Abstract
BackgroundStated principles in government policy documents serve as a set of values outlining how governments intend to work. As such, health planning principles should be reflected in health policy across the cycle of planning, implementation and evaluation. Such principles should be reflected in the process of governments commissioning and funding evaluation, and in the work of those commissioned to do evaluation on behalf of governments.MethodsWe reviewed health planning policy documents to identify principles Australian State and Territory and National governments stated as being important to the work they do within Aboriginal and Torres Strait Islander health contexts. Evaluation tenders and reports relating to Aboriginal and Torres Strait Islander health policy, programs and service for the period 1-Jan-2007 to 1-Jan-2017 were retrieved and assessed as to whether they embedded principles governments state as important.ResultsIn Aboriginal and Torres Strait Islander health planning policy contexts, Australian governments outline shared responsibility, cultural competence, engagement, partnership, capacity building, equity, a holistic concept of health, accountability, and evidence-based as fundamental principles that will underpin the work they will do.In total, we identified 390 publicly advertised evaluation tenders, but were only able to retrieve 18 tenders and 97 reports. Despite strong rhetoric placing importance on the abovementioned principles, these were not consistently embedded in tenders released by government commissioners, nor in reports largely commissioned by governments. Principles most widely incorporated in documents were those corresponding to Closing the Gap - accountability, evidence-based and equity. Principles of holistic concept of health, capacity building, cultural competence and partnership do not appear well applied in evaluation practice.ConclusionNotwithstanding the tensions and criticism of current practice that sees dominant governments policing Aboriginal and Torres Strait Islander populations and defining what principles should inform health policy and evaluation practice, this paper reveals shortcomings in current evaluation practice. Firstly, this paper reveals a lack of transparency about current practice, with only 2% of tenders and 25% of reports in the public domain. Secondly, this paper reveals that governments do not ‘walk the talk’, particularly when it comes to principles relating to Aboriginal participation in health.
Highlights
Stated principles in government policy documents serve as a set of values outlining how governments intend to work
Review of government planning documents: identification of principles In total, seven health policy planning documents were retrieved for the Commonwealth government, and the States and Territory governments of Victoria (VIC), New South Wales (NSW), Queensland (QLD), Northern Territory (NT), South Australia (SA) and Western Australia (WA)
Review of health planning documents revealed that shared responsibility, cultural competence, engagement, partnership, capacity building, equity, accountability, evidence-based, and a holistic concept of health were stated as principles of importance in two or more of the health planning documents
Summary
Stated principles in government policy documents serve as a set of values outlining how governments intend to work. In Australia, over recent decades there has been considerable policy investment by Commonwealth and State and Territory governments towards the goal of achieving health equity for Aboriginal and Torres Strait Islander people This has coincided with a government discourse focused on addressing health disparities and building a robust evidence base of what constitutes effective policy, programs and services. For decades we have seen Aboriginal people and the ACCS call for greater collaboration, engagement and leadership across health systems to allow the ACCS to define the health and well-being benefits and outcomes for Aboriginal and Torres Strait Islander populations [3, 4] These voices have asserted that Aboriginal and Torres Strait Islander ways of knowing, doing and being need to be central to the planning, delivery, implementation and evaluation of health policy, programs and services. Such perspectives continue to challenge the deficit framing of Aboriginal and Torres Strait Islander populations people and their health through their ongoing demonstration that Aboriginal people, communities and organisations have unique and valued knowledge, expertise and skills and these strengths are vital for realising optimal health and wellbeing [5,6,7,8]
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