health care is the best approach. We all know this intuitively and from our experiences on the ground.

I am not saying that we should all diversify or ‘dilute’ what we are doing. What I am saying is that while we focus on our core activities, we should also be taking every opportunity we can to link up with other Aboriginal and Torres Strait Islander services and programs in complementary areas.

From my own experience ….

When you think about it, it should not be hard to promote ourselves; to sell ourselves to a new Government. After all, we provide value for money. ACCHOs result in greater health benefits per dollar spent; measured at a value of $1.19 for every $1 spent.

Studies have also shown that the lifetime health impact of interventions delivered by ACCHOs is 50% greater than if these same interventions were delivered by mainstream health services. This is primarily due to improved Aboriginal access and outcomes.

I don’t need to tell you that we also have some pretty significant challenges ahead of us. And I’d like to address these now, one by one.

Remuneration

If we are serious about workforce development, then we cannot ignore the issue of wages. Correct me if I am wrong, but from what I have heard, remuneration is a big issue for nurses and midwives. The ALP, as part of its election platform in May of this year had much to say about improving wages and conditions in the childcare sector, and justifiably so. Childcare is another industry in which women dominate, but are underpaid.

We need the Commonwealth and State Governments to take a similar approach to nurses and midwives. As you all know, women make up almost 90% of all employed nurses and midwives. Representative bodies like NACCHO and CATSINaM need to work together to drive this message home to Governments across the country. Remuneration is an important aspect in attracting and retaining staff.

Vocational development

I think we need to keep improving the career development opportunities and skills acquisition not just for nurses and midwives, but for all Aboriginal health workers. Currently, there is an imbalance in the medical services in which we see more Aboriginal people on the lower levels and amongst the non-clinical staff.

The graph in my presentation shows the situation for ACCHOs. We need more Aboriginal non-clinical staff but we need even more Aboriginal clinical staff.

Recruitment

I see that CATSINaM has a proud record in increasing its membership in recent years. I think you had a record number in your 2018 Annual Report – 1,366 members – representing a jump of 35%. Clearly, you are doing something right to have recruited so many new members.

You must have won the trust of your members to have such a healthy and expanding membership base. With almost half of the Aboriginal and Torres Strait Islander nurses and midwifes in Australia as your members, CATSINaM is the key organisation in addressing many of the workforce development issues in our sector.

Certainly, much more needs to be done to develop career pathways to secure more Aboriginal and Torres Strait Islander nurses and midwifes as well as more doctors and allied health professionals.

Across Australia in 2015 the AIHW reported that there were only about 180 medical practitioners, 750 allied health professionals, and 3,200 nurses (including 230 midwives) who identified as Aboriginal or Torres Strait Islander people. For nurses, this represents just over 1% of all employed nurses and midwives Australia-wide.

The Northern Territory (2.4%) and Tasmania (2.2%) had the highest proportion of Aboriginal nurses and midwives, while Victoria had the lowest (0.5%). Compare these figures to our proportion of working-age Australians – close to 3.%. We should have 3% of all nurses and midwives, not 1%.

As I have already said, our sector is the largest employer of Aboriginal and Torres Strait Islander people across the country.

Now, if the ACCHOs as a group employ about 6,000 staff, of which 56 per cent are Aboriginal or Torres Strait Islanders, then we still have another 2,500 jobs in our own sector which could be filled by Aboriginal and Torres Strait Islander people.

We have a significant opportunity here. Think of what we could do for our people if we filled such a large number of jobs.

Retention

A big challenge that we confront every day – particularly in the bush – is retention. Stress and burnout is a real problem as Fran Baum’s research has shown. Turnover of staff is high and vacancies remain unfilled for longer than we would like.

With so many vacancies, particularly in remote clinics, a concerted effort could also have a significant positive impact on the size and health of our workforce. It is troubling to hear of the high reported vacancy rate of 6% (i.e. about 380 vacancies at any point in time).

Nevertheless, ACCHOs are doing pretty well in comparison with mainstream and non-Aboriginal organisations. The proportion of health vacancies was 6% compared with 9% for other organisations. My guess is that it is cultural safety that explains the advantage here.

So, if we have a good model and we have sector already working hard for Aboriginal health, then how are we going?

Life expectancy target not met

If we look at just one of the ‘Closing the Gap’ targets – life expectancy – you can see how stark the differences are. According to ABS data, which probably overestimate Aboriginal life expectancy, non-Aboriginal Australians can expect to live to about the age of 82. Aboriginal and Torres Strait Islander people are lucky to make it to 72. T

hat’s a ten-year difference. We would be better off living in other countries where the life expectancy is higher. Countries – believe it or not – like Bangladesh or Azerbaijan. Life expectancy is longer in some Third World countries than it is for our people.

Funding for Aboriginal health has fallen

Despite all the words we have heard from Commonwealth and State Governments over the years about ‘Closing the Gap’, instead of increasing expenditure, Governments have actually decreased expenditure on Aboriginal health over the past decade.

Governments need to spend two to three times more on Aboriginal health if we are to have a level of funding commensurate with the actual cost of the burden of disease. This is a huge sum – about $1.4 billion per year – on one estimate.

In real terms health expenditure (excluding hospital expenditure) for Aboriginal people fell 2% from $3,840 per person in 2008 to $3,780 per person in 2016. Over the same period, expenditure on non-Aboriginal people rose by 10%. How can you expect to close the gap when you are reducing funding for our people and increasing it for the non-Aboriginal population?

If we act as one, we can turn things around.

Look at the way that the Aboriginal peaks, like NACCHO and CATSINaM, stood together to force the nine Australian governments to restart the Closing the Gap process. Before we came together and complained to them, the consultation process was expensive lip service.

Before we stood together with one voice, our separate voices were ignored. Now they are listening. Now things are back on track.

Funds are tighter than ever to procure, but, over the years, we have built a world class model of health care and there is too much at stake for us now to start drifting backwards now.

The timing is critical, especially now that we have a re-elected Government and the new arrangements in the administration of Aboriginal programs. It is great to see Ken Wyatt as the first Aboriginal Cabinet member as the Minister for Indigenous Australians.

But we need to engage as closely as we can with him and with Minister Hunt. We also need to keep the dialogue open with Senator Dodson, Senator McCarthy and the Member for Barton in NSW, Linda Burney.

There are also plenty of good Aboriginal leaders in the State and Territory Governments and I urge you to keep talking to them. It is important to have our voice heard.

Especially when we face a mainstream system that continues to overlook us; especially when we have a mainstream system that continues to patronise us. If we don’t act now and keep the pressure up, we will lose some of our recent hard-won gains.

The future

Despite the appalling funding neglect for programs and the low wages paid to our health workers, you have shone in adversity. You are resilient. You survive despite whatever circumstances you find yourselves in.

It’s self-determination and the need to control our own health programs that led to the ACCHO model of care in the first place. It is a lesson for our sector.

If the system was working now, we would have zero preventable hospital admissions. The evidence is not just here, it is overseas as well.

In Canada it has been shown that First Nations communities that transitioned from government-control to community-control of health services experienced a 30% reduction in hospitalisation rates compared with communities where government control was maintained.

In a perfect world our model of primary care through community control would also be complete. We would have full coverage across the land.

We would also have an Aboriginal NDIS workforce in fully-funded models for disability services rolled out, Australia-wide.

And of course, all this hinges on a more accountable public health system and an uncapped needs-based funding model. Who knows, if we had all these things, we may even seriously imagine a future in which we have actually closed the health gap.

With Aboriginal health in Aboriginal hands I know that we can get there eventually.

NACCHO and CATSINaM can continue to work together and to set the way forward for Aboriginal health.

But we can also show the non-Aboriginal population what is possible. It is this future that I imagine for my daughter and my own family.

I am sure that it is a vision that we all share.

Leading the way for all of Australia through cultural safety and respect.

Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people #HaveYourSay about #closingthegap

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

 

NACCHO Aboriginal Health and Health Literacy Research : Ensuring that Indigenous communities have the opportunity to autonomously conceptualise health literacy policy and practice is critical to decolonising health care.

” Enhancing health literacy can empower individuals and communities to take control over their health as well as improve safety and quality in healthcare.

However, Indigenous health studies have repeatedly suggested that conceptualisations of health literacy are confined to Western knowledge, paradigms, and practices. The exploratory qualitative research design selected for this study used an inductive content analysis approach and systematic iterative analysis.

Publicly available health literacy-related policy and practice documents originating from Australia, Canada, and New Zealand were analysed to explore the extent to which and the ways in which Indigenous knowledges are recognised, acknowledged, and promoted.

 Findings suggest that active promotion of Indigenous-specific health knowledges and approaches is limited and guidance to support recognition of such knowledges in practice is rare.

Given that health services play a pivotal role in enhancing health literacy, policies and guidelines need to ensure that health services appropriately address and increase awareness of the diverse strengths and needs of Indigenous Peoples.

The provision of constructive support, resources, and training opportunities is essential for Indigenous knowledges to be recognised and promoted within health services.

Ensuring that Indigenous communities have the opportunity to autonomously conceptualise health literacy policy and practice is critical to decolonising health care. “

Gordon Robert Boot and Anne Lowell Charles Darwin University, Australia

Download full copy of research 

Health Literacy

Image above from Menzies study : The aim of this study was to understand the interplay between health literacy, gender and cultural identity among young Aboriginal and Torres Strait Islander males living in the Northern Territory.

The health promotion sector is increasingly recognising that developing and improving individual, population, and provider health literacy (HL) is an important and effective strategy to enhance health and wellbeing, as well as to improve safety and quality in healthcare (Australian Commission on Safety and Quality in Health Care [ACSQH], 2014; Centre for Literacy, 2011; Johnson, 2014).

Integral to HL is the capability of individuals and the wider community to take active control and participate in addressing their healthcare needs (ACSQH, 2014, Johnson, 2014, Nutbeam, 2008).

Health outcomes can be improved through HL competencies that enable self-care and self-advocacy, development of mutual trusting relationships with health professionals, more effective access to and navigation of the healthcare system, as well as the ability of service providers to communicate effectively (Paasche-Orlow & Wolf, 2007, Sørensen et al., 2012).

Recent studies have highlighted that inclusion and promotion of Indigenous health knowledges within health promotion practices can enhance overall Indigenous health outcomes through mutual recognition of differing worldviews (Smylie, Kaplan-Myrth, McShane & Métis Nation of Ontario-Ottawa, 2008; Vass, Mitchell, & Dhurrkay, 2011), improved health communication (Lowell et al., 2012), and through strengthening cultural safety within culturally diverse healthcare systems (Rowan et al., 2013; Nielsen, Alice Stuart & Gorman, 2014).

However, representation of Indigenous health knowledges and practices within health literacy-related policy and practice documents does not appear to have been investigated in previous research.

The overall purpose of this paper is to present selected findings of a larger study (Boot, 2016), which has sought to address this knowledge gap by exploring the extent and means by which Indigenous knowledges, paradigms, and practices are recognised, acknowledged, and promoted within HL-related documents across Australia, Canada, and New Zealand.

This article focuses on two themes from the findings that have particular relevance: acknowledging cultural beliefs, practices, and norms, and promotion of Indigenous cultural health knowledges, paradigms, and practices (Boot, 2016).

The next section of this article explores definitions and context encompassing Indigenous health and health literacy. The Methods section describes in detail the exploratory research approach, document selection, and content analysis process.

The Findings section illustrates prominent examples from within the two themes that are represented within this article. The relevance and implications of these findings are further explored in the concluding discussion, and recommendations for future research are presented.

Background

Many countries, including Australia, Canada, and New Zealand, are considered to have world-class healthcare systems (Organisation for Economic Co-operation and Development, 2017).

Extensive efforts are made by governments and the health promotion sector to improve overall health and quality of life outcomes within these populations (Organisation for Economic Co-operation and Development, 2017).

The majority of people living within these countries have reasonably good health and enjoy an average life expectancy of 78 to 82 years of age (Australian Bureau of Statistics [ABS], 2015b; Statistics Canada, 2015; Statistics New Zealand, 2015).

All three countries have a similarly rich history of Indigenous cultures, knowledges, and languages, but life expectancy for many Indigenous people within these countries remains significantly lower, ranging from 69 to 80 years of age, in comparison with the national average (ABS, 2015a; Statistics Canada, 2015; Statistics New Zealand, 2015).

The health inequities Indigenous people experience today are predominantly linked to the effects of colonisation and persistently unfavourable social determinants (Dudgeon, Milroy & Walker, 2014; Griffiths, Coleman, Lee & Madden, 2016; Sherwood, 2013).

Governments and frontline health services aim to overcome these inequities by developing and implementing a variety of policies, strategies, and evidence-based approaches.

Defining Health Literacy 

The concept of health literacy originates from the field of education and has in recent years expanded to include a wide range of skills and knowledges. Health literacy is commonly defined as the abilities and skills of an individual or community to access, appraise, and communicate health-related information, to navigate and engage with the healthcare system, and to advocate and maintain personal and community health and wellbeing (Centre for Literacy, 2011; Nutbeam, 2000; Sørensen et al., 2012; World Health Organisation, 2016a).

Governments and scholars advocate that developing and enhancing HL within populations supports the process of empowerment thereby enabling the individual, community, and society to take control over their healthcare needs and engage in collective action to promote health (ACSQH, 2014; Estacio, 2013; Freedman et al., 2009; Johnson, 2014; Kickbusch, 2009; Ministry of Health, 2015; Mitic & Rootman, 2012; Nutbeam, 2008; Sykes, Wills, Rowlands, & Popple, 2013).

Health literacy skills develop across the lifespan, are context specific, and influenced by social, cultural, and political contexts (Centre for Literacy, 2011; Kickbusch, Wait, & Maag 2006; Mitic & Rootman, 2012; Paasche-Orlow & Wolf, 2007; Vass et al., 2011; Zarcadoolas, Pleasant, & Greer, 2005).

Zarcadoolas et al. (2005), for example, asserted that cultural health literacy needs to be inherent within health literacy models. This is defined as having “the ability to recognize and use collective beliefs, customs, world-view and social identity in order to interpret and act on health information” (p. 197).

In addition, Ewen (2011) argued that health professionals need to obtain and effectively utilise cultural literacy skills in order for them to be culturally competent in their service delivery.

Cultural literacy is considered a skill-set that encompasses awareness, respect, and responsiveness to cultural differences and needs (Ewen, 2011). These abilities become critical within culturally diverse healthcare environments where worldviews, values, approaches to communication, and conceptualisations of health and wellbeing differ significantly from those endorsed by the dominant culture.

More recent conceptualisations of HL are increasingly recognising the significance and complexity of the health literacy environment: That is, “the infrastructure, policies, processes, materials, people and relationships that make up the health system and have an impact on the way in which people access, understand, appraise and apply health-related information and services” (ACSQH, 2014, p. 10). The Global Conference on Health Promotion in Shanghai in 2016 also identified HL as a critical social determinant of health that needs to be developed and strengthened within populations (World Health Organisation, 2016b). Enhancing HL skills within Indigenous populations, however, requires sophisticated cultural literacy and a collaborative, comprehensive, and empathetic approach due to the diversity in worldviews, perceptions of health and wellbeing, as well as complex sociocultural factors (Ewen, 2011; Smylie, Williams & Cooper, 2006; Vass et al., 2011).

Indigenous Concepts of Health and Wellbeing

Indigenous populations across and within each of the three countries that are the focus of this article

(Australia, Canada, and New Zealand) are diverse in terms of languages and their physical environment (urban, rural, level of remoteness, and climate), as well as political and social relationships, ancestral heritage, and cultural knowledges and practices (Dudgeon et al., 2014; Greaves, Houkamau & Sibley, 2015; Stephenson, 1995). Although Indigenous Peoples share some common health beliefs, their health knowledges and healing practices are diverse due to the unique social, cultural, political, and environmental circumstances within which they have developed and continue to exist (Dudgeon et al., 2014; Durie, 1994).

Despite this diversity, Indigenous people across all three countries tend to regard health and wellbeing as a holistic, multidimensional, and interconnected concept that cannot be separated from other aspects or fragmented into distinguishable individual units (Durie, 1994; Morgan, Slade & Morgan, 1997; Stephens, Porter, Nettleton & Willis, 2006). Health and wellbeing incorporates physical, psychological, social, ecological, spiritual, and cultural aspects and is sustained by nurturing and attending to all these relational aspects regularly in an appropriate and meaningful manner (Campbell, 2002; Durie, 1994; Morgan et al., 1997; Vukic, Gregory, Martin-Misener & Etowa, 2011; Wilson, 2008). Individual studies within all three countries similarly highlight how positive strengthening and maintaining of those interrelated aspects can provide preventative and long-lasting health benefits (Colles, Maypilama & Brimblecombe, 2014; Dockery, 2010; Hopkirk & Wilson, 2014; Lambert et al., 2014; Lowell, Kildea, Liddle, Cox & Paterson, 2015; Smylie et al., 2008; Wilson, 2008).

Previous research addressing Indigenous health concerns have identified HL-related barriers and challenges including racism, communication and language barriers, poor relationships, and culturally associated misconceptions (Durey & Thompson, 2012; Lambert et al., 2014; Lowell et al., 2015; Vass et al., 2011). Such challenges can significantly obstruct access to and provision of effective primary healthcare services, inevitably influencing health outcomes (Lambert et al., 2014). The need for healthcare systems to adequately acknowledge and incorporate Indigenous health knowledges within health promotion practices has also been identified (Hopkirk & Wilson, 2014; Liaw et al., 2011; Lowell et al., 2015; Nielsen et al., 2014; Priest, MacKean, Davis, Briggs & Waters, 2012; Rowan et al., 2013; Vass et al., 2011).

Incorporating and promoting Indigenous knowledges within an Indigenous healthcare environment has the potential to strengthen culturally safe practices and opportunities for self-determination, enhance health communication, and to foster relationships that are built on trust and mutual respect (Colles et al., 2014; Dockery, 2010, Hopkirk & Wilson, 2014; Lambert et al., 2014, Lowell et al., 2015). However, the majority of current conceptualisations of HL are commonly confined to Western pedagogies and paradigms. As such, they frequently disregard the significance of Indigenous cultures, languages, and knowledges as strengths, with potential health benefits (Akena, 2012; Barwin, 2012; Durey & Thompson, 2012; Lambert et al., 2014; Priest et al., 2012; Sherwood, 2013; Smylie et al., 2006; Vass et al., 2011).

Ingleby (2012) suggested that every person has some form of HL that is intrinsic to their personal and cultural beliefs. Enhancing HL within diverse populations can therefore only be achieved when distinctive personal and cultural beliefs are taken into account and appropriately acted upon (Ingleby, 2012). Indigenous concepts of holistic health and associated knowledges and practices have developed over millennia, ensuring individual and community survival, health, and well-being prior to colonisation and beyond. For example, Indigenous-specific HL includes knowledges and practices related to bush medicines and sourcing traditional food (Ewen, 2011) and the interconnectedness of language, physical, emotional, environmental, and spiritual aspects that as a whole contribute to health and wellbeing among First Nation people (Smylie et al., 2006).

 

NACCHO Aboriginal Health #SaveADate @KidneyHealth April 8 -14 #KidneyHealthWeek #iKidneyCheck Plus @AusHealthReform Defining #culturalsafety – a public consultation. The consultation ends 15 May 2019

This weeks featured NACCHO SAVE A DATE events

15 May Cultural Safety Consultation closes

Download the 2019 Health Awareness Days Calendar 

8- 14 April Kidney Health Week

9 April Webinar : What will #Budget2019 mean for health consumers?

20 -24 May 2019 World Indigenous Housing Conference. Gold Coast

18 -20 June Lowitja Health Conference Darwin

2019 Dr Tracey Westerman’s Workshops 

7 -14 July 2019 National NAIDOC Grant funding round opens

23 -25 September IAHA Conference Darwin

24 -26 September 2019 CATSINaM National Professional Development Conference

9-10 October 2019 NATSIHWA 10 Year Anniversary Conference

16 October Melbourne Uni: Aboriginal and Torres Strait Islander Health and Wellbeing Conference

5-8 November The Lime Network Conference New Zealand 

Featured Save a dates date

15 May Cultural Safety Consultation closes 

This engagement process is important to ensure the definition is co-designed with Aboriginal and Torres Strait Islander people, health professionals and organisations across Australia.

Cultural safety is essential to improving health and wellbeing outcomes for Aboriginal and Torres Strait Islander Peoples and we are committed to a genuine partnership approach to develop a clear definition “

NHLF Chair, Pat Turner said the forum’s partnership with the Strategy Group meant that the definition is being led by Aboriginal and Torres Strait Islander health experts, which is an important value when developing policies or definitions that affect Aboriginal and Torres Strait Islander Peoples.

The NHLF has been operating since 2011 and is national representative committee for Aboriginal and Torres Strait Islander health peak bodies who provide advice on all aspects of health and well-being.

Help define this important term for the scheme that regulates health practitioners across Australia.

AHPRA, the National Boards and Accreditation Authorities in the National Registration and Accreditation Scheme which regulates registered health practitioners in Australia have partnered with Aboriginal and Torres Strait Islander health leaders and the National Health Leadership Forum (NHLF) to release a public consultation.

Together, they are seeking feedback on a proposed definition of ‘cultural safety’ to develop an agreed, national baseline definition that can be used as a foundation for embedding cultural safety across all functions in the National Registration and Accreditation Scheme and for use by the National Health Leadership Forum.

In total, there are 44 organisations represented in this consultation, which is being coordinated by the Aboriginal and Torres Strait Islander Health Strategy Group (Strategy Group), which is convened by AHPRA, and the NHLF (a list of representatives is available below).

Strategy Group Co-Chair, Professor Gregory Phillips said the consultation is a vital step for achieving health equity for Aboriginal and Torres Strait Islander Peoples. (see Picture below )

‘Patient safety for Aboriginal and Torres Strait Islander Peoples is inextricably linked with cultural safety. We need a baseline definition of ‘cultural safety’ that can be used across the National Scheme so that we can help registered health practitioners understand what cultural safety is and how it can help achieve health equity for all Australians’, said Prof Phillips.

The NHLF has been operating since 2011 and is national representative committee for Aboriginal and Torres Strait Islander health peak bodies who provide advice on all aspects of health and well-being.

The consultation is a continuation of the work by the National Scheme’s Strategy Group that has achieving health equity for Aboriginal and Torres Strait Islander Peoples as its overall goal. Members of the Group include Aboriginal and Torres Strait Islander health leaders and members from AHPRA, National Boards, Accreditation Authorities and NSW Councils.

AHPRA’s Agency Management Committee Chair, Mr Michael Gorton AM, said the far reach of this work is outlined in the Strategy Group’s Statement of intent, which was published last year.

‘The approach to this consultation is embodied in the Strategy Group’s Statement of intent, which has commitment, accountability, shared priorities, collaboration and high-level participation as its values. As a scheme, we are learning from our engagement with Aboriginal and Torres Strait Islander leaders, who are the appropriate leaders in this work. I thank these leaders, and the experts who have shared their knowledge and expertise with us, for their generosity and leadership which will lead to better health outcomes’, said Mr Gorton.

The six-week consultation is open to the public. Everyone interested in helping to shape the definition of ‘cultural safety’ that will be used in the National Scheme and by NHLF members is warmly invited to share their views.

The consultation is open until 5:00pm, Wednesday 15 May 2019.

For more information:

Download the NACCHO 2019 Calendar Health Awareness Days

For many years ACCHO organisations have said they wished they had a list of the many Indigenous “ Days “ and Aboriginal health or awareness days/weeks/events.

With thanks to our friends at ZockMelon here they both are!

It even has a handy list of the hashtags for the event.

Download the 53 Page 2019 Health days and events calendar HERE

naccho zockmelon 2019 health days and events calendar

We hope that this document helps you with your planning for the year ahead.

Every Tuesday we will update these listings with new events and What’s on for the week ahead

To submit your events or update your info

Contact: Colin Cowell www.nacchocommunique.com

NACCHO Social Media Editor Tel 0401 331 251

Email : nacchonews@naccho.org.au

Kidney Health Week: 8 – 14 April, 2019

” I’m Alice, I’m 31, and I have chronic kidney disease. When I found out my kidneys were failing, I didn’t understand what it meant or what my kidneys do, but now I do. The kidneys are one of the main organs in your body and if they aren’t well, you can get really sick, and end up in hospital on dialysis.

Before my health issues, I remember running around with my brother and cousins and doing everything kids are allowed to do. But when I turned 10, I couldn’t anymore. I felt like my freedom had been taken away from me. I asked all the time ‘why does this have to happen to me?’

Starting dialysis was terrifying. I didn’t know anything about it until I had been on it myself. It’s annoying knowing the fact that I’m going to be on it dialysis for the rest of my life. My advice is to go get your kidneys checked every 6 months. Having kidney disease is just as bad as having cancer but nobody knows about it until they get it.”

See Alice’s Webpage to donate 

This Kidney Health Week, Kidney Health Australia is asking Aboriginal and Torres Strait Islander
communities to visit their local Indigenous Health Centre to complete simple tests – blood, urine and blood pressure – to see if they are at risk of developing chronic kidney disease.

Download Kidney Health Week Supporter Kit with all the tools and resources you need to assist Kidney Health Australia to raise awareness of kidney disease. This includes social media text and images, newsletter copy, and key messages for your staff, affiliates, supporters as appropriate.

Kidney Health Week 2019 Supporter Kit – Alliances

Kidney Health Australia CEO, Chris Forbes, explained that while Aboriginal and Torres Strait Islander people represent less than 2.5 percent of the national population, they account for approximately eleven percent of people commencing kidney replacement therapy each year and the incidence of end-stage kidney disease for Indigenous peoples in remote areas of Australia is 18 to 20 times higher than that of comparable non-Indigenous peoples.

TAKE THE TEST HERE 

9 April What will #Budget2019 mean for health consumers?

What will  mean for health consumers? Join us next Tuesday for our webinar to learn more.

Register here 

20 -24 May 2019 World Indigenous Housing Conference. Gold Coast

Thank you for your interest in the 2019 World Indigenous Housing Conference.

The 2019 World Indigenous Housing Conference will bring together Indigenous leaders, government, industry and academia representing Housing, health, and education from around the world including:

  • National and International Indigenous Organisation leadership
  • Senior housing, health, and education government officials Industry CEOs, executives and senior managers from public and private sectors
  • Housing, Healthcare, and Education professionals and regulators
  • Consumer associations
  • Academics in Housing, Healthcare, and Education.

The 2019 World Indigenous Housing Conference #2019WIHC is the principal conference to provide a platform for leaders in housing, health, education and related services from around the world to come together. Up to 2000 delegates will share experiences, explore opportunities and innovative solutions, work to improve access to adequate housing and related services for the world’s Indigenous people.

Event Information:

Key event details as follows:
Venue: Gold Coast Convention and Exhibition Centre
Address: 2684-2690 Gold Coast Hwy, Broadbeach QLD 4218
Dates: Monday 20th – Thursday 23rd May, 2019 (24th May)

Registration Costs

  • EARLY BIRD – FULL CONFERENCE & TRADE EXHIBITION REGISTRATION: $1950 AUD plus booking fees
  • After 1 February FULL CONFERENCE & TRADE EXHIBITION REGISTRATION $2245 AUD plus booking fees

PLEASE NOTE: The Trade Exhibition is open Tuesday 21st May – Thursday 23rd May 2019

Please visit www.2019wihc.com for further information on transport and accommodation options, conference, exhibition and speaker updates.

Methods of Payment:

2019WIHC online registrations accept all major credit cards, by Invoice and direct debit.
PLEASE NOTE: Invoices must be paid in full and monies received by COB Monday 20 May 2019.

Please note: The 2019 WIHC organisers reserve the right of admission. Speakers, programs and topics are subject to change. Please visit http://www.2019wihc.comfor up to date information.

Conference Cancellation Policy

If a registrant is unable to attend 2019 WIHC for any reason they may substitute, by arrangement with the registrar, someone else to attend in their place and must attend any session that has been previously selected by the original registrant.

Where the registrant is unable to attend and is not in a position to transfer his/her place to another person, or to another event, then the following refund arrangements apply:

    • Registrations cancelled less than 60 days, but more than 30 days before the event are eligible for a 50% refund of the registration fees paid.
    • Registrations cancelled less than 30 days before the event are no longer eligible for a refund.

Refunds will be made in the following ways:

  1. For payments received by credit or debit cards, the same credit/debit card will be refunded.
  2. For all other payments, a bank transfer will be made to the payee’s nominated account.

Important: For payments received from outside Australia by bank transfer, the refund will be made by bank transfer and all bank charges will be for the registrant’s account. The Cancellation Policy as stated on this page is valid from 1 October 2018.

Terms & Conditions

please visit www.2019wihc.com

Privacy Policy

please visit www.2019wihc.com

18 -20 June Lowitja Health Conference Darwin


At the Lowitja Institute International Indigenous Health and Wellbeing Conference 2019 delegates from around the world will discuss the role of First Nations in leading change and will showcase Indigenous solutions.

The conference program will highlight ways of thinking, speaking and being for the benefit of Indigenous peoples everywhere.

Join Indigenous leaders, researchers, health professionals, decision makers, community representatives, and our non-Indigenous colleagues in this important conversation.

More Info 

2019 Dr Tracey Westerman’s Workshops 

More info and dates

7 -14 July 2019 National NAIDOC Grant funding round opens 

The opening of the 2019 National NAIDOC Grant funding round has been moved forward! The National NAIDOC Grants will now officially open on Thursday 24 January 2019.

Head to www.naidoc.org.au to join the National NAIDOC Mailing List and keep up with all things grants or check out the below links for more information now!

https://www.finance.gov.au/resource-management/grants/grantconnect/

https://www.pmc.gov.au/indigenous-affairs/grants-and-funding/naidoc-week-funding

23 -25 September IAHA Conference Darwin

24 September

A night of celebrating excellence and action – the Gala Dinner is the premier national networking event in Aboriginal and Torres Strait Islander allied health.

The purpose of the IAHA National Indigenous Allied Health Awards is to recognise the contribution of IAHA members to their profession and/or improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples.

The IAHA National Indigenous Allied Health Awards showcase the outstanding achievements in Aboriginal and Torres Strait Islander allied health and provides identifiable allied health role models to inspire all Aboriginal and Torres Strait Islander people to consider and pursue a career in allied health.

The awards this year will be known as “10 for 10” to honour the 10 Year Anniversary of IAHA. We will be announcing 4 new awards in addition to the 6 existing below.

Read about the categories HERE.

24 -26 September 2019 CATSINaM National Professional Development Conference

 

 

The 2019 CATSINaM National Professional Development Conference will be held in Sydney, 24th – 26th September 2019. Make sure you save the dates in your calendar.

Further information to follow soon.

Date: Tuesday the 24th to Thursday the 26th September 2019

Location: Sydney, Australia

Organiser: Chloe Peters

Phone: 02 6262 5761

Email: admin@catsinam.org.au

9-10 October 2019 NATSIHWA 10 Year Anniversary Conference

SAVE THE DATE for the 2019 NATSIHWA 10 Year Anniversary Conference!!!

We’re so excited to announce the date of our 10 Year Anniversary Conference –
A Decade of Footprints, Driving Recognition!!! 

NATSIHWA recognises that importance of members sharing and learning from each other, and our key partners within the Health Sector. We hold a biennial conference for all NATSIHWA members to attend. The conference content focusses on the professional support and development of the Health Workers and Health Practitioners, with key side events to support networking among attendees.  We seek feedback from our Membership to make the conferences relevant to their professional needs and expectations and ensure that they are offered in accessible formats and/or locations.The conference is a time to celebrate the important contribution of Health Workers and Health Practitioners, and the Services that support this important profession.

We hold the NATSIHWA Legends Award night at the conference Gala Dinner. Award categories include: Young Warrior, Health Worker Legend, Health Service Legend and Individual Champion.

Watch this space for the release of more dates for registrations, award nominations etc.

16 October Melbourne Uni: Aboriginal and Torres Strait Islander Health and Wellbeing Conference

The University of Melbourne, Department of Rural Health are pleased to advise that abstract
submissions are now being invited that address Aboriginal and Torres Strait Islander health and
wellbeing.

The Aboriginal & Torres Strait Islander Health Conference is an opportunity for sharing information and connecting people that are committed to reforming the practice and research of Aboriginal & Torres Strait Islander health and celebrates Aboriginal knowledge systems and strength-based approaches to improving the health outcomes of Aboriginal communities.

This is an opportunity to present evidence-based approaches, Aboriginal methods and models of
practice, Aboriginal perspectives and contribution to health or community led solutions, underpinned by cultural theories to Aboriginal and Torres Strait Islander health and wellbeing.
In 2018 the Aboriginal & Torres Strait Islander Health Conference attracted over 180 delegates from across the community and state.

We welcome submissions from collaborators whose expertise and interests are embedded in Aboriginal health and wellbeing, and particularly presented or co-presented by Aboriginal and Torres Strait Islander people and community members.

If you are interested in presenting, please complete the speaker registration link

closing date for abstract submission is Friday 3 rd May 2019.
As per speaker registration link request please email your professional photo for our program or any conference enquiries to E. aboriginal-health@unimelb.edu.au.

Kind regards
Leah Lindrea-Morrison
Aboriginal Partnerships and Community Engagement Officer
Department of Rural Health, University of Melbourne T. 03 5823 4554 E. leah.lindrea@unimelb.edu.au

5-8 November The Lime Network Conference New Zealand 

This years  whakatauki (theme for the conference) was developed by the Scientific Committee, along with Māori elder, Te Marino Lenihan & Tania Huria from .

To read about the conference & theme, check out the  website. 

NACCHO Aboriginal Health #Racism and #CulturalSafety : Has the The Ways of Thinking and Ways of Doing #WoTWoD  program designed to improve cultural respect in general practice and improve health outcomes for Aboriginal patients failed

“Cultural respect reflects the attitudes and behaviour of the entire medical practice, from reception to consulting room.

In addition, general practice organisations must work in partnership with Indigenous community-controlled organisations to reduce health care disparities, address social determinants of poor health, and increase access to safe, effective and culturally respectful care. ” 

 Professor Siaw-Teng Liaw, professor of General Practice at the UNSW Sydney and and colleagues 

A YEAR-long program designed to improve cultural respect in general practice and improve health outcomes for Aboriginal patients, has failed to either increase the rate of Indigenous health checks or improve cross-cultural behaviours, according to the authors of research published in the Medical Journal of Australia.

Download 6 page copy of research 

Cultural respect in general practice

Read full report online at MJA 

Cover : The painting created for the Ways of Thinking and Ways of Doing (WoTWoD) study by Ashley Firebrace, a Wurundjeri man from Melbourne.

With the majority of Australia’s Aboriginal population living in cities, suburban doctors’ clinics are part of the front-line effort to close the gap in health inequalities.

There are efforts to improve the way general practices treat Indigenous patients, but progress is slow.

A new study into a program designed to make GP clinics more culturally sensitive has found little improvement after 12 months.”

ABC Radio AM Interview with Janine Mohammed. interim chief executive, Lowitja Institute : Teng Liaw, professor of general practice, University of New South Wales and Dr Tim Senior, Aboriginal and Torres Strait Islander health medical advisor, Royal Australian College of General Practice and GP, Tharawal Aboriginal Medical Service

Listen HERE 3 Minutes

 

Read over 50 Aboriginal Health and Cultural Safety articles here  

The Ways of Thinking and Ways of Doing (WoTWoD) program was developed by a team led by Professor Siaw-Teng Liaw, professor of General Practice at the UNSW Sydney and the Ingham Institute of Applied Medical Research.

It was designed to “translate the systemic, organisational, and clinical elements of the Australian Health Ministers’ Advisory Council Cultural Competency Framework into routine clinical practice”.

The WoTWoD program includes “a toolkit [comprising 10 scenarios that illustrate cross-cultural behaviour in clinical practice], one half-day workshop, cultural mentor support for the practice, and a local care partnership of participating Medicare Locals/PHNs and local ACCHSs for guiding the program and facilitating community engagement”.

In evaluating the program, Liaw and colleagues introduced WoTWoD to 28 intervention general practices and compared the results after 12 months with 25 control practices.

After 12 months “the rates of MBS item 715 claims (health assessment for Aboriginal and Torres Strait Islander People) and recording of risk factors for the two groups were not statistically significantly different, nor were mean changes in cultural quotient scores, regardless of staff category and practice attribute”.

Liaw and colleagues wrote that the negative results may be attributable to “variability in the fidelity of the intervention, especially the local care partnership … the clinical and organisational reasons for low usage rate [of the MBS item 715] … and the length of the trial”.

“The length of the trial (12 months) may not have been sufficient to detect significant changes in professional practice dependent on organisational changes that require time to formulate and implement.

“Nevertheless, it is encouraging and promising that the data trends over the 12 months within each group were positive and participant perceptions of the WoTWoD were very positive.

“Further collaborative and participatory mixed methods research is required to examine the complexities of co-creating, implementing, and evaluating programs that integrate ‘thinking and doing’ cultural respect in the context of the changing needs and priorities of general practice and Indigenous communities,” Liaw and colleagues concluded.

The known: The gap in life expectancy between Indigenous and non‐Indigenous Australians remains large. Urban Indigenous Australian‐controlled health services are under‐resourced, and mainstream primary care services are often not culturally sensitive.

The new: A practice‐based cultural respect program — including a workshop and toolkit of scenarios, with advice from a cultural mentor, and guided by a care partnership of Indigenous and general practice organisations — did not significantly influence Indigenous health check rates or cultural respect levels.

The implications: Cultural respect programs may require more than 12 months to increase Indigenous health check rates and the cultural quotient scores of general practice clinic staff.

Closing the health and care gaps between Aboriginal and Torres Strait Islander (Indigenous) Australians and non‐Indigenous Australians has been a longstanding challenge.,

In 2018, a decade after Australian governments committed themselves to Closing the Gap, mortality and life expectancy for Indigenous Australians had not markedly improved, and nearly 80% of the difference in mortality between adult Indigenous and non‐Indigenous Australians was attributable to chronic disease.

The Practice Incentives Program–Indigenous Health Incentive (PIP‐IHI), introduced in May 2010, assists general practitioners undertake chronic disease care planning for their Indigenous patients. Initial uptake was poor: only 64% of general practices expected to register (1275 of 2000) did so during 2010–11. However, the proportion had increased by May 2012.

The rebate for health assessments for Aboriginal and Torres Strait Islander People (Medicare Benefits Schedule [MBS] item 715), constitutes an additional strategy for improving the access of Indigenous Australians to primary health care matched to their needs. GPs can engage suitably qualified practice nurses or Aboriginal Health Workers to assist with the assessment, including patient history‐taking, clinical examination and investigations, and with providing patients with education and resources for managing their own health.

The proportion of Indigenous Australians for whom payment for MBS item 715 was claimed increased from nearly 11% in 2010–11 to nearly 29% in 2016–17 (New South Wales, 26.8%; Victoria, 17.1%). However, the rate is still low and access to comprehensive care planning for Indigenous Australians is poor

Aboriginal Community Controlled Health Services (ACCHSs) are important providers of primary health care to Indigenous communities. However, most Indigenous Australians living in urban areas also use standard primary care and GP services.

In 2016, Indigenous Australians comprised 3% of the Australian population (744 956 people); 38% lived in New South Wales (229 951) or Victoria (53 663). About one‐third of Indigenous Australians live in major cities, but only 16 of 138 ACCHSs are in major cities; urban ACCHSs have lower staff/client ratios than regional and remote ACCHSs.

Indigenous Australians frequently encounter cultural disrespect in mainstream primary care services., The 2012–13 Australian Aboriginal and Torres Strait Islander Health Survey reported that 16% of Indigenous Australians had experienced racism in health settings; 20% of these respondents reported that doctors, nurses and other hospital or clinic staff were discriminatory, and 7% avoided seeking health care because of unfair treatment.

Of 755 adult Indigenous Victorians surveyed in 2011, 29% had experienced racism in health settings. Lack of cultural respect in health care restricts access to and reduces the quality of care for Indigenous Australians.

We have previously identified trust, access, flexibility, time, support, outreach, and working together as key aspects of cultural respect. Although the Indigenous Chronic Disease Package (2009–2014) supported increased cultural awareness training for health workers, it did not change attitudes or behaviour sufficiently to bridge the cultural gap between health professionals and Indigenous people.

We developed the Ways of Thinking and Ways of Doing (WoTWoD) cultural respect program with a trans‐theoretical approach, harmonising many similar conceptual frameworks and the terminology applied to Indigenous and cross‐cultural health in Australia. The theoretical underpinnings of WoTWoD were described in the article describing our pilot study. The WoTWoD framework translates the systemic, organisational, and clinical elements of the Australian Health Ministers’ Advisory Council Cultural Competency Framework into routine clinical practice. Cultural respect reflects the attitudes and behaviour of the entire medical practice, from reception to consulting room. In addition, general practice organisations must work in partnership with Indigenous community‐controlled organisations to reduce health care disparities, address social determinants of poor health, and increase access to safe, effective and culturally respectful care. This is fundamental to Indigenous Australians’ right to the highest standard of health.,

We undertook a cluster randomised controlled trial to examine whether the WoTWoD program improves clinically appropriate anticipatory care in general practice and the cultural respect of medical practice staff.

 

NACCHO Aboriginal Health and Continuous Quality Improvement (CQI): Minister @KenWyattMP announces $2.8 million national project improving people’s health through better quality control and health data collection at local ACCHO’s Aboriginal Community Controlled Health Services  

 ” Improving people’s health through better quality control and health data collection at local Aboriginal Community Controlled Health Services is the aim of a $2.8 million national project funded by the Federal Government.

Our Government recognises the importance of Aboriginal Community Controlled Health Services (ACCHS), with data showing they provide over 2.5 million episodes of care each year for more than 350,000 people.

However, to help achieve better health outcomes as our Aboriginal and Torres Strait Islander population grows, we need to support accountability, quality improvement and accurate data reporting.”

Minister Ken Wyatt Press Release Part 1 Below

” This National Framework for Continuous Quality Improvement in Primary Health Care for Aboriginal and Torres Strait Islander people, 2018-2023 booklet is designed to provide practical support for all primary healthcare organisations in their efforts to ensure that the health care they provide is high quality, safe, effective, responsive and culturally respectful.”

NACCHO Acting Chair Donnella Mills

” NACCHO is proud of the record of the Aboriginal Community Controlled Health Services (ACCHSs) in delivering primary health care to our community. We have learnt many lessons over the last 50 years about how to structure, deliver and improve care so that it best meet the needs of our communities across Australia.

This experience is used in the Framework to describe how to do, support and inform culturally respectful continuous quality improvement (CQI) in primary health care.”

Further resources including the Framework are available on our NACCHO website.

Direct link to PDF – https://www.naccho.org.au/wp-content/uploads/NACCHO-CQI-Framework-2019.pdf

Updated CQI pagehttps://www.naccho.org.au/programmes/cqi/

Pat Turner CEO of NACCHO see Press Release Part 2 below

 

Part 1 Ministers Press Release

In 2017, the Department of Health engaged KPMG to develop a national baseline quality audit at the individual service level to identify issues impacting on data quality and reporting and make recommendations for improvement. From February to May last year, 53 ACCHS volunteered to participate in the project.

The final report found that, despite reporting on national Key Performance Indicators and Online Services Report data collections since 2012-13 and 2007-08 respectively, only 30 per cent of the services visited were rated as having effective and mature processes in place to support and measure health data. The remaining 70 per cent were classified as needing support to improve.

The reports found characteristics of mature services include:

* Leadership focussed on a strong culture of Continuous Quality Improvement

* Clear workflows including induction, training and monitoring programs

* Resources and staff dedicated to recording and reporting health care activities

In Stage 2 of this project this year, KPMG will offer all health services not involved in Stage 1 the opportunity to participate, plus follow-up consultations for ACCHS in Stage 1 and the development of online training resources.

KPMG will also convene a national forum on best practice so ACCHS can share successful and effective reporting processes and practices with each other.

Part 2

The National Aboriginal Community Controlled Health Organisation (NACCHO) has just published the National Framework for Continuous Quality Improvement in Primary Health Care for Aboriginal and Torres Strait Islander people, 2018-2023.

Download the full NACCHO Press Release HERE 

al Community Controlled Health Services and Affiliates, health professional organisations and government. The project was funded by the Commonwealth Department of Health.

The CQI Framework provides principles and guidance for primary health care organisations in how to do, support and inform culturally respectful CQI.

It is designed to assist Aboriginal health services and private general practices, NACCHO Affiliates and Primary Health Networks, national and state/territory governments in their efforts to ensure that Aboriginal and Torres Strait Islander people have access to and receive the highest attainable standard of primary health care wherever and whenever they seek care.

It is relevant to clinicians, board members and practice owners, health promotion, administrative and management staff. Six case studies which illustrate how CQI has been implemented in ACCHSs are included.

NACCHO welcomes further case studies from other health services, general practice and Primary Health Networks.

Further resources including the Framework are available on the NACCHO website.

  1. Direct link to PDF – https://www.naccho.org.au/wp-content/uploads/NACCHO-CQI-Framework-2019.pdf
  2. Updated CQI page – https://www.naccho.org.au/programmes/cqi/

For further information about the CQI Framework please contact: cqi@naccho.org.au

 

NACCHO Aboriginal Health #CulturalSafety and @CATSINaM News : Minister @KenWyattMP provides $350,000 to produce an Australian-first online cultural safety training course for nurses and midwives delivering frontline care to Indigenous people.

 

“Providing culturally safe services is critical to Closing the Gap in health equality. We welcome CATSINaM’s initiative to share experiences and to learn from Aboriginal and Torres Strait Islanders to strengthen the capacity of health professionals to deliver culturally safe services for our people.

This training will not only support all nurses and midwives to meet the standards of their Codes of Practice, it will also embed cultural safety in the health system, improving healthcare and helping Close the Gap in Aboriginal and Torres Strait Islander health outcomes,” 

CATSINaM CEO Janine Mohamed said the funding would help realise a project the organisation had been working on with the Government and other partners for the past five years

Picture above : The Minister with Janine Mohamed of CATSINaM and Annie Butler of ANMF

Please note : Melanie Robinson has been appointed as the as the new CATSINAM CEO as from 4 th February See Part 2 below 

Read over 40 NACCHO Aboriginal Health and Cultural Safety articles HERE

The Federal Government will provide $350,000 to produce an Australian-first online cultural safety training course for nurses and midwives delivering frontline care to Aboriginal and Torres Strait Islander people.

Indigenous Health Minister Ken Wyatt AM made the announcement at a national roundtable in Sydney on developing and rapidly expanding the Aboriginal health workforce.

  The Minister with Aboriginal Elder Aunty Beryl and some of the staff and students from the National Centre for Indigenous Excellence in Redfern who prepared the wonderful morning tea and BBQ lunch at the Indigenous Health Workforce Roundtable

“Everyone using health services in Australia should feel valued and respected throughout their consultation and aftercare,” Minister Wyatt said.

“Our Government, through the Indigenous Australians’ Health Program, will fund the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives to develop the online cultural safety training course this year.

“The innovative use of established web technology will enable all nurses and midwives to learn about culturally safe care where they live and work, and at a time which suits them.”

The Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) is the peak body representing Aboriginal and Torres Strait Islander nursing and midwifery professionals across Australia.

“The online training program will be adapted for Australia from a successful model developed by Indigenous leaders in Canada,” said Minister Wyatt.

The inclusion of cultural safety as one of the Codes of Professional Standards for nurses and midwives is driving an increase in demand for cultural safety training.

“The importance of cultural safety training is recognised across the health sector,” Minister Wyatt said.

“There is also potential for this initiative to build the cultural understanding of health professions beyond the fields of nursing and midwifery.

“The training will align with the objectives of the Cultural Respect Framework 2016-2026 for Aboriginal and Torres Strait Islander Health to include local culture in the design, delivery and evaluation of services.”

Provision of cultural safety training also supports strategies under the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023, to prevent and address systemic racism and discrimination in the health system.

The Liberal National Government is providing $3.9 billion to improve the health of Aboriginal and Torres Strait Islander people over the next four years.

Part 2 Melanie Robinson has been appointed as the as the new CATSINAM CEO as from 4 th February

The Congress of Aboriginal and Torres Strait Nurses and Midwives (CATSINaM), the national peak body for Aboriginal and Torres Strait Islander Nurses and Midwives, today welcomes the appointment of Melanie Robinson as the new CEO. Ms Robinson, a nurse who has been a director of CATSINaM for three years, has worked clinically, in nurse training and policy development, most recently holding a senior position with the Western Australian Department of Health (see bio below).

She will move from Perth to Canberra to take up her new position with CATSINaM on 4 February 2019.

CATSINaM acting president, Marni Tuala, said that Melanie Robinson is a fantastic addition to the CATSINaM team given her unswerving commitment to Aboriginal and Torres Strait Islander health as well as nurse and midwife employment issues, and her profile within the national Aboriginal and Torres Strait Islander healthcare community

. “Melanie brings valuable experience and a fresh perspective to the role of CEO,” Ms Tuala said. “Melanie knows the benefits and rewards of working as a nurse and has a deep understanding of the issues that Aboriginal and Torres Strait Islander nurses and midwives face on a daily basis.” Ms Robinson said it is an honour to be a part of such a vibrant and important organisation that advocates for Aboriginal and Torres Strait Islander nurses and midwives.

Her priorities would include growing the number of Aboriginal and Torres Strait Islander nurses and midwives across Australia, and ensuring the workforce was strongly supported.

“It’s important that we look at what is working – within the universities, the vocational training sector and in terms of employment pathways – and translate these lessons more widely,” Ms Robinson said. “I am looking forward to advocating for our members, engaging with national policy development, and building strong partnerships across the government and non-government sectors, and working with the other peak bodies

. “I am also keen to continue the work of raising CATSINaM’s profile, at local, national and international levels.”

As a passionate advocate for CATSINaM, Ms Robinson said the organisation had been critical for her own journey of professional development and she wanted to ensure that others had similar opportunities.

“When I discovered CATSINaM, it opened up this whole other world as I met others with a shared history and experiences,” she said. “I will be working hard to ensure that CATSINaM offers those same opportunities to others that it has brought me.”

Ms Robinson said she hoped that the wide-ranging experience she had gained over the last 30 years would be useful for CATSINaM and its members. She commended an Aboriginal Leadership and Excellence Development program that she undertook in WA for building her confidence to take on senior roles.

Acting CATSINaM president Marni Tuala said the CATSINaM Board was keen to acknowledge the legacy of the outgoing CEO, Janine Mohamed. “CATSINaM recognises and commends the incredible achievements made by the outgoing CEO, Janine Mohamed. Her contributions during her six years in the role will not be forgotten, especially in the advocacy and implementation of cultural safety across healthcare.

Janine will continue to be a valuable member of the CATSINaM community,” Ms Tuala said.

Media Contact: Sarah Stewart: 02 62625761/ Melanie is available for interviews and profile articles.

Please contact Sarah Stewart for full information

Bio – Melanie Robinson I was born in Derby in the Kimberley region of Western Australia and grew up on the Gibb River Road in Ngallagunda community.

When I was 8 years old we moved into Derby for school and after that I went to boarding school at Stella Maris College.

I finished year 12 in 1989 and then in 1990 I commenced a Bachelor of Science (Nursing) at Curtin University completing the course in December 1993.

As a graduate I move back to Derby and completed 18 months in Derby Hospital working in paediatrics, general medical and emergency department. During this time I worked in Fitzroy Crossing hospital and the aged care facility in Derby called Numbla Nunga.

In 1996 I travelled overseas and lived in London for 6 months and then I returned to Perth and began working at Royal Perth Hospital a tertiary service where I worked for the next 2.5 years in aged care, acute medical and the intensive care unit.

In 1998 I travelled to Dublin and lived there for a year with a friend and her family, working in a local aged care unit. In 1998 I returned to Perth and commenced work in Princess Margaret Hospital where I worked in oncology, hematology and Intensive Care for the next 9.5 years.

I loved working with children and their families, which is a very specialised area and often extremely challenging.

In 2008 I decided to take a position as a nurse educator at Marr Mooditj Training and mentored and taught a number of Aboriginal students in enrolled nursing and Aboriginal Health Worker Programs. I loved this work and really enjoyed learning more about Noongar people and getting to know the local Aboriginal community.

In 2013 I took on a new position as a Senior Policy Officer in the Western Australian Department of Health.

In 2015 I managed to gain a promotion into a Senior Development Officer role and I completed a Masters in Nursing Research at the University of Notre Dame Australia in June 2018.

In 2018 for 6 months I acted as the Director Aboriginal Health in the Child and Adolescent Health Service in Western Australia. In the future I plan to return to nursing and enrol in the Masters in Midwifery Practice to gain the skills as a midwife.