The current framework represents a summary of the main career categories and roles practiced in contemporary Aboriginal Primary Health Care. The main goal of the framework is to understand, and map, non-clinical roles, however, clinical roles are also included to gain a complete picture of the workforce.
For the purposes of this current framework, the emphasis will be on Aboriginal Australians who compromise the vast majority of Indigenous Australians in the NT, however, it is acknowledged there are many similarities between Aboriginal and Torres Strait Islander cultures. For instance, Aboriginal and Torres Strait Islander models of healthcare differ from mainstream models by taking a holistic approach to health and wellbeing. Additionally, for Aboriginal and Torres Strait Islander people, health is intrinsically connected through interrelationships with family, community, and country.
Healthcare models that utilize this holistic approach create healthcare where the direction and treatment, as well as the workforce, is holistically interrelated more broadly than what is considered clinical in the mainstream health and wellbeing services.
Knowledge and practices which have foundations in a culture that impacts social and environmental systems, as well as health, are a necessary part of health systems that support Aboriginal and Torres Strait Islanders. Cultural knowledge and practice is key in healing and can be utilized alongside Western approaches to health and wellbeing care.
Consequently, roles have emerged in Aboriginal health care in the NT based on this holistic model of health and wellbeing. This ranges from using Aboriginal languages in more established roles to creating flexible models of employment more suited to Aboriginal rhythms. This has supported the identification of integral emerging roles, which are newly defined in the mainstream health sector, however, long-established in Aboriginal traditional cultural ways. Some of these include traditional healers, community workers, cultural mentors, and workplace liaisons. A need for Aboriginal people to work across both worlds has seen the development of some of these emerging roles, which enables integral skills to be utilised in creating a new way of working, which is suitable and appropriate to the here and now. For a list of some of these roles, please see below.
Non-clinical roles are defined as those which do not require registration under the Australian Health Practitioner Regulation Agency (AHPRA), but may still require training and qualifications to practice in a competent and ethical manner.
Clinical Roles are more defined, recognised and structured in the Primary Health Care (PHC) workforce compared with non-clinical roles. Clinical roles include medical, nursing, midwifery, Aboriginal and Torres Strait Islander health practice, dental, occupational therapy, optometry, physiotherapy, psychiatry and psychology.
In Aboriginal PHC, within the NT, non-clinical roles for Aboriginal people have been limited to largely non-professional support roles involved in providing and supporting clinical services. These include receptionists, cleaners, drivers, gardeners, maintenance workers, support workers, and community workers. Currently, the progression into other roles requires navigating a system where there are poorly understood ways to build career pathways, which the current report aims to identify and improve.
Some roles in the clinical category including Aboriginal Health Worker (AHW), Aboriginal Health Practitioner (AHP) and Aboriginal Mental Health Practitioner (AMHP) involve cultural knowledge and community expertise as a key part of the role. While the AHW role has a longer history, the AHP has built upon this role with additional training, accreditation, and recognition. The AMHW role has a long history as well but is currently less defined in terms of training and accreditation than the AHP role, these roles are examples of how the sector would benefit from strengthening these roles, as well as additional roles, and training pathways.
Defining and forging training pathways for these emerging roles is of fundamental importance to strengthening the Aboriginal health workforce and quality of care for Aboriginal people.
While many organisations offer cultural safety, cultural awareness, and cultural competency courses - mainly to the non-Indigenous workforce - there appear to be no clear training options for Aboriginal people to become cultural educators or advisors. Despite the real need for such roles, there are no clear options for Aboriginal people to enter the workforce and build career pathways based on their cultural knowledge and experience. Aboriginal people are employed in many health roles where they apply their cultural knowledge and expertise, however, there is currently no formal recognition of this form of cultural expertise.
The only course which offers 'capacity building for and with aboriginal people, organisations and communities' is offered by Cross Cultural Consultants who are based in Darwin. However, details regarding this course and training are not publicly available.
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