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Aboriginal and Torres Strait Islander Health Performance Framework - Summary report

The Aboriginal and Torres Strait Islander Health Performance Framework

Since 2006, Aboriginal and Torres Strait Islander Health Performance Framework (HPF) reports have provided information about Indigenous Australians’ health outcomes, key drivers of health and the performance of the health system.

The HPF was designed, in consultation with Aboriginal and Torres Strait Islander stakeholder groups, to promote accountability, inform policy and research, and foster informed debate about Indigenous Australians’ health.

The Aboriginal and Torres Strait Islander Health Performance Framework

The HPF is made up of 68 measures across three levels, or tiers:

Tier 1: Health status and outcomes

Tier 2: Determinants of health

Tier 3: Health system performance

Each HPF measure represents a health-related concept that is explored in detail, using various indicators drawn from relevant data sources and research.  It is important to note that measures in the 3 tiers are interconnected, and understanding the reasons for progress (or lack thereof) in the health status and outcomes of Indigenous Australians (Tier 1) may often be best understood by examining relevant measures in Tier 2 (determinants of health) and Tier 3 (performance of the health system).

The HPF illustrates change that has occurred for the measures, and draws implications for further improvement. It also explores differences within the Indigenous population by age, geography and other characteristics. This helps identify what is working well and how to better target policy and services to meet the needs of Indigenous Australians.

The HPF reporting process is overseen by a Steering Committee made up of Aboriginal and Torres Strait Islander representatives and other stakeholders. These include:

  • an Aboriginal and Torres Strait Islander person as Chair
  • the National Aboriginal Community Controlled Health Organisation
  • a Torres Strait Islander representative
  • the Australian Institute of Health and Welfare
  • the National Indigenous Australians Agency
  • the Australian Government Department of Health
  • two state health departments
  • epidemiologists

The design of the HPF recognises that the health system and factors beyond the health sector contribute to health outcomes, and that achieving better health outcomes requires a whole-of-government approach, working in partnership with Aboriginal and Torres Strait Islander people (AHMAC 2006).

Information from HPF reporting has been used, in part, to monitor progress towards achieving Australian governments’ Closing the Gap health targets and the Implementation Plan goals for the Aboriginal and Torres Strait Islander Health Plan 2013–2023 (Department of Health 2019).

A key theme from the research is the importance of culturally competent service delivery, and the need to partner with and share decision-making with Aboriginal and Torres Strait Islander people in the design of services and programs that affect them.

While there are organisations across sectors that provide culturally competent services to Indigenous Australians, the HPF highlights the crucial role of Aboriginal Community Controlled Health Services. These services provide comprehensive, culturally appropriate and safe primary health care services for Indigenous Australians throughout their lives.

The HPF also highlights where mainstream services are not adequately meeting the needs of Indigenous Australians, or where there are service gaps.

The Cultural safety in health care for Indigenous Australians: monitoring framework aims to measure progress in achieving cultural safety in the Australian health system by bringing together data focusing on:

  • culturally respectful health care services
  • patient experience of health care among Indigenous Australians
  • access to health care (AIHW 2019a).