National Strategic Framework for Aboriginal and Torres Strait Islander Health 2003-2013

Introduction

To ensure that Aboriginal and Torres Strait Islander peoples enjoy a healthy life equal to that of the general population that is enriched by a strong living culture, dignity and justice.

Page last updated: 30 August 2011

This is the second Australian Government Implementation Plan against the National Strategic Framework for Aboriginal and Torres Strait Islander Health 2003-2013. This new Plan will cover the period 2007-2013. All jurisdictions committed to develop implementation plans that detail the specific activities to be undertaken to realise the aims and objectives of the National Strategic Framework for Aboriginal and Torres Strait Islander Health.

Since the National Strategic Framework was signed in 2003, the 17 year disparity in life expectancy between Indigenous and non-Indigenous Australians continues to be the most obvious indicator of overall Indigenous disadvantage. The unacceptable level of health disadvantage still being experienced by Indigenous Australians highlights that there is much still to be done, particularly using a whole-of-government approach, to increase life expectancy and quality of life for Aboriginal and Torres Strait Islander people.

The second National Strategic Framework for Aboriginal and Torres Strait Islander Health Australian Government Implementation Plan builds on the achievements of the first Australian Government Implementation Plan 2003-2008 as identified through qualitative and quantitative reporting and focuses on gaps identified by these reports.

The 2005-06 Progress Report against the Australian Government Implementation Plan, and the Aboriginal and Torres Strait Islander Health Performance Framework 2006 Report both provide important information to allow government to refine and refocus its efforts.

This Australian Government Implementation Plan was developed by the Department of Health and Ageing in consultation with all relevant Australian Government agencies and the National Aboriginal and Torres Strait Islander Health Council. It has a strong emphasis on a whole of government approach to addressing the key priorities identified. This Plan is consistent with the National Strategic Framework’s Goal, Aims and Priorities (see Appendix 1) and retains the same structure of nine Key Result Areas.

Health Performance Framework

The Aboriginal and Torres Strait Islander Health Performance Framework provides quantitative measures relevant to the achievement of the aims, objectives and key result areas of the National Strategic Framework and has been developed to measure the impact of health system efforts under the National Strategic
Framework and the contribution of non-health system determinants. It represents a significant step forward in performance measurement and reporting of progress in Aboriginal and Torres Strait Islander health. The first report finds that there are some areas of improvement (but still room for improvement), such as:
  • overall mortality and infant mortality,
  • deaths caused by circulatory disease,
  • hospitalisation for pneumonia,
  • expansion of Aboriginal and Torres Strait Islander primary health care, top of page
  • immunisation,
  • education, and
  • unemployment,
but several areas of continuing concern, such as:
  • deaths caused by chronic diseases,
  • oral health,
  • hospitalisation for injury and poisoning,
  • sexually transmissible infections,
  • end stage kidney disease,
  • smoking including smoking during pregnancy,
  • low birth weight,
  • nutrition,
  • social and emotional wellbeing,
  • obesity,
  • community safety,
  • physical activity,
  • workforce,
  • relative per capita health expenditure, and
  • chronic ear disease,
  • access to health services.
The Department of Health and Ageing has considered the findings of the report and has identified eight areas that require particular attention. These are included as priority areas of focus in the new Plan. The areas identified are:
  • Smoking, nutrition, alcohol, physical activity, overweight and obesity
  • Chronic disease management (including uptake of Medicare health checks)
  • Access to primary health care (including mainstream GPs) and secondary/tertiary care
  • Sexually transmissible infections (including HIV) and blood borne viruses
  • Oral health
  • Social and emotional well-being (including substance use and mental health)
  • Urban areas (accessibility, appropriateness and affordability of health services)
  • Health determinants – education, employment, economic development, housing and environmental conditions.
In this Plan, the Australian Government has a commitment to strengthen access to culturally sensitive health care services (both Indigenous-specific and mainstream) for Aboriginal and Torres Strait Islander peoples with a particular focus on primary health care. The Plan also has an increased emphasis on addressing the social and environmental determinants of health. A whole-of-government approach recognises that sufficient access to quality, effective health services is an essential requirement but on its own is not enough to increase the life expectancy of Indigenous Australians. Life expectancy is the result of a range of factors, some directly related to health policy and others linked to broader socio-economic and psycho-social factors. Aboriginal and Torres Strait Islander peoples experience disadvantage across a range of social indicators, including employment, income, education, housing and incarceration rates, as well as poorer access to health care services.

The whole-of-government approach to Indigenous affairs offers the opportunity to address the causes of life expectancy disparity through concerted action. top of page

A Whole of Government Approach

There have been significant changes since the National Strategic Framework was signed in 2003. However, the Framework in many ways anticipated the
whole of government approach to Indigenous Affairs and is entirely consistent with the changed approach.
In 2003, the National Strategic Framework recognised that:

“Resolving the issues underpinning Aboriginal and Torres Strait Islander health problems is a shared responsibility requiring partnerships between Aboriginal and Torres Strait Islander organisations, individuals and communities, and a number of government agencies across all levels of government. It requires concerted action both across and beyond the health sector to address the complex and inter-related factors that contribute to the causes and persistence of health problems amongst Aboriginal and Torres Strait Islander peoples.”

In 2004, the Australian Government changed its approach to Aboriginal and Torres Strait Islander affairs. It abolished the Aboriginal and Torres Strait Islander Commission (ATSIC) and the Aboriginal and Torres Strait Islander Services (ATSIS) and introduced new arrangements. Under these arrangements, the Australian Government’s Aboriginal and Torres Strait Islander programs are now administered by mainstream agencies, but under a whole-of-government approach.

This approach also involves the preparation of a single Indigenous Budget submission, where all new policy proposals from Ministers for government investment in Indigenous-specific initiatives are considered together in a single submission. A summary of 2007-08 Indigenous Affairs Budget Measures is at Appendix 2.

This plan is consistent with the key areas of need in the Australian Government's overarching Blueprint for Action in Indigenous Affairs. The three priority

are as identified in the Blueprint are:
  • Early childhood intervention;
  • Safer communities; and
  • Building wealth, employment and an entrepreneurial culture.
The Plan is also consistent with COAG’s National Framework of Principles for Government Service Delivery to Indigenous Australians and the Overcoming Indigenous Disadvantage Framework (see Appendix 3). Alignments with the OID framework strategic areas for action are mapped in this plan for each applicable KRA.

Actions identified in the Plan signal the range of Australian Government agencies responsible for implementation, in accordance with a whole-of-government approach and according to the Australian Government’s arrangements for Indigenous affairs. top of page

Utilising Indigenous Coordination Centres to Meet Local Needs

Engagement with Aboriginal and Torres Strait Islander communities and development of specific responses under this Plan may also occur through the regional network of Indigenous Coordination Centres (ICCs). Through these arrangements, tailored responses for Aboriginal and Torres Strait Islander communities can be developed, in consultation with communities, and implemented by officers from different Australian Government agencies, and with officers from other levels of government, working together. These officers may include dedicated solution brokers. Arrangements may be through Shared Responsibility Agreements and State and Regional Partnership Agreements.

Utilising the Framework Agreements on Aboriginal and Torres Strait Islander Health

Engagement with State Affiliates of the National Aboriginal Community Controlled Health Organisation (NACCHO) and with State and Territory governments in the development of specific responses under this Plan is also necessary. This occurs through the State/Territory Health Partnership Forums in each jurisdiction according to the Framework Agreements.

Monitoring and Reporting

As required under the National Strategic Framework, the Australian Government will continue to produce a qualitative report to AHMC on health portfolio progress against this implementation plan every year and on the contribution of all portfolios every two years. A further report against the Aboriginal and Torres Strait Islander Health Performance Framework will be produced in 2008 and every two years thereafter.

In its role of providing policy advice to AHMAC, the National Aboriginal and Torres Strait Islander Health Council (NATSIHC) will monitor the National Strategic Framework implementation process. The National Aboriginal and Torres Strait Islander Health Officials’ Network (NATSIHON) will retain an informal role in relation to reporting requirements. Health Council will also develop an evaluation strategy against which the National Strategic Framework for Aboriginal and Torres Strait Islander Health will be measured.

This Plan recognises that all health information pertaining to Aboriginal and Torres Strait Islander peoples must be managed ethically and meaningfully in a manner which is consistent with the National Aboriginal and Torres Strait Islander Health Data Principles endorsed by AHMAC in 2006.

Timeframe

All actions contained in this plan, where a timeframe for implementation is not specifically stated, will be ongoing. Within the priority areas of focus, the Australian Government has identified actions of immediate priority. These are consistent with the Australian Government’s Blueprint for Action in Indigenous Affairs and are listed at the start of each Key Result Area. The actions listed as immediate priorities are to be initiated in the current year, but may also be ongoing. top of page