Module 1: Culturally respectful health care services

Structures, policies and processes across the health system all play a role in delivering culturally respectful health care. The provision of culturally safe health care for Aboriginal and Torres Strait Islander people reflects the extent to which health care systems and providers are aware of and responsive to Indigenous Australians’ cultural needs and experiences. Cultural safety cannot be improved in isolation from the provision of health care.

What data are available?

New data were available to update 5 out of 12 measures reported in Module 1 for the 2023 release. The other 7 measures could not be updated due to discontinued data items in the Online Services Report (OSR). For more information see Data gaps and limitationsData sources and data gaps and Technical notes.

The main information source of data for this module is the Online Services Report (OSR). OSR data is collected from organisations funded by the Australian Government to deliver primary health care services to Aboriginal and Torres Strait Islander people under the Indigenous Australians Health Program. The OSR includes organisations providing comprehensive primary care services and organisations providing maternal and child health programs and services. Mainstream services are not included in the OSR data.

The numbers and proportions of Indigenous Australians in the health workforce can also be obtained from the National Health Workforce Data Set and the ABS Census of Population and Housing (the census). Data from the National Health Workforce Data Set are presented in domain 1.3 below. Health labour force data from the census are presented in Measure 3.12 of the Aboriginal and Torres Strait Islander Health Performance Framework. The data from the census differ from the National Health Workforce Data Set due to differences in methodology.

In addition, national data are also reported on Indigenous Australians enrolled in health-related training courses and those registered across the health system, including GPs, nurses and some specialist doctors. The Indigenous workforce is integral to ensuring that the health system addresses the health needs of Indigenous Australians in a culturally safe and sensitive way.

For further information on the data sources used in this module, see Module 1 – Data sources and data gaps.

Key findings

Among the Indigenous-specific primary health care organisations and maternal/child health services reporting to the OSR:

  • Of the total 2,305 FTE employed in the services in 2021–22, 46% were Indigenous. This proportion varied by type of health staff:
    • Aboriginal Health Practitioners/ Aboriginal Health Workers (960 FTE, 99.5%)
    • other health workers including sexual health workers , traditional healers and trainees (1,114 FTE, 52%)
    • GPs (42 FTE, 6.1%)
    • nurses and midwives (189 FTE, 15%).
  • Of the total 217 services, 40% provided interpreter services, while around one third offered culturally appropriate services such as bush tucker, bush medicine and traditional healing in 2017–18.

National health workforce data show that in Australia from 2013 to 2021, the number of Indigenous:

  • medical practitioners registered increased from 247 to 604
  • nurses and midwives registered increased from 2,833 to 6,160.

Higher education statistics from the Department of Education show that from 2001 to 2021, the rate of enrolment in health-related courses for Indigenous Australian students increased from 27 per 10,000 (931 students) to 71 per 10,000 (4,227 students).

See Module 1 data tables for all data presented in this module.

Data gaps and limitations

Following a review of the OSR and nKPI collections in 2018, the collection of specific OSR data items on cultural safety were paused (AIHW 2020). Data collected in 2017–18 reporting period are the latest data available on cultural safety from Indigenous specific primary health care services.

Data on cultural safety in mainstream health services, such as general practitioners, and public hospitals continue to be critical data gaps. Data on these services are required to provide a more comprehensive assessment of cultural safety across the Australian health system.

References

AIHW (Australian Institute of Health and Welfare) 2020. Review of the two national Indigenous specific primary health care datasets: The Online Services Report and the national Key Performance Indicators. Cat. no. IHW 222. Canberra: AIHW. Accessed 20 June 2023.

Module 1 domains