Aboriginal and Torres Strait Islander Primary Health Care Systems Evaluation
Fully funded by the Australian Government Department of Health
Introduction
The evaluation focuses on the Australian Government’s investment in primary health care for Aboriginal and Torres Strait Islander peoples, which occurs primarily through the Indigenous Australians’ Health Programme (IAHP).
From November 2018-December 2023 the evaluation is in the implementation phase. The evaluation has engaged 17 geographical site partners across Australia. Over three participatory action research (PAR) cycles, the team will undertake interviews and yarns with site partners as well as national and state/territory-level stakeholders. Each cycle will include two site-based workshops to support development of shared priorities, reflection, sense making and planning for change. Each cycle also includes 1-2 deep-dive cross-cutting collaboratives.
Last modified 03/10/2022
Artwork
The original artwork was produced by Emma Walke. Emma is a Bundjalung Aboriginal woman from northern NSW and was part of the evaluation team which designed and set-up the evaluation. Here is her description of the artwork:
Because I don’t speak for every country, and because we are working across many of them, the work seeks to represent Indigenous Australia. I feel that colour makes a statement so I have used colours that can be linked to many of our communities and countries, land or sea based. The colours represent our people and the land they come from – ochres/yellows represent desert and hills and the cliffs where our ochres come from. Blues for ocean and blue greens for rivers.
The circles are universal in the way they represent groups or clans of people, the markings inside some of the circles represent individuals.
The dots and slashes are representational of tracks and time lines. There are a few blank circles – they represent the missing, the lost peoples.
I thought I would try and incorporate the colours to show respect for them.
Last modified 01/10/2019
The evaluation design process
The evaluation design process began in late 2017. The following diagram charts the progress and timeline of the evaluation design, and the start date of the evaluation itself.
The structure for co-designing the evaluation is shown in the figure below. It shows that the evaluation team is working collaboratively with a group of people working across the health sector – the Health Sector Co-design Group (HSCG) – and engaging with people in communities, as part of a community co-design process. It also shows engagement with a wider group of interested people across states and territories. As part of the community co-design process, we are working towards the establishment of a Community Co-design Group for the implementation phase of the evaluation. The Community Co-design Group will be in direct conversation with the HSCG as well as the evaluation team.
Last modified 13/09/2019
The project team
The following independent team has been appointed by the Department of Health to lead the evaluation design process. Please click on their names below for more information.
Roxanne is from the Gungarri/Kunja nations of south-west Queensland.
Public health equity research, specifically the social and cultural determinants of health.
Extensive experience and expertise in Indigenous research impact assessment and evaluation; the implementation of quality improvement approaches in and beyond primary health care settings; family-centred care; and participatory action-oriented approaches.
Currently Master of Public Health, Diploma of Community Development, Diploma of Community Service (Aboriginal Sexual Health), Certificate IV (Training and Assessment; Frontline Management; Assessment and Workplace Training).
Relevant experience
Robert is a descendant of the Bundjalung Nation on his mother’s side. His family and his extended family are from the North Coast of NSW alongside the Clarence River at Baryulgil. On his father’s side a long and rich history of descendants from Ireland.
18 years working within both National/State and Local Governments working within the Aboriginal community controlled sector.
Research projects at UNSWs Kirby Institute for the past 4 years in Aboriginal communities across Australia.
Diverse range of learnt and lived experiences that he attributes to working in and with communities that are passionate about Aboriginal culture that is rich in life.
Managing Partner of Allen + Clarke’s Melbourne office.
Paul is an experienced public policy and business change consultant.
Paul has provided services to a range of clients in different sectors, including the Australian Department of Health, NSW Health, the World Health Organisation, the Fred Hollows Foundation, Solomon Islands Ministry of Health and the United Nations Population Fund.
Michael is a Central Arrernte of the Arrernte Nation, he also acknowledges his Irish, English and Finnish heritages. Michael was raised in Alice Springs. Michael has extensive experience across community, government and the private sectors in roles including public/primary health promotion/education, research, advocacy, policy and management.
Honour’s degree in Psychology from University of Leeds
Relevant experience
Hannah is an experienced Program Manager in the health and research fields. Her key skills are project management including development, implementation and evaluation, partnership building, stakeholder engagement and strategy development.
She was responsible for the scoping and implementation of innovative statewide tele-trials program with the aim of improving access and participation in clinical trials for regional and rural cancer patients.
She also managed the Victorian Cancer Covid-19 Network (VCCN) Telehealth Expert Working Group and project team and provided oversight of strategies to ensure high quality, equitable implementation and evaluation of telehealth across cancer services.
She was the Program Manager for research and education across Primary Care, Haematology, and Melanoma and Skin Cancer. In this tole she undertook strategic planning, project management practice and framework development and governance processes.
Hannah was also a Researcher with the Melbourne Neuropsychiatry Centre at University Melbourne.
Bachelor of Medicine, Bachelor of Surgery, Diploma from the Royal College of Obstetricians and Gynaecologists.
Fellow of the Royal New Zealand College of General Practitioners, Fellow of the Australian College of Rural and Remote Medicine, Fellow of the Australasian Faculty of Public Health Medicine.
Relevant experience
Clinical medicine (general practice/primary care) and public health physician in New Zealand and Australia.
GP in Indigenous health services in both urban and rural settings, including for Inala Indigenous Health Service in Brisbane, CWAATSICH and Ngati Porou Hauora on New Zealand’s East Coast.
Senior Lecturer Primary Care, Griffith University School of Medicine
Health policy development, evaluation and innovation
Health interface with justice sector; innovation for hard to reach and marginalised populations
Experience in service planning and funding.
Quantitative and qualitative analytical skills, as well as health systems and population health perspectives.
Graduate Australian Institute of Company Directors
Doctor of Philosophy (Health Economics Ph.D.) – University of Newcastle
Bachelor of Economics (Honours) – University of Newcastle
Relevant experience
Professor Chris Doran holds a Bachelor of Economics (Honours), a PhD in Health Economics and is a recent graduate of the Australian Institute of Company Directors. Chris is a Professor of Health Economics in the Centre for Indigenous Health Equity Research and is currently leading the research cluster for resilience and wellness.
Chris works within a multidisciplinary environment and collaborates extensively with academics, clinicians and policy makers in building capacity in the knowledge, use and translation of complex health data and systems analysis.
He has over 15 years’ experience in working with Aboriginal and Torres Strait Islander communities, health organisations and people. Examples include: working with the Yarrabah community in Far North Queensland to co-design and evaluate a Best Da Binge alcohol intervention; an NHMRC funded project to find solutions to Indigenous alcohol problems; an ARC funded project that embeds research into-youth services in remote Australian communities; an NHMRC funded project to reduce smoking rates among Indigenous pregnant women; and, a government funded project to evaluate the governments investment into Aboriginal and Torres Strait Islander residential rehabilitation services.
Masters of E-Commerce from Curtin University of Technology
Honour’s degree in Management and Marketing from Curtin University of Technology
Relevant experience
Kitty brings 20 years experiences in managing programs that drive and support the delivery of people, process, and technical solutions in different sectors including health management services and international logistics.
She managed and supervised large teams of clinicians and allied professionals, and is an effective collaborator to develop business plans, establish operational objectives, streamline processes, and implement change.
She managed the operations management of the National Institute of Integrative Medicine and was responsible for overall management of the clinical arm of the organisation that included full P&L responsibility, governance, audit and accreditation, business and legal risk management and compliance.
She was also the Service Manager for an international logistics and shipping organisation. In this role she undertook the responsibility for the management of all aspects of all service delivery, processes, country-level audit governance, and compliance for Oceania.
Master of Population Studies from Australian National University
Relevant experience
Erika is an English Australian, a demographer and social epidemiologist, who previously worked as a research focussed academic at the Centre for Indigenous Health Equity Research.
Erika has worked on Indigenous led projects relating to health, education, community development and systems integration. These include evaluations of government support services for Indigenous students, capacity building programs for staff and schools working with Indigenous students, the suitability of administrative data for Indigenous research, the provision of integrated team care by a primary health network.
Erika has been an investigator on Indigenous research projects funded by the Medical Research Future Fund, Western Queensland Primary Health Network, the Queensland Department of Education, Lowitja Institute, National Health and Medical Research Council, the Australian Research Council, as well as institutionally funded projects by Central Queensland University and Menzies School of Health Research. These projects have examined aspects of Indigenous youth mental health, Indigenous health workforce, transition of primary healthcare to community control, service delivery models in primary health care, and community led responses to gambling harm.
She has published on the validity of western health measures for Indigenous youth, health screening of Indigenous youth in primary health settings, the integration of health services, and contributed to a range of systematic reviews relating to health and education.
Erika embedded Indigenous data sovereignty and Indigenous research and evaluation methods in curriculum she developed and delivered for public health students, provided training and mentoring for students and community partners, and developed workshops for knowledge translation.
BA (Social&Political Science), MA (Cultural Studies), PhD (Cultural Anthropology)
Relevant experience
Sara is an experienced Social Science researcher with expertise in qualitative data collection and critical theory. She specialises in a diverse range of qualitative methods and analytical approaches, such as semi-structured interviews, participant observation, document analysis, thematic and narrative analysis, discourse analysis, and auto-ethnography.
She is passionate about collaborative and community orientated research with a focus on social justice and change making. Her research projects over the years have explored issues around multiculturalism, immigration, minority rights, equity policies, racism and decolonisation.
Sara is originally from Denmark and completed her Bachelor and Master degree in Cultural Studies at Roskilde University. She has presented research papers at various seminars and conferences internationally.
William is a researcher and policy analyst with experience working across projects in the health, education, justice and social service sectors. He is experienced in qualitative, quantitative, and mixed-method data collection and analysis, literature reviews, stakeholder engagement and management, legal analysis, research design and internal operations development.
William is passionate about engaging with complex issues at a systemic level, understanding where best changes can be made to attain lasting and impactful change. He is particularly interested in issues related to gender, alcohol-related violence, criminal justice system reform and transformative justice. William enjoys collaborating with colleagues, clients and stakeholders to produce high quality work based in strong and empathetic relationships.
Bachelor of Psychology (Honours) – Griffith University
Graduate Certificate in Mathematical Science – Queensland University of Technology
Relevant experience
Boyd has an educational background in psychology and maths, focusing on statistics and computational methods. He is particularly interested in the problem of nonlinear scaling of epidemiological metrics for small populations and rare events.
Boyd contributed to Aboriginal and Torres Strait Islander health research projects with Menzies School of Health Research, including the Centre for Research Excellence in Integrated Quality Improvement (CRE-IQI) and the Better Cardiac Care Data Linkage Project, examining the continuum of care for Aboriginal and Torres Strait Islander patients in the Queensland health system.
He has previously worked with Griffith University’s EEG laboratory and later with the Queensland Suicide Register where he developed the automated text data extraction from police and coronial reports, provided statistical and geospatial analyses for suicide mortality.
Judy has over 15 years’ experience in project management, event management and executive support having worked in a range of sectors including health education and training, government, finance, sports and telecommunication. This has allowed her to develop extensive experience in facilitating the implementation of education and training programs in a variety of health-related settings, as well as stakeholder management and coordination and management of large-scale programs and budgets over a project’s life cycle.
Celia is an evaluative analyst with experience in both the education and community service sectors, working directly with youth, adults and disadvantaged groups. Her background in psychology provides her with both the theoretical knowledge and empathetic understanding to succeed across these fields.
Celia is also experienced in leadership, public speaking, and stakeholder collaboration, as she has planned and delivered educative materials to key stakeholders and successfully advocated on behalf of her clients to achieve positive results.
Celia is passionate about education and health equality and is currently applying her skills in research methodology and analysis through her work on the Indigenous Australians’ Health Programme Evaluation.
Bachelor of Health Science (Aboriginal Health and Community Development), University of Sydney
Relevant experience
Sarina is a proud Adnyamathanha woman from South Australia who is focused on Aboriginal and Torres Strait Islander health, education and community engagement.
Sarina has extensive experience working within the Aboriginal and Torres Strait Islander health and education sector with over 20 years of community engagement/development experience. She is highly competent in developing positive working relationships with government and non-government organisations.
High level strategic planning and policy implementation experience and research skills focusing on quantitative and qualitative research. Effective management of program deliverables and expertise around leadership and partnership collaborations.
Sarina is passionate and dedicated to working with Aboriginal communities to build capacity, self-determination and leadership.
Last modified 06/03/2023
Health Sector Co-design Group
The Health Sector Evaluation Co-design Group was established in late 2017 to co-design and guide the development and implementation of the Evaluation of Aboriginal and Torres Strait Islander primary health care (PHC).
The Group brings together a wide range of experiences and perspectives from people working across the health system. Members come from a range of organisations including the National Health Leadership Forum, the Implementation Plan Advisory Group, the National Aboriginal Community Controlled Health Sector, the Primary Health Networks, health service providers, state health services, the Department of the Prime Minister and the Cabinet, the Australian Institute of Health and Welfare, and the Department of Health. The group also includes research expertise in primary health care and co-design.
All people involved in designing the evaluation so far – evaluation team members, the Department of Health, the Health Sector Co-design Group (HSCG) and others – have expressed a strong desire that the evaluation design process genuinely engages with a diverse group of Aboriginal and Torres Strait Islander peoples, particularly those whose voices are not commonly heard.
The community co-design process is evolving organically. Essentially, it is occurring in reverse to that of the co-design process with the health sector. The community co-design has started with a wider engagement process, working towards the formation of a group for the implementation of the evaluation. The health sector co-design process has started with bringing a group together – the HSCG – followed by engaging with the health sector more broadly.
In our discussions to date we have found that many people want to discuss real issues and concerns rather than the design of an evaluation. Therefore, we have identified several areas that we are discussing with people in the community to inform the evaluation design, including:
what ‘health’ means for people
where people go to see a nurse or doctor
who are using health services and who is missing out
what works well and not so well with health services
what is important to people about healthcare.
We are mindful there is already a lot of research and understanding about these areas, including among the project team and the HSCG, and will also be drawing on this to design the evaluation.
Last modified 19/08/2019
Ethics
Phased ethics applications
Given the multi-year and responsive nature of the evaluation, we are undertaking a phased ethics application approach to ensure the evaluation is responsive to community and organisational needs, as well as being carried out in line with the National Statement on Ethical Conduct in Human Research and other relevant ethical guidelines.
Phase two ethics approval:
Phase two ethical applications have been approved for all 17 sites. The phase two ethics applications sought approval for all evaluative activities that are to occur over the three years of the evaluation 2020-2023.
Last modified 04/07/2021
The IAHP
The Indigenous Australians’ Health Programme (IAHP) is delivering $4.1 billion over four years from 2019-20 to 2022-23 to improve:
access to culturally appropriate comprehensive primary health care for Indigenous Australians, and
areas of critical need through targeted investment that are expected to accelerate progress in reaching targets.
The IAHP:
Funds organisations to deliver PHC to Aboriginal and Torres Strait Islander peoples
Funds Aboriginal and Torres Strait Islander-specific initiatives to address issues such as maternal and child health, smoking, mental health, and drug use
Seeks to strengthen the health system so that it works better for Aboriginal and Torres Strait Islander peoples.
Please see the Department of Health’s website for more information on the IAHP.
The team has commenced data gathering for Cycle 1 of the evaluation. This involves:
Undertaking engagement through interviews and yarns with ACCHSs, PHNs, members of the community and other organisations or people key to improving PHC systems in the evaluation sites across Australia
Extracting data from existing national level quantitative data sets
Developing coding frameworks and analysing data collected through interviews and yarns
Identifying preliminary findings from this analysis to inform workshops to establish shared priorities and an agenda for change in each site
Completing the first cross-cutting collaborative that examines how well the health system for Aboriginal and Torres Strait Islander people responded to the COVID-19 pandemic
From time to time we will be inviting people to provide views on specific questions we have. These will be found under the ‘Have your say’ button below.
To ask us a question, or to provide us with any comments you have on the evaluation at any time, please click on the ‘Ask us a question’ button or email us at IPHCeval@allenandclarke.com.au
Last modified 19/08/2019
Reports
The IAHP Yarnes Year One Report Summary is available here.
The evaluation will focus on the Australian Government’s main investment in primary health care for Aboriginal and Torres Strait Islander peoples, which occurs primarily through the Indigenous Australians’ Health Programme (IAHP). The IAHP:
Funds organisations to deliver primary health care to Aboriginal and Torres Strait Islander peoples.
Funds Aboriginal and Torres Strait Islander-specific initiatives to address issues such as maternal and child health, smoking, mental health, and drug use.
Seeks to strengthen the health system so that it works better for Aboriginal and Torres Strait Islander peoples.
The evaluation was designed by an independent team of evaluators and researchers. As well as reviewing documents and literature and mapping existing data to evaluation questions, the design process included:
Co-design processes with a group of health sector and evaluation specialists and with Aboriginal and Torres Strait Islander communities.
Seeking input from a wider group of people working in primary health care across Australia.
An evaluation co-design phase occurred from November 2017 to April 2018. The implementation phase began in November 2018 and will end in December 2023.
Year One Report Summary: Site Engagement – July 2020
Monitoring and Evaluation Design Report
