Skip to main content
Top
Published in: BMC Health Services Research 1/2019

Open Access 01-12-2019 | Research article

Working well: strategies to strengthen the workforce of the Indigenous primary healthcare sector

Authors: Crystal Jongen, Janya McCalman, Sandy Campbell, Ruth Fagan

Published in: BMC Health Services Research | Issue 1/2019

Login to get access

Abstract

Background

The capacity of the Indigenous primary healthcare (PHC) sector to continue playing a crucial role in meeting the health needs of Aboriginal and Torres Strait Islander Australians is in large part reliant on the skills, motivation and experience of its workforce. While exhibiting many workforce strengths, the sector faces significant challenges in building and maintaining a strong and stable workforce. Drawing on data from one Aboriginal Community Controlled Health Service (ACCHS), this study reports what is working well and what could be improved to strengthen the Indigenous PHC sector workforce.

Methods

Using grounded theory methods, interviews with 17 ACCHS staff from a range of organisational positions were transcribed, coded and analysed. This paper focuses on the strategies identified that contribute towards strengthening the Indigenous PHC workforce.

Results

Four overarching strategies for Indigenous PHC workforce strengthening were identified. These were Strengthening Workforce Stability, Having Strong Leadership, Growing Capacity, and Working Well Together. A range of enabling factors at the macro, community, organisational and individual levels were also identified.

Conclusion

Indigenous PHC services are already implementing many important workforce-development strategies that are having a positive impact on the sector. There are also several persistent challenges which need to be addressed through action at organisational and structural levels. Approaches to workforce strengthening in Indigenous PHC should be tailored to local needs to ensure they address the unique workforce challenges experienced in different contexts.
Appendix
Available only for authorised users
Literature
1.
go back to reference SCRGSP (Steering Committee for the Review of government service provision). Overcoming Indigenous Disadvantage: Key Indicators 2016. Canberra: Productivity Commission; 2016. SCRGSP (Steering Committee for the Review of government service provision). Overcoming Indigenous Disadvantage: Key Indicators 2016. Canberra: Productivity Commission; 2016.
2.
go back to reference Health Workforce Australia. Aboriginal & Torres Strait Islander Health Worker Project: Interim Report. Adelaide: Health Workforce Australia; 2011. Health Workforce Australia. Aboriginal & Torres Strait Islander Health Worker Project: Interim Report. Adelaide: Health Workforce Australia; 2011.
3.
go back to reference Panaretto KS, et al. Aboriginal community controlled health services: leading the way in primary care. Med J Aust. 2014;200(11):649–52.CrossRef Panaretto KS, et al. Aboriginal community controlled health services: leading the way in primary care. Med J Aust. 2014;200(11):649–52.CrossRef
4.
go back to reference Macfarlane F, et al. A new workforce in the making? A case study of strategic human resource management in a whole-system change effort in healthcare. J Health Organ Manag. 2011;25(1):55–72.CrossRef Macfarlane F, et al. A new workforce in the making? A case study of strategic human resource management in a whole-system change effort in healthcare. J Health Organ Manag. 2011;25(1):55–72.CrossRef
5.
go back to reference Commonwealth Department of Health and Ageing. In: D.o.H.a. Ageing, editor. Report on the Audit of Health Workforce in Rural and Regional Australia. Canberrra: Commonwealth of Australia; 2008. p. 53. Commonwealth Department of Health and Ageing. In: D.o.H.a. Ageing, editor. Report on the Audit of Health Workforce in Rural and Regional Australia. Canberrra: Commonwealth of Australia; 2008. p. 53.
6.
go back to reference Australian Health Ministers' Advisory Council. In: A. Aboriginal and Torres Strait Islander Health Workforce Working Group, editor. National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework 2016–2023. Canberra: Australian Health Ministers' Advisory Council; 2017. Australian Health Ministers' Advisory Council. In: A. Aboriginal and Torres Strait Islander Health Workforce Working Group, editor. National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework 2016–2023. Canberra: Australian Health Ministers' Advisory Council; 2017.
7.
go back to reference Australian Health Ministers' Advisory Council. In: AHMAC, editor. The Australian National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework 2016–2023. Canberra: Australian Health Ministers' Advisory Council; 2017. Australian Health Ministers' Advisory Council. In: AHMAC, editor. The Australian National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework 2016–2023. Canberra: Australian Health Ministers' Advisory Council; 2017.
8.
go back to reference Lai GC, et al. Factors affecting the retention of indigenous Australians in the health workforce: a systematic review. Int J Environ Res Public Health. 2018;15(5):914.CrossRef Lai GC, et al. Factors affecting the retention of indigenous Australians in the health workforce: a systematic review. Int J Environ Res Public Health. 2018;15(5):914.CrossRef
9.
go back to reference Gwynne K, Lincoln M. Developing the rural health workforce to improve Australian aboriginal and Torres Strait islander health outcomes: a systematic review. Aust Health Rev. 2017;41(2):234–8.CrossRef Gwynne K, Lincoln M. Developing the rural health workforce to improve Australian aboriginal and Torres Strait islander health outcomes: a systematic review. Aust Health Rev. 2017;41(2):234–8.CrossRef
10.
go back to reference Buykx P, et al. Systematic review of effective retention incentives for health workers in rural and remote areas: towards evidence-based policy. Aust J Rural Health. 2010;18(3):102–9.CrossRef Buykx P, et al. Systematic review of effective retention incentives for health workers in rural and remote areas: towards evidence-based policy. Aust J Rural Health. 2010;18(3):102–9.CrossRef
12.
go back to reference Abbott P, Gordon E, Davison J. Expanding roles of aboriginal health workers in the primary care setting: seeking recognition. Contemp Nurse. 2008;27(2):157–64.CrossRef Abbott P, Gordon E, Davison J. Expanding roles of aboriginal health workers in the primary care setting: seeking recognition. Contemp Nurse. 2008;27(2):157–64.CrossRef
13.
go back to reference Taylor KP, et al. Exploring the impact of an aboriginal health worker on hospitalised aboriginal experiences: lessons from cardiology. Aust Health Rev. 2009;33(4):549–57.CrossRef Taylor KP, et al. Exploring the impact of an aboriginal health worker on hospitalised aboriginal experiences: lessons from cardiology. Aust Health Rev. 2009;33(4):549–57.CrossRef
14.
go back to reference Health Workforce Australia. Growing Our Future: the Aboriginal and Torres Strait Islander Health Worker Project Final Report. Adelaide: Health Workforce Australia; 2011. Health Workforce Australia. Growing Our Future: the Aboriginal and Torres Strait Islander Health Worker Project Final Report. Adelaide: Health Workforce Australia; 2011.
15.
go back to reference Murray RB, et al. Sustaining remote-area programs: retinal camera use by aboriginal health workers and nurses in a Kimberley partnership. Med J Aust. 2005;182(10):520–3.CrossRef Murray RB, et al. Sustaining remote-area programs: retinal camera use by aboriginal health workers and nurses in a Kimberley partnership. Med J Aust. 2005;182(10):520–3.CrossRef
16.
go back to reference Shephard MDS, Gill JP. An innovative Australian point-of-care model for urine albumin: creatinine ratio testing that supports diabetes management in indigenous medical services and has international application. Ann Clin Biochem. 2005;42(3):208–15.CrossRef Shephard MDS, Gill JP. An innovative Australian point-of-care model for urine albumin: creatinine ratio testing that supports diabetes management in indigenous medical services and has international application. Ann Clin Biochem. 2005;42(3):208–15.CrossRef
17.
go back to reference McDermott RA, et al. Community health workers improve diabetes care in remote Australian indigenous communities: results of a pragmatic cluster randomized controlled trial. BMC Health Serv Res. 2015;15(1):68.CrossRef McDermott RA, et al. Community health workers improve diabetes care in remote Australian indigenous communities: results of a pragmatic cluster randomized controlled trial. BMC Health Serv Res. 2015;15(1):68.CrossRef
18.
go back to reference Si D, et al. Aboriginal health workers and diabetes care in remote community health centres: a mixed method analysis. Med J Aust. 2006;185(1):40–5.CrossRef Si D, et al. Aboriginal health workers and diabetes care in remote community health centres: a mixed method analysis. Med J Aust. 2006;185(1):40–5.CrossRef
19.
go back to reference Rayner RD, et al. The case for aboriginal health workers in palliative care. Aust Health Rev. 2007;31(3):430–9.CrossRef Rayner RD, et al. The case for aboriginal health workers in palliative care. Aust Health Rev. 2007;31(3):430–9.CrossRef
20.
go back to reference Stamp G, et al. Aboriginal maternal and infant care workers: partners in caring for aboriginal mothers and babies. Rural Remote Health. 2008;8(3):883.PubMed Stamp G, et al. Aboriginal maternal and infant care workers: partners in caring for aboriginal mothers and babies. Rural Remote Health. 2008;8(3):883.PubMed
21.
go back to reference Wright A, Briscoe K, Lovett R. A national profile of aboriginal and Torres Strait islander health workers, 2006–2016. Aust N Z J Public Health. 2019;43(1):24–6.CrossRef Wright A, Briscoe K, Lovett R. A national profile of aboriginal and Torres Strait islander health workers, 2006–2016. Aust N Z J Public Health. 2019;43(1):24–6.CrossRef
22.
go back to reference Brigg M, Curth-Bibb J. Recalibrating intercultural governance in Australian indigenous organisations: the case of aboriginal community controlled health. Aust J Polit Sci. 2017;52(2):199–217.CrossRef Brigg M, Curth-Bibb J. Recalibrating intercultural governance in Australian indigenous organisations: the case of aboriginal community controlled health. Aust J Polit Sci. 2017;52(2):199–217.CrossRef
23.
go back to reference Campbell S. et al, The establishment of Australian Aboriginal Community- Controlled Health Services: A systematic scoping review. Aust J Prim Health. 2019; In press. Campbell S. et al, The establishment of Australian Aboriginal Community- Controlled Health Services: A systematic scoping review. Aust J Prim Health. 2019; In press.
24.
go back to reference Baba JT, Brolan CE, Hill PS. Aboriginal medical services cure more than illness: a qualitative study of how indigenous services address the health impacts of discrimination in Brisbane communities. Int J Equity Health. 2014;13(1):56.CrossRef Baba JT, Brolan CE, Hill PS. Aboriginal medical services cure more than illness: a qualitative study of how indigenous services address the health impacts of discrimination in Brisbane communities. Int J Equity Health. 2014;13(1):56.CrossRef
25.
go back to reference Freeman T, et al. Case study of an aboriginal community-controlled health service in Australia: universal, rights-based, publicly funded comprehensive primary health care in action. Health Hum Rights. 2016;18(2):93–108.PubMedPubMedCentral Freeman T, et al. Case study of an aboriginal community-controlled health service in Australia: universal, rights-based, publicly funded comprehensive primary health care in action. Health Hum Rights. 2016;18(2):93–108.PubMedPubMedCentral
26.
go back to reference Campbell S, et al. Working Well: Tailoring a workforce development model to deliver sustained improvements in community-controlled health care.Project Report for Gurriny Yealamucka Health Service. Cairns: Centre For Indigenous Health Equity Research, Central Queensland University; 2019. Campbell S, et al. Working Well: Tailoring a workforce development model to deliver sustained improvements in community-controlled health care.Project Report for Gurriny Yealamucka Health Service. Cairns: Centre For Indigenous Health Equity Research, Central Queensland University; 2019.
27.
go back to reference McCalman J, Jones G. Gurriny Yealamucka Health Service Evaluation Report 2014-15. Cairns: The Cairns institute, James Cook University; 2015. McCalman J, Jones G. Gurriny Yealamucka Health Service Evaluation Report 2014-15. Cairns: The Cairns institute, James Cook University; 2015.
28.
go back to reference Campbell S, et al. Transition of primary healthcare services in Yarrabah to community control Project Report for Gurriny Yealamucka Health Service and Queensland Health. Cairns: Centre For Indigenous Health Equity Research, Central Queensland University; 2019. Campbell S, et al. Transition of primary healthcare services in Yarrabah to community control Project Report for Gurriny Yealamucka Health Service and Queensland Health. Cairns: Centre For Indigenous Health Equity Research, Central Queensland University; 2019.
29.
go back to reference Larkins S, et al. Regional health workforce planning in North Queensland: starting with the end in mind. Canberra: Health Workforce Australia; 2014. Larkins S, et al. Regional health workforce planning in North Queensland: starting with the end in mind. Canberra: Health Workforce Australia; 2014.
30.
go back to reference Bainbridge R, McCalman J, Whiteside M. Being, knowing and doing: a phronetic approach to constructing grounded theory with indigenous partners. Qual Health Res. 2013;23(2):275–88.CrossRef Bainbridge R, McCalman J, Whiteside M. Being, knowing and doing: a phronetic approach to constructing grounded theory with indigenous partners. Qual Health Res. 2013;23(2):275–88.CrossRef
31.
go back to reference Charmaz K. Constructing grounded theory: a practical guide through qualitative analysis. London: SAGE. xiii; 2014. p. 208. Charmaz K. Constructing grounded theory: a practical guide through qualitative analysis. London: SAGE. xiii; 2014. p. 208.
32.
go back to reference Glaser BG. Theoretical sensitivity : advances in the methodology of grounded theory. Mill Valley: Sociology Press. x; 1978. p. 164. Glaser BG. Theoretical sensitivity : advances in the methodology of grounded theory. Mill Valley: Sociology Press. x; 1978. p. 164.
35.
go back to reference Topp SM, Edelman A, Taylor S. "We are everything to everyone": a systematic review of factors influencing the accountability relationships of Aboriginal and Torres Strait Islander health workers (AHWs) in the Australian health system. Int J Equity Health. 2018;17(1):67.CrossRef Topp SM, Edelman A, Taylor S. "We are everything to everyone": a systematic review of factors influencing the accountability relationships of Aboriginal and Torres Strait Islander health workers (AHWs) in the Australian health system. Int J Equity Health. 2018;17(1):67.CrossRef
36.
go back to reference Suazo MM. The mediating role of psychological contract violation on the relations between psychological contract breach and work-related attitudes and behaviors. J Manag Psychol. 2009;24(2):136–60.CrossRef Suazo MM. The mediating role of psychological contract violation on the relations between psychological contract breach and work-related attitudes and behaviors. J Manag Psychol. 2009;24(2):136–60.CrossRef
37.
go back to reference Shannon EA. Motivating the workforce: beyond the ‘two-factor’ model. Aust Health Rev. 2019;43(1):98–102.CrossRef Shannon EA. Motivating the workforce: beyond the ‘two-factor’ model. Aust Health Rev. 2019;43(1):98–102.CrossRef
38.
go back to reference Gould-Williams J. The effects of ‘high commitment’ HRM practices on employee attitude: the views of public sector workers. Public Adm. 2004;82(1):63–81.CrossRef Gould-Williams J. The effects of ‘high commitment’ HRM practices on employee attitude: the views of public sector workers. Public Adm. 2004;82(1):63–81.CrossRef
39.
go back to reference Australian Health Ministers’ Advisory Council. National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework 2016–2023. Canberra: Australian Health Ministers' Advisory Council; 2017. Australian Health Ministers’ Advisory Council. National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework 2016–2023. Canberra: Australian Health Ministers' Advisory Council; 2017.
40.
go back to reference Onnis LaL, Pryce J. Health professionals working in remote Australia: a review of the literature. Asia Pac J Hum Resour. 2016;54(1):32–56.CrossRef Onnis LaL, Pryce J. Health professionals working in remote Australia: a review of the literature. Asia Pac J Hum Resour. 2016;54(1):32–56.CrossRef
41.
go back to reference Knights JA, Kennedy BJ. Psychological contract violation: impacts on job satisfaction and organizational commitment among Australian senior public servants; 2005. Knights JA, Kennedy BJ. Psychological contract violation: impacts on job satisfaction and organizational commitment among Australian senior public servants; 2005.
42.
go back to reference Low J. A pragmatic definition of the concept of theoretical saturation. Sociol Focus. 2019;52(2):131–9.CrossRef Low J. A pragmatic definition of the concept of theoretical saturation. Sociol Focus. 2019;52(2):131–9.CrossRef
43.
go back to reference Larkins S, Panzera A, Beaton N, Murray R, Mills J, Coulter K, Stewart R, Hollins J, Matich P, Baird D. Regional health workforce planning in north Queensland: Starting with the end in mind. Adelaide: Health Workforce Australia; 2014. Larkins S, Panzera A, Beaton N, Murray R, Mills J, Coulter K, Stewart R, Hollins J, Matich P, Baird D. Regional health workforce planning in north Queensland: Starting with the end in mind. Adelaide: Health Workforce Australia; 2014.
44.
go back to reference Panzera AJ, et al. Regional health workforce planning through action research: lessons for commissioning health services from a case study in far North Queensland. Aust J Prim Health. 2016;22(1):63–8.CrossRef Panzera AJ, et al. Regional health workforce planning through action research: lessons for commissioning health services from a case study in far North Queensland. Aust J Prim Health. 2016;22(1):63–8.CrossRef
Metadata
Title
Working well: strategies to strengthen the workforce of the Indigenous primary healthcare sector
Authors
Crystal Jongen
Janya McCalman
Sandy Campbell
Ruth Fagan
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-019-4750-5

Other articles of this Issue 1/2019

BMC Health Services Research 1/2019 Go to the issue