“Aboriginal health to me is the people that provide the service.”
(A participant in the Career Pathways Project)
An Aboriginal-led national research project has been exploring how best to develop and maintain a strong Aboriginal and Torres Strait Islander health workforce.
A widespread and strong Aboriginal and Torres Strait Islander health workforce is crucial for improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples. Aboriginal and Torres Strait Islander health managers struggle every day with recruiting, supporting, developing and retaining a suitably skilled workforce to meet local community needs.
The Career Pathways Project is funded by the Lowitja Institute. This large multi-method and multi-site project has many partners including Bila Muuji Aboriginal Corporation Health Service, Maari Ma Health, Western NSW Local Health District, Western Sydney University, UNSW Sydney and the Aboriginal Medical Service Alliance Northern Territory (AMSANT).
A key focus of the research has been to learn from the real-world experiences of Aboriginal and Torres Strait Islander health staff and their managers, as well as Indigenous health professional associations and other key stakeholders, about their work and career development.
In western New South Wales we conducted a series of yarning circles across community-controlled and mainstream health services to explore in-depth the factors impacting on career trajectories and to generate potential strategies for enhancing career pathways.
We found that Aboriginal and Torres Strait Islander health staff bring many things to a health service beyond their formal qualifications or generic skills. Most importantly, they bring valuable (and often under-valued) cultural expertise and community connections and ways of conducting business. At the core lies their holistic and patient-centred focus, with consideration of the ‘we’ in wellness coming naturally in the ways they work for their communities. Their contributions are both unique and influential, making them vital and irreplaceable members of the health care team.
When it comes to Aboriginal and Torres Strait Islander people enjoying careers in the health sector, it seems that there are barriers all along the way, including financial pressures which impact at every step from recruitment to retirement.
Aboriginal and Torres Strait Islander health staff, and their managers, also identified several enablers to career development and progression. Aboriginal and Torres Strait Islander leadership at all levels of the organisation is essential, along with the ‘right’ governance and management structures and strategies that place cultural safety and cultural values at the forefront. Providing opportunities through identified and targeted recruitment, nurturing staff, developing skills and strengthening culture is important, but this needs to come with the necessary supports to aid staff to make the most of these opportunities.
Working together and growing together with their Aboriginal and Torres Strait Islander colleagues in a team-focused and understanding workplace environment enables Aboriginal and Torres Strait Islander health staff to thrive. Family and community encouragement and support is critical too. These supportive networks help foster resilience to cope with the physical, emotional and spiritual demands of training and working in Aboriginal and Torres Strait Islander health.
Strategies to improve Aboriginal and Torres Strait Islander career pathways in health are necessary at all levels from the ground up: community, organisation, system and society. A focus on providing well-supported and varied opportunities to grow at work will ultimately contribute to the health and wellbeing of Aboriginal and Torres Strait Islander communities.
The Career Pathways Project Team presented a paper Better together: working and growing together will enhance Aboriginal careers in health at the 15th National Rural Health Conference, Hobart 24-27 March 2019. We hope to launch the final project report at the IAHA and CATSINaM national conferences in September 2019.