A unique and vital role in rural primary health care

Across the country, Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners have vital and unmatched primary health care roles at the front line of rural and remote health care.

As the peak body for the profession, the National Aboriginal and Torres Strait Islander Health Worker Association (NATSIHWA) seeks to improve recognition for their unique capabilities and scopes of practice within the multi-disciplinary health care team. Increasing professional recognition will help address recruitment, retention and professional development challenges and support more effective workforce utilisation and deployment. Appreciating the distinctive nature of the work that  Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners undertake is important, as their roles are central to building culturally safe relationships between health care services and Aboriginal and Torres Strait Islander communities.

Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners make up the only Indigenous ethnic-based health workforce in Australia. Uniquely, the workforce possesses inherent cultural intellect and social and linguistic knowledge and skills that are central to the provision of culturally safe care and to reducing health service access barriers that can be experienced by Aboriginal and Torres Strait Islander people. Their training foundations in comprehensive primary health care and their lived experience in the communities they serve informs their unique service perspectives and reach. Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners, along with their Aboriginal and Torres Strait Islander health care colleagues, are recognised as being vital to building health system capacity to address the needs of their peoples. Ensuring this capacity in rural and remote health services is essential given that the burden of disease and injury experienced by Aboriginal and Torres Strait Islander people increases by remoteness.

Strategic support for the Aboriginal and/or Torres Strait Islander Health Worker and Health Practitioner workforce varies greatly across jurisdictions impacting its sustainability and optimal utilisation.

Furthermore, per capita there are fewer Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners today than there were in 2006 and the workforce is also ageing. Coordinated strategic planning and investment is required to ensure its sustainability. Underpinning this, is the need to recognise that their roles are vital and unique and cannot be substituted by any other professional group as this would diminish health systems capacity to reach and appropriately respond to the diverse primary health care needs of Aboriginal and Torres Strait Islander people.

Our workforce has a primary health care profile and, effectively, does not sit within any particular discipline or professional field but works with the full range of health professionals providing services in rural and remote areas. While Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners play important roles in directly supporting primary care and specialist service delivery, their roles are not interchangeable with any other professional group. For example, Allied Health Assistants who are Aboriginal and Torres Strait Islander people may undertake similar tasks in the context of the multidisciplinary team, however, the professions have distinctively different qualifications and practice supervision requirements.

The training foundations and scopes of practice of Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners are structured within a comprehensive primary health care framework, with a focus on prevention and health promotion, unlike other health fields which tend to be more narrowly framed. At the Certificate IV level the Aboriginal and/or Torres Strait Islander Health Worker and Health Practitioner qualifications prepare the workforce to undertake a broad range of tasks either individually or as a member of a multidisciplinary team. Comparable qualifications at this level do not generally include the scope to work autonomously which is an important health service capacity consideration.

NATSIHWA seeks to ensure that the unique roles of Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners are understood and recognised to help secure the workforce pipeline into the future and to maintain its contribution to building culturally safe health service systems.  

The National Aboriginal and Torres Strait Islander Health Worker Association (NATSIHWA) is the peak body for Aboriginal and/or Torres Strait Islander Health Workers and Aboriginal and/or Torres Strait Islander Health Practitioners in Australia.