Beyond Parity in Aboriginal and Torres Strait Islander Health Workforce Planning: Achieving Equity through Needs-Based and Strengths-Based Approaches
Meeting the healthcare needs of Aboriginal and Torres Strait Islander people requires needs-based and strengths-based planning of the Aboriginal and Torres Strait health workforce. Substantial gains have been made over recent decades in growing the Aboriginal and Torres Strait Islander health workforce. However, the overall size of this workforce remains low, retention is poor and workforce growth in some areas is not commensurate with population growth. Through the National Agreement on Closing the Gap, Australian governments have recognised that achieving better Aboriginal and Torres Strait Islander health outcomes requires equity in health system investment, system-wide workplace reforms and strength-based approaches that emphasise partnerships with Indigenous organisations and communities. However, at present there is no national commitment to achieving an equitable number of Aboriginal and Torres Strait Islander people within a culturally safe and responsive health workforce.
We were commissioned by the National Health Leadership Forum to investigate approaches to workforce planning based on the healthcare needs of Aboriginal and Torres Strait Islander people. Through reviews of published literature and existing datasets and a renal case study, we show that needs-based workforce planning requires establishing and modelling targets that take into consideration the burden of disease; geographic location of health needs; access to culturally safe care; and addressing deficiencies in the workforce data currently available. Appropriate workforce planning also requires addressing very low retention rates of Aboriginal and Torres Strait Islander health professionals through structural, system-wide reforms to foster culturally safe workplaces that are free of racism. Realising the need for and contributions of the Aboriginal and Torres Strait Islander health workforce to improving health outcomes necessitates working in partnership with Aboriginal and Torres Strait Islander health peak organisations.