Case study: Establishing a cultural governance model to support public health actions in Hunter New England LHD

Local, state and national pandemic plans suggest that governance arrangements, local decision making and partnerships between public health services and Aboriginal Community Controlled Health Organisations are important for effective and culturally appropriate pandemic responses. However, how representation of Aboriginal people should be established within governance structures is not made clear within these plans.

To address this issue, Aboriginal staff from the Hunter New England Public Health Unit established a cultural governance model. The model embedded cultural governance and accountability within the local public health Incident Control System, ensuring appropriate representation of Aboriginal people at all levels in the local emergency management response. The approach aimed to ensure that Aboriginal people actively participated in shared strategic decision making to develop and implement culturally appropriate and effective public health measures. This approach had not previously existed.

Central also to the model was the establishment of the Public Health Aboriginal Team. This team oversaw several priority actions from April 2020 to January 2022, including:

• developing strategic governance groups, including the Hunter New England Aboriginal Governance Group on COVID-19, Hunter New England Aboriginal Vaccination Steering Committee, and the Hunter New England Aboriginal Data Governance Group
• establishing an Aboriginal Cultural Support Team which received over 7,000 cultural support referrals and supported 3,671 pre-Omicron COVID-19 cases and contacts
• partnering with the Centre for Aboriginal Health and Aboriginal Health and Medical Research Council to develop culturally appropriate COVID-19 communication
• authoring the Hunter New England COVID-19 Response Sub-Plan for Aboriginal Communities.

This work highlights the importance of Aboriginal people leading and changing the system, to develop a cultural governance model that privileges Aboriginal voices in a pandemic response. The model was shared at national, state and local levels, including being presented at the Australian Public Health Conference 2020, the Public Health Association of Australia Conference 2022, and the Health, Race and Racism International Conference 2022. It can be replicated by other local health districts, particularly for notifiable disease response and any large-scale emergency responses.