OORA200 Working with Aboriginal People Manita Shrestha 220235846

CASE STUDY REPORT: EVALUATING THE IMPACT OF CLOSING

Student’s name: Manita Shrestha

Student ID: 220235846

Unit code and name: OORA200 Working with Aboriginal People

Unit coordinator: Darin Gorry

Word count: 2527

Due date: 20/09/2021

Extension due date: 27/09/2021

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Table of Contents

Abstract ............................................................................................................3

Introduction ......................................................................................................4-5

Identify successes of program .........................................................................5-7

Identification of problems of program ............................................................7-9

Solutions to identified problems. What could improve the program? ............9-11

Discussion and conclusion….........................................................................11-

13

Recommendations ........................................................................................13-14

References .....................................................................................................15

Abstract

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Closing the gap is a policy that has been created by the Australian governments

to close the gaps between Indigenous and other Australians. This case study

report emphasizes the achievements, issues, solutions and recommendations of

the closing the gap policy in health outcomes of Indigenous people in Australia.

Social determinants of health such as education, housing, employment, health

facilities are the main areas of concern of this policy. 

Moreover, this study has mentioned the main targets of the Closing the Gap

policy. Although the child mortality rate is on track it has not met the target yet.

However, the “Housing for Heath” project has focused on safety and healthy

living practices by providing maintenance services to Indigenous people.

Similarly, the Aboriginal community is still behind in the education,

employment sector as well as leadership sectors. Therefore, the government

should encourage them to involve in education and employment training by

hiring an excellent trainer. 

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Introduction:

Closing the Gap (CTG) is the policy which targets to enhance the life of

Aboriginal and Torres Strait Islander people in terms of health and wellbeing,

education, employment, justice, safety, housing, land and waters, and languages

to close the gaps in the health discriminations among the indigenous and non-

indigenous people (Fisher et al., 2018). CTG policy has become culturally safe

health services to the Aboriginal people (NSW Department of Health, 2010). 

Close the Gap campaign was launched in April 2007 and focused on ‘closing

the gap’ in life expectancy between Aboriginal and Torres Strait Islander and

non-Indigenous Australians by 2031, on 20 December 2007 by the Council of

Australian Government (COAG) (Victoria State Government, 2014). The given

case study report will explain and evaluate the impact of closing the gap in

terms of the health sectors of Indigenous people.

 The Australian government started a process to refresh the Closing the Gap

agenda in 2017 (Victoria State Government, 2014). The government and

Coalition of Aboriginal and Torres Strait Islander Peak Organisations signed a

formal agreement for partnership in 2019 (Victoria State Government, 2014).

Therefore, they shared responsibility and jointly developing an agreed

framework and new targets and the government and Indigenous people focused

on partnership in 2020 (NSW Department of Health, 2010).

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Similarly, the government of Australia has also created a partnership with the

department of Aboriginal affairs to provide house and infrastructure repairing

and replacing services to Indigenous people as it is one of the major elements

which impacts health (NSW Department of Health, 2010).

Identify success of program

There are many positive aspects of the CGT program. To minimize inequalities

in Aboriginal people’s life expectancy, under 5 years children’s mortality,

education, and employment are the first set targets of CTG policy (Fisher et al.,

2018). One of the successes of CTG policy is the progression in pre-school

education which has set the goal to get 95 per cent of Aboriginal children are

enrolled in education by 2025 and is on track because 86.4 per cent of children

has been enrolled by 2018 (Milroy & Bandler, 2021). 

Secondly, providing primary health care as per the need of Indigenous people to

eliminate health inequalities within Aboriginal and non-Aboriginal Australians

is another successful target of this program (Parter et al., 2018). With the help

of CGT policy, the Australian health care system had distributed budgets to

establish indigenous health authority including cultural safety training among

the health professions to offer better health care service to the Aboriginals

(NSW Department of Health, 2010). According to the Australian government

housing and infrastructure has been identified as the major social determinants

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of health that can cause serious illness (NSW Department of Health, 2010).

Thus, Aboriginal people are very prone to spread infectious diseases like

rheumatic heart disease as they are more likely to live in unhealthy and

overcrowded areas (Green & Minchin, 2014).

Another reason behind successful CTG policy is it helps to provide interim

national partnership agreements in which they offer resources for housing for

very needy people among them to provide safety first and to encourage healthy

living activities such as washing, hygiene, waste management and so on.

Therefore, it reflects the advantages of the CTG policy which is to minimize the

rate of serious illness (Parter et al., 2018).

On other hand, the Australian government has identified the key elements that

are creating gaps between Aboriginal and non-Aboriginal to use health care

services which are become another success of CGT policy (Green & Minchin,

2014). Because of this, the government has special consideration to provide

health facilities as well as cultural sensitivity by developing culturally

competent hospitals for the Aboriginal people to make them happy and

comfortable. 

Additionally, another reason behind the success of CTG policy is the ability to

identify an impact of social determinants of health among Aboriginal people

such as employment (Fisher et al., 2018). As a result of this, the government

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considered building a healthy and strong Aboriginal society by participating

them in community-based training, a high level of leadership training, to make

them capable and independent to promote a healthy lifestyle (Lovell, 2021).

Tackling smoking to reduce the rate of smoking to improve health outcomes

and healthy transition program to adulthood to increase the sense of social and

emotional wellbeing which impacts positively in young and teenagers’ quality

of life (Lovell, 2021). These are the main two health priorities to close the gap

in health areas where the smoking rate has fallen up to 9 per cent between 2002

to 2014-15 (NSW Department of Health, 2010). 

The Australian government is motivating Indigenous students to achieve a

higher level of study to grab opportunities to involve in employment or to

contribute to Indigenous business sectors which helps to improve the quality of

Indigenous people’s life (Skerrett et al., 2018). This is another success of the

CTG policy.

Identification of problems of the program

Although there are many successful events of CGT policy, there are also some

problems identified. The first vital element of Indigenous health is respect and

love towards their land which has been unseen and excluded in CTG policy by

the government (Walter et al., 2020). This may create aggression and negative

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impacts on the mental health of Indigenous people as they may feel like they

have been dominated by non-Indigenous Australians (Parter et al., 2018).

The Aboriginal child mortality rate is one of the focused targets of CTG policy

which shows little improvement since 2008 including attendance at antenatal

care and reduced smoking during pregnancy (Dawson et al., 2020). But the

child mortality rates for non-Indigenous children is still high and the gap is still

wide. 

Similarly, CGT policy has focused on closing the gap among the Indigenous

and non-Indigenous Australians health inequalities which haven’t been solved

till today’s date. As a result, Aboriginal people are still disadvantaged in health

care facilities. The main cause of the problem is racism in healthcare facilities

that are experienced by the CGT policy to reach in set goal (Milroy & Bandler,

2021).

Likewise, the Australian government has not allocated need-based resources

effectively due to which the CTG policy turnout failed (Fogarty et al.,

2021). On other hand, mental health is another issue that the government has

not focused on enough for Aboriginal people, so they are unaware of mental

wellbeing. Because of this, the number of suicidal tendencies has been

increased among the Aboriginal population (Skerrett et al., 2018). Likewise,

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racism between the members of the committee is another problem of CTG

policy.

Additionally, housing for health is one of the set goals to promote Aboriginal

health. It is a survey and fixes methodology to improve the Aboriginal

community lifestyles by assessing, repairing, or replacing health hardware to

ensure the houses are safe to do healthy living activities (NSW Department of

Health, 2010).

The Australian government focused on good housing and the budget allocation

for that is limited for ten years and it excludes aesthetic work such as painting,

and other improvements such as guttering because of the increasing population

rate of Aboriginal people, it may be very hard to provide a home to live healthy

and safe life for them (Bailie et al., 2014).

In these cases, other Aboriginal housing funding programs can do aesthetic

works, however, it is hard to find out accurate data to recognise the work, exact

location and time it has been carried out (NSW Department of Health, 2010).

As a result, the repair work can be repeated in the same house for several years

and other people are unable to get a chance for maintenance services who needs.

It can affect their daily living which may create health-related issues. Thus, it

can be another problem toward the success of CTG policy by reducing its

effectiveness. Reduced crossovers rate and activities are done without focusing

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on health outcomes are the main reason for the unsuccess of CTG policy (Bailie

et al., 2014). 

However, CTG policy targeted to close the gap in school attendance and reduce

the gap in reading and numeracy and employment by 2018 were not met (Bailie

et al., 2014). To improve health outcomes, successful progression and transition

from school are essential but an Indigenous child in years 5,7, and 9 remained

below national standards in reading (Dawson et al., 2020). 

Solutions to identified problems: What could improve the program?

To solve the problems that have been mentioned above, some solutions can be

applied to improve the health outcomes of Aboriginal people. The main issue is

racism. The Australian government should provide better training to the health

staff not only in providing health care but also in cultural sensitivity, the history

of Indigenous people (Fogarty et al., 2021). Therefore, the government should

hire a good trainer or a trainer from Indigenous background who have excellent

knowledge of the history of Aboriginal people and their culture (Dawson et al.,

2020). For this reason, the government may need to invest a large number of

funds, but it can help to reduce the rate of racism in Aboriginal people by

reducing the disparities among Indigenous and non-Indigenous people (Fogarty

et al., 2021).

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Lack of coordination in between housing for a health project and other

Aboriginal housing programs is another issue of CTG policy. Due to that, the

success rate of this projects has been reduced (Victorian State Government,

2014). Therefore, it is very important to improve coordination between housing

for health and other programs by the Australian government. The advantage of

this solution is it can provide excellent housing facilities to provide healthier

and stronger homes by tracking the maintenance work, however, doing this may

create a negative impact on housing for health projects by reducing

effectiveness among the Aboriginal population (Bailie et al., 2014).

To add more, mental health is another problem that has been excluded by CTG

policy. The Australian government hasn’t considered the mental health of

Indigenous people because of that the suicidal tendency rate has been increased

(Skerrett et al., 2018). Disadvantage: to solve this issue the government has to

invest a large number of funds to develop proper mental health facilities with

well-trained counsellors and mental health professionals is to promote the

mental health of Indigenous people along with physical wellbeing. The result

can be beneficial as it will help to decrease the suicide rate (Skerrett et al.,

2018).

Another solution could be proper documentation. The Australian government

should prefer strict documentation to get success in housing for health projects

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(NSW Department of Health, 2010). Doing so may help to track the work,

location and time of housing facilities offered by housing for health and another

Aboriginal housing program. It is an advantage of proper documentation

whereas, the process could be time-consuming and longer (Parter et al., 2018).

The government should follow written documentation once they provide their

repairing services to an individual. This will help to allocate the service as per

the need of Aboriginal people.

Discussion and conclusion

This case study report is about closing the gap in the health aspects of

Aboriginal people. CTG policy plays a vital role to close the gap between

Aboriginal and non-Aboriginal people. It has improved the way of living of the

Aboriginal people by prioritising safety first and healthy living practices later in

effective manner. CTG policy also helps the Aboriginal people to improve

health, employment and education which are the main targets. Furthermore, this

policy also provided housing and maintenance services to Aboriginal people

through the “Housing for Health” project from which they received adequate

housing services. This helps to create a sense of safety and security for

Aboriginal people.

Similarly, smoking tackling and transition to adulthood from teenage for an

Aboriginal child is another positive part of CTG policy. Closing the gap in life

expectancy by 2031 to reduce child under 5 years mortality is also beneficial.

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However, some indigenous people are not satisfied with the CTG policy and its

targets as it does not cover holistic care for indigenous people. For instance, the

Australian government excluded mental health in its policy as a result the

suicidal tendency is still high among them. Moreover, racism in health care

facilities among Indigenous and non-indigenous patient and staffs minimise the

effectiveness of CTG policy. To add on lack of proper documentation is another

negative part of CTG policy which decreases the rate of success of this policy.

Limited budget allocation for housing for health project is another negative

aspect of the CTG policy as it was unable to track and provide housing services

effectively to indigenous people. 

In conclusion, to make the CTG policy more effective, the Australian

government must hire intelligent trainers to train health professionals who are

more aware of the history of indigenous people and cultural sensitivity. It will

help to eliminate health inequalities among them. Similarly, the government can

create cooperation among housing for a health project and other Aboriginal

housing programs to provide need-based maintenance services to provide safety

and security to indigenous people. Likewise, proper documentation is also

essential to track the work in housing for health projects to avoid repetition of

service in the same house for many years and provide need-based housing

services among them. Along with that, it is important to offer mental health

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services and develop special targets to promote the mental and physical

wellbeing of indigenous people. 

Recommendations

The first thing that the government needs to follow is proper planning on health

policy. To provide effective health services to Aboriginal people it is very

important to set a plan as per the need of the recipient. Unplanned action will

never be successful. To add on, the government must include mental health by

developing special mental health services with mental health professionals to

recognize mental health problems and to promote counselling services which

may help to minimize the number of Aboriginal people who attempts suicide.

In the same context, proper planning on budget allocation considering future

changes may be beneficial for the government which helps to provide

sustainable facilities to an Aboriginal community as an evidence-based practice.

Providing strong leadership training, diversity, and cultural awareness training

(Aboriginal and non-Aboriginal people), participating indigenous staff in job

opportunities and education showing respect towards an indigenous cultural

belief may help to achieve targeted health outcomes. 

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children’s carers: a cohort study in Australian Aboriginal

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2458-14-472

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A. (2020). Closing the Gap: Examining how the problem of Aboriginal

and Torres Strait Islander disadvantage is represented in

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Fisher, M., Battams, S., Mcdermott, D., Baum, F., & Macdougall, C. (2018).

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Reality for Australia's National Aboriginal and Torres Strait Islander

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