Evaluating our First Nations health programs

Outreach Programs Evaluation Report

Our outreach programs aim to reduce the disparity in access to health services between metropolitan and regional and remote areas of Australia. The outreach programs include:

• Medical Outreach Indigenous Chronic Disease Program
• Rural Health Outreach Fund
• Visiting Optometrists Scheme
• Eye and Ear Surgical Support Scheme
• Healthy Ears – Better Hearing, Better Listening
• Heart of Australia.

In 2022, the organisation Health Policy Analysis evaluated:

• the delivery, efficiency, and effectiveness of the outreach programs
• the coordination of activities across programs
• whether the programs achieved their intended outcomes.

The evaluation found the programs are working well. Stakeholders consistently acknowledged the programs’ essential role in increasing access to a range of health services for communities where they otherwise would not have been available.

Australian Government response to the evaluation report

The Australian Government welcomes the findings of the evaluation and acknowledges the importance of programs that reduce the difference in service access between Australians living in metropolitan and rural and remote Australia.

To learn more, see the Australian Government response to the Evaluation of Outreach Programs Report.

IAHP primary health care system evaluation

In 2017, the department engaged Allen + Clarke Consulting to undertake an independent evaluation of the Indigenous Australians’ Health Programme (IAHP) to:

• Assess how appropriate and effective primary health care services for Aboriginal and Torres Strait Islander people are
• Inform us as we refine primary health care under the IAHP.

Allen + Clarke worked with the First Nations health sector to co-design and conduct the evaluation through:

• a Health Sector Co-design Group made up of key stakeholders
• site partners
• Aboriginal and Torres Strait Islander Health Partnership Forums.
   

The evaluation spanned urban, regional and rural Australia, with 17 sites participating in the evaluation. Sites were chosen in consultation with stakeholders and included local Aboriginal Community Controlled Health Services, Primary Health Networks, communities and relevant stakeholders.

The evaluation was delayed due to the global pandemic, with the final evaluation report being delivered in June 2023.

Key findings 

The Allen + Clarke evaluation identified 11 key findings: 

1. The IAHP provides critical investment in primary health care for Aboriginal and Torres Strait Islander people
2. People value comprehensive, holistic, high-quality health care
3. People do not routinely experience health care that aligns with what they value in health care design and delivery
4. ACCHSs carry significant responsibility within their communities
5. Mainstream health settings cannot reproduce the experience of community-driven, place-based care
6. IAHP funding is too low for services to consistently deliver values-aligned care
7. Reporting and administrative burden has improved under the IAHP but remains too onerous for many services
8. Orientation and role of the IAHP in broader primary care system lacks clarity
9. Administration of the IAHP is not well integrated to the broader health policy and funding landscape
10. Client journeys and outcomes are not tracked through data and reporting processes
11. There are complex relationships between primary care activity, social determinants of health and health outcomes. 
     

Australian Government response to the evaluation report

The Australian Government welcomes the findings of the evaluation and remains committed to achieving improved health outcomes for First Nations peoples.

The Government is delivering on this commitment through implementation of key frameworks including the National Agreement on Closing the Gap (National Agreement), the National Aboriginal and Torres Strait Islander Health Plan 2021-2031 (Health Plan) and the National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework and Implementation Plan 2021-2031 (Workforce Plan). The IAHP is a key initiative supporting the implementation of these frameworks.

First Nations people’s interactions with the health system is complex, and there are a wide range of factors that affect health outcomes in the population that extend beyond the scope of the IAHP. The IAHP does, however, provide an opportunity to have significant impact on the health system and on health outcomes for First Nations people in Australia. 

The IAHP evaluation provides a valuable contribution to the evidence-base that examines the appropriateness and effectiveness of the Australian Government’s investment in Aboriginal and Torres Strait Islander primary health care. Insights from this evaluation will help to inform future prioritisation and investment of funds within the IAHP and will support continual policy and program improvement.

Tackling Indigenous Smoking evaluation

Our Tackling Indigenous Smoking (TIS) program aims to reduce tobacco use among Aboriginal and Torres Strait Islander Peoples.

Monitoring and evaluation for the TIS program involves:

• local evaluation of activities and project outcomes – done by participating organisations
• national evaluation of all the components of the TIS program – done by organisations that we commission.

The national evaluation report for 2015 to 2018 is available.

The Australian National University is conducting an impact and outcomes assessment. The assessment will identify what impact locally-tailored population health activities have on smoking rates and related indicators for Aboriginal and Torres Strait Islander people.

This quantitative evaluation includes the analysis and reporting of relevant data from:

• the Mayi Kuwayu study: national study of Aboriginal and Torres Strait Islander wellbeing
• the Australian Bureau of Statistics
• the National Perinatal Data Collection
• continuous quality improvement measures from ACCHSs
• other datasets that include the Pharmaceutical Benefits Scheme.

See more on TIS monitoring and evaluation.