DHS Principles of good practice in Aboriginal affairs: a guide for

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DHS Principles of good practice in Aboriginal affairs: a
guide for developing, funding and delivering programs
to Aboriginal people
Department of Human Services 2009
Contents
Overview ........................................................................................ 1
Background .................................................................................... 2
DHS Principles for funding and delivering programs to Aboriginal
people ............................................................................................ 4
Acknowledgement of existing principles .............................................. 7
Overview
A review of national and international
literature suggests there are a number of
good practice principles, which together can
create the framework for positive change in
health and well-being outcomes for
Aboriginal people.
These principles are not listed in any
particular order of importance; however the
principles cannot be separated and must be
considered as a whole.
These principles emphasise strong
community governance as the basis for
Aboriginal people achieving social and
economic development, supported by
effective public administration.
-
Recognise and value Aboriginal culture
and history
-
Adhere to a holistic definition of health
and wellbeing when developing
programs with Aboriginal people and
communities
-
Effectively partner with Aboriginal
organisations and communities
-
Respect the skills and ability of
Aboriginal people and organisations to
make genuine decisions about the needs
of the local community
-
Develop programs that are integrated
and coordinated across government and
the mainstream sector
It is important to note these are ‘good
practice’ principles, not ‘best practice’
principles. Good practice principles reflect
values that encourage flexibility in
developing programs to meet the needs of
Aboriginal people. Alternatively, best
practice principles suggest there is a single
approach to which the development of
programs must comply.
-
Ensure programs are supported by long
term funding and resource provision
-
Design initiatives that are transparent
and accountable
-
Develop programs based on available
evidence and continue to monitor and
evaluate performance
-
Programs should be sustainable and
adaptable
The good practice principles may also be
used to inform the evaluation of proposed or
existing programs.
-
Enhance the capacities of the Aboriginal
community, government, service
systems, organisations and the
workforce
The Department of Human Services has
developed a broad set of good practice
principles based on available research and
consultation with the community. These
principles are to be used in central and
regional offices in the funding, development
and implementation of programs and
policies in Aboriginal affairs, in collaboration
with the Aboriginal community.
The key elements of the DHS Principles of
good practice in Aboriginal affairs include:
It is intended that these principles will
provide a framework for the department to
create successful programs for Aboriginal
people. This in turn will build the platform
for better relationships between DHS and
Aboriginal communities and generate the
basis for change and improved outcomes.
1 DHS Principles of good practice in Aboriginal programs – Department of Human Services 2009
Background
Aboriginal culture is the oldest living culture
in the world. Traditional community and
family life was structured around complex
kinship systems, which was underpinned by
culture. This provided guidance on politics,
law, land, economic activity and spirituality.
Victoria is rich in Aboriginal culture and
traditions, which Aboriginal people continue
to honour and maintain today.
Despite the strength and pride of Victorian
Aboriginal people, most continue to
experience significant hardship in the areas
of health, housing, education, employment
and almost all western measures of
wellbeing, including a life expectancy that is
12 years less than non-Aboriginal Australian
males and ten years less than nonAboriginal Australian females.
It is also clearly understood that socioeconomic status alone does not account for
the life expectancy gap between Aboriginal
and non-Aboriginal people.
Aboriginal health and wellbeing is
intrinsically linked to Aboriginal culture and
history including discrimination,
dispossession of the land, the stolen
generations and social exclusion.
Health risk behaviours such as smoking,
alcohol and substance abuse and
environmental factors such as poor housing
also contribute significantly.
Aboriginal people view health holistically,
which requires more than just focusing on
the physical body; the goal is a wellness
that encompasses the social, emotional,
spiritual and cultural wellbeing of individuals
and the community as a whole.
The national apology made to the Stolen
Generations by the Commonwealth
Government of Australia on 13 February
2008 placed Aboriginal disadvantage and
the impacts of ill-advised government policy
squarely in the spotlight. It also provided an
opportunity for all Australians to focus and
reflect on the meaning of reconciliation and
to renew our commitment to addressing
Aboriginal disadvantage.
The Council of Australian Government’s
(COAG) identification of specific targets for
Indigenous reform and the signing of the
Statement of Intent by the Commonwealth
and Victorian governments in 2008, has
committed all parties to collaborate on
addressing Aboriginal disadvantage. These
milestones have also shown that political
leaders believe the health and wellbeing of
Aboriginal people is a priority.
In response to the changing landscape in
Aboriginal affairs at a State and
Commonwealth level, DHS engaged KPMG
to conduct a review of roles and
responsibilities in Aboriginal affairs within
the department.
The review included an analysis of a number
of DHS initiatives against a set of good
practice principles1 to measure the extent to
which the department is delivering
successful outcomes in Aboriginal affairs.
In the most successful of the case studies,
there was strong adherence with the
principles, with better outcomes for
Aboriginal people emerging as a result. In
the remaining case studies, there was clear
evidence that while DHS was making a
tangible effort, work had not been taken far
enough, and that fundamentally a different
approach was required. In particular, DHS
needed to ‘work differently’ to create
positive change.
The department is currently engaged in a
number of activities aimed at working
differently and to help build cultural
competence in the organisation. Building
cultural competence in DHS is regarded as
an ongoing process and an ideal to strive
towards. Rather than simply complying with
legislation, meeting minimum standards of
practice, or having a fixed end point,
cultural competence in the department is a
process which is continually evolving.
The development of the DHS Principles of
good practice in Aboriginal affairs: a guide
for developing, funding and delivering
programs to Aboriginal people will help build
cultural competence and position the
1
The principles presented here incorporate KPMG’s
principles, as well as other relevant schemas (see
section on “Acknowledgement of existing principles”).
2 DHS Principles of good practice in Aboriginal programs – Department of Human Services 2009
department to take a lead role in proactively
addressing the needs of Aboriginal people.
3 DHS Principles of good practice in Aboriginal programs – Department of Human Services 2009
DHS Principles of good
practice in Aboriginal
affairs: a guide for
developing, funding and
delivering programs to
Aboriginal people
Principle 1:
Recognise and value Aboriginal culture
and history.
Programs should acknowledge past history
and affirm and reflect Aboriginal culture and
values. It is important to understand the
historical, social and cultural context of
Aboriginal communities and the
fundamental impact this has on determining
health and wellbeing outcomes.
Historical and cultural factors affect the way
an Aboriginal person accesses (or chooses
not to access) services, their satisfaction
with the service and the outcomes of the
service. These perceptions may then impact
upon the utilisation of services by other
Aboriginal people in the community.
Programs that ignore Aboriginal history and
the social environment of Aboriginal people
will have limited success.
and carers should be involved in discussions
and decisions surrounding treatment, where
possible. Personal health and wellbeing
information needs to be treated with
sensitivity and confidentiality.
Principle 3:
Effectively partner with Aboriginal
organisations and communities.
Partnering refers to government and
Aboriginal communities sharing
responsibility for identifying solutions to
improve the conditions, wellbeing and
outcomes of Aboriginal people and
communities.
The partnership approach rests on
understanding each other and requires
demonstrated respect and support for
Aboriginal language, heritage and culture.
Governments risk failure – and will continue
to risk doing so – if they develop and
implement programs about Aboriginal issues
without empowering Aboriginal people to be
self determining and involved from the
outset in developing, running and evaluating
programs.
Aboriginal people are best placed to work
on interventions that build community
ownership and respond to the needs and
motivations of the Aboriginal community
with cultural understanding and sensitivity.
Principle 2:
Adhere to a holistic definition of health
and wellbeing when developing
programs with Aboriginal people and
communities.
Aboriginal people have different
perspectives and understandings of health
and wellbeing.
Aboriginal health and wellbeing is
intrinsically linked to Aboriginal culture and
history including discrimination,
dispossession of the land, the stolen
generations and social exclusion.
A holistic approach requires more than just
focusing on the physical body; the goal is a
wellness that encompasses the social,
emotional, spiritual and cultural wellbeing of
individuals and the community as a whole.
These aspects of life are closely
interconnected and represent equally
important approaches to treatment.
Principle 4:
Respect the skills and ability of
Aboriginal people and organisations to
make genuine decisions about the
needs of the local community.
Aboriginal organisations and communities
need access to information in a form that is
useful and meaningful to enable good
decision-making.
Initiatives driven by the Aboriginal
community will stimulate action around
“burning issues” and encourage cultural
understanding and sensitivity.
Initiatives are most effective when
Aboriginal communities support them and
provide input and feedback, and where this
feedback is taken on board. Priorities must
reflect the choices of the community as well
as government.
Aboriginal concepts of men’s and women’s
business must be considered and families
4 DHS Principles of good practice in Aboriginal programs – Department of Human Services 2009
Ongoing community involvement and
ownership at all levels of program planning,
implementation and evaluation is needed.
Support from the boarder community and
within the wider health system is also
required to ensure effective and sustainable
practice.
Principle 5:
Develop programs that are integrated
and coordinated across government
and the mainstream sector.
No single agency or program has the
capacity to address Aboriginal disadvantage
in isolation.
Government departments, service
providers, non-government agencies and
private providers need to work together in a
timely and coordinated way to share
knowledge and deliver effective programs.
It is important to deliver programs in a way
that makes sense to Aboriginal people,
addressing the complex nature of Aboriginal
disadvantage and the barriers people face to
accessing care. An integrated response
across services and organisations lessens
the burden of dealing with multiple
organisations and supports continuity of
care.
Principle 6:
Ensure programs are supported by long
term funding and resource provision.
Programs require the certainty of adequate
funding over the medium term (3 year
minimum) to increase skills, ownership,
infrastructure, education and trust.
Sustainable programs are well planned,
organised and funded from the outset to
include rigorous evaluation, and should have
the ability to respond to the outcomes of
evaluation.
Properly funded programs build the capacity
of Aboriginal people and organisations,
which increases the likelihood of programs
being successful. It is also important to offer
new positions as full time, even when
programs are operating in small Aboriginal
communities. It is not always viable for part
time positions to meet the huge amount of
work required to implement programs,
whether Aboriginal communities are large or
small.
Principle 7:
Design initiatives that are transparent
and accountable.
Programs based on visible decision-making
policies and sound rationale will have the
capacity to take into account the complex
and changing environments that exist
between and within Aboriginal communities.
It is important to support Aboriginal
organisations where possible to develop the
infrastructure and skills needed to record
and document what they are doing. In this
way, Aboriginal organisations will be better
able to manage available resources, utilise
data and information and assist other
Aboriginal communities to design or improve
programs.
Principle 8:
Develop programs based on available
evidence and continue to monitor and
evaluate performance
Programs based on evidence of good
practice identify what already works and
allows the design of better interventions.
Programs should take account of the
strengths, limitations and gaps in available
evidence.
Where data does not exist, it will be
necessary to rely on anecdotal evidence
from the Aboriginal community regarding
the most pertinent issues facing Aboriginal
people.
Aboriginal communities are more likely to
adopt service models where there is
evidence of success from other Aboriginal
programs.
It is important to continue to gather data
and monitor performance throughout
program implementation and respond to the
outcomes of the evaluation. This will help to
build a strong evidence base and ensure
services remain relevant and effective. This
requires dedicated funding and people with
expertise to carry out evaluation.
Information about Aboriginal people
gathered from evaluation should be owned
by Aboriginal people and shared on their
terms.
Principle 9:
5 DHS Principles of good practice in Aboriginal programs – Department of Human Services 2009
Programs should be sustainable and
adaptable.
Programs that are multi-faceted and involve
more than just one single approach increase
the awareness and involvement of
Aboriginal people and the likelihood of
success.
Involving a number of different
stakeholders, in particular those who have
been involved in similar programs can
positively influence the adaptability of
programs to different communities and
contexts.
Programs that include effective evaluation
are also more likely to be sustainable and
will help to improve the design of future
programs.
Principle 10:
Enhance the capacities of the
Aboriginal community, government,
service systems, organisations and the
workforce.
Both the Aboriginal, government and
mainstream workforces must work together
to build understanding and support for the
provision of culturally appropriate and
accessible services.
Government and mainstream organisations
require training and knowledge in culturally
sensitive practice to work effectively with
Aboriginal people and organisations.
Providing formal or informal training,
support and development of the Aboriginal
workforce is required for programs to be
effective. Employment opportunities and
skills development impacts directly and
indirectly on the wellbeing of Aboriginal
communities.
Well designed leadership initiatives also help
to increase self esteem, identity and create
opportunities for the future.
6 DHS Principles of good practice in Aboriginal programs – Department of Human Services 2009
Acknowledgement of
existing principles
The DHS Principles of good practice in
Aboriginal affairs: a guide for developing,
funding and delivering programs to
Aboriginal people recognise and embrace a
number of existing principles of good
practice which originate from literature
reviews and community consultations.
The Allen Consulting Group Review:
Indigenous Family Violence in Victoria4
highlights good practice elements for
Indigenous family violence programs.
DHS specific
3. Composite programs
The KPMG review of the Koori Human
Services Unit2 identified Good practice
principles in Aboriginal affairs as a
framework to create positive change in wellbeing and outcomes for Aboriginal people.
5. Ensuring the involvement of Elders
1. Partnerships and joint governance
2. Whole of government approach
3. Holistic focus
4. Empowerment
5. Capacity building
6. Harnessing the mainstream
1. Cultural grounding of programs
2. Community grounding/development of
programs
4. Engagement of men into programs
6. Self-empowerment and self-esteem as
capacity-building by-products
7. Examining inter-generational family
history and colonial experience as a
healing element
8. Cultural preference for tailored
responses, including group approaches
9. Capacity building through networking,
partnerships and interagency
collaboration
7. Cultural competence
10. Information collection and dissemination
The Indigenous health promotion
literature review 20073 highlights health
promotion principles for better Aboriginal
health. The review emphasises the critical
point that success depends not only on
what you do but also how you do it.
12. Flexibility and adaptability of programs
1. Culturally appropriate approaches
2. Foster and improve
networking/partnerships/consultation
11. Training and skills acquisition
The Australian Institute for Primary
Care at La Trobe University5 used themes
to build a useful framework for thinking
about how government policy can contribute
to improved outcomes for Aboriginal people.
1. Service integration/coordination
3. Community supported/based
2. Partnerships with Indigenous
communities
4. Flexible but accountable
3. Culturally appropriate services
5. Skills development/training
4. Meeting local needs
6. Multi-strategy approach
5. Evidence-based practice/planning
7. Sustainable funding/transferable/long
time frame
6. Evaluation
7. Workforce development
8. Establishing evidence-base
9. Developing leadership
4
2
KPMG, Review of roles and responsibilities for
Aboriginal Affairs, July 2008
3
J. Kingsley, Public Health, Department of Human
Services, Indigenous Health Promotion Literature
Review, 2008
The Allen Consulting Group, Indigenous Family
Violence in Victoria: Supporting the Development of a
Ten-Year Plan, March 2007
5
Australian Institute of Primary Care, La Trobe
University, Review to Identify Opportunities through
DHS Funding to Improve Outcomes for Aboriginal
People, October 2007
7 DHS Principles of good practice in Aboriginal programs – Department of Human Services 2009
Features of successful programs in
Aboriginal health promotion were based on
the Indigenous health promotion literature
review 2007 and presented at the
November 2007 Aboriginal Human
Services Forum6.
1. Recognise and value Aboriginal culture
and history
2. Initiatives are driven by the community
3. Use a number of (evidence based)
strategies in a flexible way
4. Are sustained over time (funding)
5. Develops local community leadership
6. Develops and supports staff
7. Monitors, evaluates and feeds back
learning to the community
International work
Work developed in the UK highlights key
elements for effective community
engagement with disadvantaged and
discriminated groups.
1. Focus on assets not deficits
2. Not capacity building but capacity
releasing
3. Resourcefulness not resources
4. Reciprocal relationships/peer built up
over time
5. Challenge assumptions – know each
other’s worlds
6. Shared learning not training
7. OD as well as CD
8. Stimulate community action around
“burning issues”
Other Australian work
In a 2002 workshop comprising State and
Territories health departments and peak
Aboriginal organisations, participants
developed the Principles for Better
Practice Aboriginal Health Promotion –
the Sydney Consensus Statement
20027.
1. Aboriginal health promotion should
acknowledge Aboriginal cultural
influences and the historical, social and
cultural context of communities
2. Aboriginal health promotion practice
should be based on available evidence
3. Effective Aboriginal health promotion
practice means building the capacities of
the community, government, service
systems, organisations and the
workforce, ensuring equitable resource
allocation (flexible purchaser-provider
arrangements) cultural security and
respect in the workplace
4. Aboriginal Health Promotion should
ensure ongoing community involvement
and consultation
5. The practical application of Aboriginal
self-determination principles is
fundamental in all Aboriginal health
promotion planning
6. Aboriginal health promotion adheres to
the holistic definition of health and
acknowledges that primary health care
in Aboriginal communities incorporates
Aboriginal health promotion
7. The establishment of effective
partnerships is required to address many
of the determinants of health
8. Aboriginal Health Promotion programs
should aim to be sustainable and
transferable
9. Aboriginal health promotion should
demonstrate transparency of operations
and accountability
6
C. Pickin, Public Health, Department of Human
Services, Presentation to the Aboriginal Human
Services Forum, November 2007
7
NSW Department of Health, Principles for better
practice in Aboriginal health promotion – The Sydney
Consensus Statement, NSW Health 2002, June 2004
8 DHS Principles of good practice in Aboriginal programs – Department of Human Services 2009
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