cultural respect framework cultural respect framework - SA.Gov.au

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• Localised decision-making: health authorities devolving decision-makingcapacity to local Aboriginal and Torres Strait Islander communities to define theirhealth needs and priorities and arrange for them to be met in a culturallyappropriate way in collaboration with Aboriginal and Torres Strait Islanderspecific and mainstream health services.• Promoting good health: recognising that health promotion and illness preventionis a fundamental component of comprehensive primary health care and must be acore activity for specific and mainstream health services.• Building the capacity of health services and communities: strengthening healthservices and building community expertise to respond to health needs and takeresponsibility for health outcomes. This includes effectively equipping staff withappropriate cultural knowledge and clinical expertise, building physical, humanand intellectual infrastructure, and fostering leadership, governance and financialmanagement.• Accountability for health outcomes: recognising that accountability is reciprocaland includes accountability for health outcomes and effective use of funds bycommunity controlled and mainstream services to governments and communities.Governments are accountable for effective resource application through long-termfunding and meaningful planning and service development in genuine partnershipwith communities.2.4 The Dimensions of a Cultural Respect FrameworkThere are many well intentioned and designed programs and initiatives acrossjurisdictions that aim to improve the cross-cultural skills and abilities of health serviceproviders in responding to Aboriginal and Torres Strait Islander peoples. Differentlabels are used across the jurisdictions and the meanings are not necessarilyconsistent. For a number of years the policy focus has been on knowledge buildingand awareness raising that has variously resulted in more culturally skilled practiceand changed behaviour. For many commentators, this focus on inputs and on theindividual worker rather than on outputs and outcomes at the whole-of-system level is17 18increasingly problematic.The Cultural Respect Framework is not another tool for building cross-culturalcompetency. It is an overarching framework that recognises that a concerted effortacross a number of dimensions is required to systematically lift the culturalcompetency of mainstream health services. The challenges of today are aroundsystematic action, value-adding and lifting the bar. A useful example for alljurisdictions, especially public hospitals, comes from the Northern Territory.The Northern Territory Government has established an NT AboriginalInterpreter Service comprising 245 qualified registered Aboriginalinterpreters and 104 registered Northern Territory spoken Aboriginal17 Aboriginal Cultural Security: Background Paper, Health Department of Western Australia, page 1118 Dench McLean Pty Ltd, Report to New South Wales Health Regarding The Effectiveness of CulturalAwareness Training, page 219
languages. The public hospitals are the major users of this service forthe provision of quality of treatment, service standards and informedconsent issues. The Commonwealth Government has recentlyconducted an evaluation and review of this program and is satisfiedthat the program is successful. As a result, the Government hascontinued funding until August 2004.Fig 1 - The Dimensions of a Cultural Respect FrameworkEquity of OutcomesOUTCOMESStrong RelationshipsSkilled Practice and BehaviourOUTPUTSKnowledge and AwarenessINPUTSAs presented in Fig 1, the Cultural Respect Framework recognises that it is importantto have strategies and initiatives across the range of dimensions.Knowledge and Awareness - this is the individual cognitive dimension where thefocus is on understandings and awareness of the history, experience, culture and rightsof Aboriginal and Torres Strait Islander peoples. The goal in this dimension is tochange attitudes to facilitate changes in behaviour and ensure that all jurisdictionshave relevant programs. It is well recognised, however, that influencing attitudes is acomplex proposition and programs are focusing now on building stronger links to theaction dimension.Skilled Practice and Behaviour - this is the action dimension where the focus is onchanged behaviour and practice. Strategies include formal education and training aswell as strong performance management processes to encourage good practice andculturally appropriate behaviour. Recognising the legitimacy of traditional health10
Page 1 and 2: CULTURALfor Aboriginal andTorres St
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Page 18 and 19: The following practical examples of
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Page 22 and 23: SELECTED BIBLIOGRAPHYThe key docume

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