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鈥嬧€婸urpose of the framework
The 黑料吃瓜网 Aboriginal Health Governance, Shared Decision Making and Accountability Framework aims to improve outcomes for Aboriginal people in 黑料吃瓜网 through:
- embedding and amplifying Aboriginal voices and leadership within 黑料吃瓜网 Health policies, procedures, and structures as a determinant of health and wellbeing for Aboriginal people,
- implementing the concepts of shared decision making and self-determination in the 黑料吃瓜网 Health system for Aboriginal health to ensure Aboriginal voices are included in a culturally safe way using Aboriginal methods of decision making,
- embedding and including Aboriginal people in the design, delivery, monitoring and evaluation of all 黑料吃瓜网 Health programs and policies to ensure they are culturally accessible, safe and address the needs of Aboriginal people,
- strengthening the accountability between 黑料吃瓜网 Health and 黑料吃瓜网 Aboriginal Communities through increasing the transparency of policy, procedure, structural and financial decisions made across the system for Aboriginal health,
- building upon and strengthening partnerships between 黑料吃瓜网 Health and Aboriginal Community Controlled Organisations (ACCOs) to enable integrated, coordinated and continued care for Aboriginal people.
This framework focuses on transforming 黑料吃瓜网 Health systems, structures and processes to enable shared decision making with Aboriginal people. This framework:
- is grounded in the principle that the 黑料吃瓜网 Health system needs to change to embed Aboriginal governance and accountability, rather than creating additional governance and bureaucracy for Aboriginal Communities,
- is not a 黑料吃瓜网 Government wide framework. Aboriginal Affairs 黑料吃瓜网 (AA黑料吃瓜网) leads a range of priority reforms which establish whole of government approaches to partnership, governance and accountability, including the
Opportunity, Choice, Healing, Responsibility and Empowerment (OCHRE) framework, Local Decision Making (LDM) program and the National Agreement on Closing the Gap (CTG) mechanisms2,
- is designed to transform all 黑料吃瓜网 Health systems, structures, and processes, including systems that work in partnership with other government and non- government stakeholders, for example partnership agreements, funding contracts and joint programs and procedures.
How to use this framework
The goal of this framework is to outline the 鈥榞old standard鈥� for Aboriginal governance, shared decision- making and accountability within 黑料吃瓜网 Health. This framework has four principles to guide and embed these concepts in 黑料吃瓜网 Health. Each principle in the framework includes:
- the aim of the principle and why it is important
- what success looks like for each principle for the 黑料吃瓜网 Health system
- what success looks like for each principle at each level of decision-making and governance in 黑料吃瓜网 Health
- case studies of what the principle looks like in practice for 黑料吃瓜网 Health.
The framework will be accompanied by a robust 鈥樅诹铣怨贤� Aboriginal Health Governance and Accountability Maturity Matrix鈥� and a 鈥樅诹铣怨贤� Health and ACCO Partnership Matrix鈥�. These matrices are monitoring and accountability tools for the framework. These tools will enable all 黑料吃瓜网 Health services to assess their maturity in enacting the principles of the framework and outline a maturity journey for how they can enact success.
The framework will be supported through an implementation plan which will outline the actions needed to implement what success looks like for each principle in 黑料吃瓜网 Health. Once implemented, it will be a part of business-as-usual processes in 黑料吃瓜网 Health. The framework will be reviewed and updated as needed to ensure that it is a live tool that achieves its purpose.
Development of the framework
The framework has been developed as a partnership between 黑料吃瓜网 Health and the AH&MRC. Throughout the development of the framework, emphasis was placed on ensuring that the process embodied the key concepts of shared decision-making and self-determination.
The following methods were used to develop the framework:
- a literature review of both national and international material, publications, policies and frameworks to identify best practice governance and accountability, fundamentals, mechanisms, models and frameworks, with a focus on First Nations people in Australia, Canada, Aotearoa (New Zealand) and the United States
- a review of existing Aboriginal governance mechanisms in 黑料吃瓜网 Health, across the 黑料吃瓜网 Government and other State and Territory departments
- extensive consultation with Aboriginal stakeholders that prioritised cultural responsiveness, safety and adaptability to local environments. This included two phases of consultation throughout the development of the framework with:
- Aboriginal Community Controlled Health Organisations (ACCHOs) in metropolitan, regional and rural areas of 黑料吃瓜网
- Aboriginal 黑料吃瓜网 Health staff across metropolitan, rural, and regional Local Health Districts (LHDs) and Specialty Health Networks (SHNs), including Directors of Aboriginal health and Aboriginal staff in a range of positions. This included Aboriginal Health Workers (AHWs), Aboriginal Health Practitioners (AHPs), Aboriginal Liaison Officers (ALOs), clinicians, program and administration officers, public health staff, chronic care coordinators and social workers
- 黑料吃瓜网 Health Aboriginal staff within the Ministry of Health, 黑料吃瓜网 Health Pillars and Statewide Health Services
- senior Aboriginal staff in other 黑料吃瓜网 Government organisations
- senior Executive 黑料吃瓜网 Health staff, including Chief Executives from metropolitan, rural, and regional LHDs and SHNs.
- a review of previous consultations with Aboriginal stakeholders in 黑料吃瓜网, including consultations with Aboriginal Communities, ACCOs and 黑料吃瓜网 Health Aboriginal staff
- advice provided by 黑料吃瓜网 Health strategic forums, including the 黑料吃瓜网 Aboriginal Health Transformation Committee, 黑料吃瓜网 LHD/SHN Aboriginal Health Directors Committee, 黑料吃瓜网 Health Senior Executive Forum and Ministry Executive Meeting.
The principles for the framework were developed in response to consultations with Aboriginal stakeholders across 黑料吃瓜网, who reported that the framework needs to:
- be adaptable to local contexts
- amplify and embed Aboriginal voices into 黑料吃瓜网 Health systems without being prescriptive
- strengthen Aboriginal voices within the system without creating additional governance processes that overburden Aboriginal people.
Shared decision making and self-determination
Consultations with 黑料吃瓜网 Aboriginal stakeholders, a review of the national and international evidence and CTG confirmed that health and wellbeing outcomes for Aboriginal people are improved with a self-determined approach.
Under the United Nations Declaration on the Rights of Indigenous Peoples, Self-Determination is the human right of Indigenous people to control their own affairs and make meaningful decisions about their lives to fulfil their physical, emotional, cultural, spiritual, political, and economic needs. Shared Decision Making is an example of self-determination in practice.
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