Factors supporting retention of aboriginal health and wellbeing staff in Aboriginal health services: a comprehensive review of the literature

Sara Deroy,Heike Schütze

doi:10.1186/s12939-019-0968-4

Sara Deroy, Heike Schütze

Open Access

https://doi.org/10.1186/s12939-019-0968-4

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Abstract

IntroductionAboriginal Health and Wellbeing staff are crucial for successful primary health care for Aboriginal communities. However, they are often affected by high rates of stress, burnout, and staff turn-over, which can impact primary health care delivery to Aboriginal peoples. The aim of this review was to identify organisational factors that help support the retention of Aboriginal Health and Wellbeing staff in Aboriginal Health services.MethodsA comprehensive literature review was undertaken. Eleven electronic databases were searched for papers published between 2002 and 2017 and supplemented by hand searching. Papers were included if they were in English, full text, peer-reviewed, and had a focus on retention of Aboriginal Health and Wellbeing staff, or health staff in comparable roles working in Aboriginal health services. Twenty-six papers were included in the final review.ResultsFive key themes were identified as being important to the retention of Aboriginal Health and Wellbeing staff in Aboriginal Health Services: feeling culturally safe and secure within the workplace; teamwork and collaboration; supervision and strong managerial leadership and support from peers (to debrief, reflect, receive emotional support and strengthen coping mechanisms); professional development (the opportunity for skill development and role progression); and recognition (of work load, quality of work performed, being trusted to work autonomously, and financial remuneration that reflected the high pressure of the role).ConclusionAboriginal Health and Wellbeing staff are fundamental to successful primary health care for Aboriginal peoples. State and Federal Governments should consider formalising recognition of the significant cultural knowledge that Aboriginal Health and Wellbeing staff bring to their roles. Formal recognition could also pave the way to revise remuneration as well as ensure adequate support mechanisms are put in place to improve retention and reduce stress and burnout affecting Aboriginal Health and Wellbeing staff.

Highlights

Aboriginal Health and Wellbeing staff are crucial for successful primary health care for Aboriginal communities
Central to this effort are the roles played by Aboriginal Health and Wellbeing staff within Aboriginal health services
Aboriginal Health and Wellbeing staff are still affected by discrimination in the workforce from their non-Aboriginal counterparts, and the needs exists to ensure that adequate cultural awareness training is undertaken by non-Aboriginal staff

Summary

Introduction

Aboriginal Health and Wellbeing staff are crucial for successful primary health care for Aboriginal communities. Despite prevailing racism and discrimination, Aboriginal Community Controlled Health Services (ACCHS) were established. These services operate and are governed by Aboriginal people, for Aboriginal people, and there are currently over 140 ACCHS’s across Australia [5]. ACCHS’s deliver a range of comprehensive primary health care services for patients, which recognises the impact that the social determinants have on health outcomes and takes a holistic approach to health [6]. This approach is promising for addressing issues like chronic disease prevention and management through social change [6]. Positive social change made by individuals and the community can improve long term health outcomes where medical interventions play a minor or temporary role [7]

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