The focus of the exploratory research detailed in this paper is on Indigenous participation in health sciences education and training. While there is evidence in recent years of increasing levels of participation in higher education in general by Indigenous students, until now it has been unclear to what degree that trend has carried over into the health fields. The research was undertaken in order to identify and analyse available data pertaining to Indigenous health training participation in higher education with an aim to assist policy makers in shaping workforce development efforts in the various health fields. The research articulates with a broad base of policy study, strategy and framework documents relevant to the continuing development of an Indigenous health workforce.

Data sources and key variables

This research involved analysis of higher education data compiled annually by the Department of Education, Training and Youth Affairs (DETYA), previously Department of Employment, Education, Training and Youth Affairs (DEETYA). These data are reported by the 43 (in 1997) public higher education institutions receiving government operating grants. The unpublished DEETYA data analysed in this study provide a useful depiction of current patterns of Indigenous participation in higher education health training. The key variables used in this analysis are: field of study; State/Territory; level of course; and gender and enrolment type. These variables are framed within two types of student data sets used by DEETYA on commencing students and award course completions.

Findings: commencing students

The analysis of data related to Indigenous higher education students commencing studies in health reveals that:

• In 1997, there were 351 Indigenous higher education students who commenced studies in the field of health, a decline from the previous two years.
• While the proportion of all Australian students in health was steady at about 11 per cent during the period 1995-97, the Indigenous proportion dropped from 12 per cent to 9 per cent.
• 50 per cent of commencing students in 1997 were enrolled in the health support activities field of study, a field that includes courses of study related to health administration, counselling and surveying, environmental health and occupational health and safety.
• 34 per cent of 1997 students were enrolled in health sciences and technologies. Most in this field of study were nursing students.
• The number of Indigenous students commencing studies in nursing declined by 32 per cent (from 132 to 90) between 1995 and 1997.
• The number of commencing students in medicine doubled between 1995 and 1997 (from 6 to 12), yet only one Indigenous student commenced study in the field of dentistry in 1997.
• The highest numbers of commencing students in 1997 were in New South Wales (104) and Western Australia (71).
• Overall, between 1995 and 1997, declines in the numbers of commencing students were apparent in New South Wales, Victoria, Tasmania and for the multi-campus Australian Catholic University. Between 1995 and 1997, modest increases in commencing student numbers were apparent in the Northern Territory, Queensland and South Australia.
• Declines in the numbers of bachelors and non-award commencing students were offset by increases at both the pre-bachelor and post-bachelor levels.
• In 1997, males comprised 27 per cent of all commencing Indigenous students in health; in comparison, 24 per cent of all Australian commencing students in health were male.
• Between 1995 and 1997, full-time enrolments increased while part-time enrolments declined; in 1997, 75 per cent of commencing students were full-time students.

Findings: course completions

The analysis of data related to Indigenous higher education students completing courses of study in health reveals that:

• Indigenous completions in health are rising, climbing 65 per cent between 1994 and 1996. There were 158 completions in 1996.
• Nearly half (45 per cent) of all completions in 1996 were in the health support field of study; these represent completions at lower qualification levels.
• 42 per cent of completions in 1996 were in health sciences and technologies (most of these were in nursing).
• In 1996, the proportion of Indigenous students completing courses in health was higher than the proportion of all Australian students (about 17 per cent and 14 per cent, respectively).
• Most of the course completions in 1996 were in New South Wales, the Northern Territory and Queensland, accounting for over 75 per cent of all completions.
• 53 per cent of completions were at the bachelor's level in 1996.
• Indigenous students were far more likely to have completed lower level (pre-bachelor) courses in 1996 than other Australians (34 per cent versus 1 per cent), and Indigenous students are much less likely to have completed higher level (post-bachelor) courses than other Australians (13 per cent versus 2.5 per cent).
• Completing students in 1996 were predominantly female (66 per cent) but the male proportion was growing. In comparison, females comprised 78 per cent of completing students among other Australians.
• 59 per cent of completions in 1996 were by full-time students.
• Females who completed courses in 1996 were nearly four times more likely than males to be external students.

Implications for policy

Among the policy implications identified are:

• There is a need to implement a system for routine performance monitoring of Indigenous student participation in the higher education health sector.
• There remains a need to develop an effective inter-sectoral relationship between departments such as DETYA, Department of Health and Aging (previously Department of Health and Family Services) and State and Territory governments with respect to the development of a coherent national strategic framework for Aboriginal health worker education and training.
• There is a need to promote the development of a national strategy involving a targeted recruiting program for Indigenous students to undertake studies in health sub-fields relevant to specific Indigenous health problems (e.g., nutrition, health counselling and podiatry).
• The number of Indigenous students commencing studies in nursing, a field traditionally of interest to Indigenous students, appears to be declining rapidly. Given the critical role played by nurses in health provision, particularly to remote Indigenous communities, this issue requires immediate attention.
• The highest proportion of Indigenous commencing students is in health support, a field of study which tends to yield a relatively lower level of qualification. The lack of depth in the current profile of students raises significant questions about existing capacity to develop and sustain a cadre of Indigenous public health and health sciences leaders and policy makers.
• Indigenous health education students in the higher education sector are predominantly female. This pattern mirrors an existing gender bias in the public health field in Australia, but has significance for Indigenous health care provision where cultural constraints surrounding interaction between the sexes may affect the willingness of Indigenous men to seek out health care.
• A high proportion (75 per cent) of Indigenous students in health sciences programs begin their studies as full-time students, but only 59 per cent of completing students are enrolled full-time (this is similar to the pattern for all Australians). This suggests that it is important that programs to promote and assist part-time study among such health workers be supported.

ISBN: 0 7315 2606 6

ISSN:1036 1774