Reconciliation Week and findings from an Aboriginal health evaluation

Six years ago I worked with colleagues to evaluate a health program operating in five Western Australian communities where Aboriginal people were chronically under-served. The state government funded mainstream organisations to employ Aboriginal community workers, conduct healthy lifestyle activities and improve referrals to health services.

We employed a unique methodology and came up with findings that are still relevant. I’m chuffed that every few months another person asks me for the report.

The evaluation covered most dimensions primary health care delivery: governance, coordination; workforce development; community demand; prevention; quality care and increased access.

My team put a lot of effort into developing a robust and replicable methodology to capture what the program was really likely like for participants, workers, their host organisation and other organisations in the community.  Data collection was done by small teams of Aboriginal and non-Aboriginal researchers to ensure the interviews and analysis were done in a culturally secure and informed manner.

Our four main findings are listed below.  They were offered in an effort to contribute evidence of what mainstream organisations needed to do in order to serve Aboriginal people better.  At the core of these recommendations are the goals of Reconciliation Week: relationships based on trust and respect; equal opportunities for Aboriginal people; active support of reconciliation by institutions; valuing the contribution of Aboriginal people and understanding and accepting the impact of the wrongs of the past.

  1. Effective governance is critical. Without good processes, projects had poor impact and outcomes. Correct processes require the full support of senior management in an organisation. These should include a commitment to a Reconciliation Action Plan, development of consultation protocols with the Aboriginal community, and orientation for all staff in working with Aboriginal people.
  2. Workforce development is also an important success factor. Aboriginal project workers, especially those working in mainstream organisations, can feel isolated and this affects their ability to work effectively. Clarity of roles, effective line management, and mentoring by someone with content expertise were strategies used by some projects to increase the confidence and capacity of Aboriginal staff.
  3. Relations with other service providers were also crucial to achieving improved access. Weak relations compromised health outcomes because most other services lacked Aboriginal workers and could have benefited from closer links with the project. Projects that had better service integration used a steering or advisory group of local service providers and formal agreements about collaboration.
  4. Formal strategic plans and monitoring tools can be alienating for workers and are not associated with project success. An agreed set of activities and targets are sufficient for projects. These should be developed with other services – after working with the Aboriginal communities to set priorities. Monitoring should take place through conversations between workers, other services and the community about what worked, what did not work, and what should be done next. One project which had a good record of collaboration called this process ‘yarning.’

More information on the evaluation, including summaries and the full report can be found here.

Categories: Blog Evaluation methods Health Tags: , , ,

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