The purpose of this NSW Aboriginal Health Plan 2024–2034 is to drive change to achieve the highest possible levels of health and wellbeing for Aboriginal people in NSW by:
While this plan will influence change, it is only with purposeful action that its vision and outcomes will be realised. To coordinate and support action, a statewide implementation plan will be developed through a collaborative process and will reflect priorities and ideas identified through the consultation which informed the development of this plan.
The implementation plan will provide more detailed information on actions for each strategy, with specific timeframes, and identify which part of the health system will be responsible for leading each action. The statewide implementation plan will build on work already underway including through Future Health, the Regional Health Strategic Plan and other NSW Health strategic plans. It is intended that the state-wide implementation plan will be reflected in local implementation plans based on local priorities.
In partnership with AH&MRC, NSW Health will develop a monitoring and measurement framework to outline reporting on progress of the NSW Aboriginal Health Plan. To ensure a flexible focus and prioritisation of action, each phase of monitoring and reporting will support the development of the next implementation plan.
This will ensure emerging priorities are met and required action is sustained. Reporting will be consistent with NSW Health Aboriginal governance and accountability mechanisms and will be designed to avoid duplication and limit the burden of reporting across the health system.
The development of the statewide implementation plan and the monitoring and measurement framework will commence following the release of this plan, allowing sufficient time for stakeholders to consider opportunities for action.
Although there have been some important improvements in the health of Aboriginal peoples in NSW2, Aboriginal people do not always enjoy the same health outcomes or access to healthcare as the non-Aboriginal population. This can be observed across a wide range of morbidity, mortality, service usage and patient experience indicators. Many of these discrepancies can be attributed to the inequities experienced by Aboriginal people and communities in key determinants of health3, 4, and there is a clear relationship between socio-economic inequalities and the health gap due to the impacts of intergenerational trauma5, 6.
While acknowledging these inequities is important, a focus on the negative can create barriers to improving health outcomes. Understanding and addressing Aboriginal health and wellbeing priorities requires a focus on the strength and resilience of Aboriginal people.
The Mayi Kuwayu National Study of Aboriginal and Torres Strait Islander Wellbeing identified a range of cultural determinants of health which act as protective factors to enhance resilience, strengthen identity and support good health, and social and emotional wellbeing. These include: Connection to Country, family, kinship and community, beliefs and knowledge, cultural expression and continuity, language, self-determination and leadership7.
This Aboriginal Health Plan makes a commitment to recognising, respecting and elevating the cultural determinants of health and wellbeing and their restorative impact in the lives of Aboriginal people.
Ensuring culture remains at the centre of actions to implement this plan is vital to its success.
The National Agreement on Closing the Gap (the National Agreement) commits all Australian state and territory governments to a fundamentally new way of developing and implementing policies and programs that impact the lives of Aboriginal people. To support implementation of the National Agreement and guide the government’s actions, the NSW Implementation Plan for Closing the Gap sets out the NSW Government’s strategies for delivering progress against the National Agreement’s Priority Reforms and Socio-Economic Outcomes.
While the National Agreement and the NSW Implementation Plan covers all government agencies (for example, Health, Education, Justice, Transport), this NSW Aboriginal Health Plan has been influenced by those plans, and adds more nuanced, health-specific strategies to ensure the overarching goals of the National Agreement are realised.
Future Health: Guiding the next decade of care in NSW 2022–2032 is NSW Health’s roadmap for how services are delivered, positioning our health system to meet the needs of patients, the community and workforce over the coming years.
The vision of Future Health is multi-faceted and complex, so several core strategies guide NSW Health's work, including the NSW Regional Health Strategic Plan 2022–2032, NSW Health Workforce Plan 2022-2032 and this Aboriginal Health Plan. These three core strategies target specific policy, population, or program areas and have direct ties to Future Health and strong alignment with each other.
Across these strategies, there are shared deliverables, as well as shared monitoring and reporting activities, to ensure NSW Health is working effectively while also minimising duplication and efficiently managing resources.
The alignment of the strategies, actions and metrics makes it easier to ensure everyone is working towards common outcomes.
For more information on these and other plans and policies intersecting with this plan, please refer to Policy context.
To ensure the aspirations of this NSW Aboriginal Health Plan are realised, it must connect with areas such as housing, family services, education, and environment, which each contribute significantly to the social, cultural, economic, political and planetary determinants of health and wellbeing8. Strategic collaboration is essential across these different sectors for preventing illness and injury and embedding long-term improvements in communities’ health and wellbeing.
Interfacing closely with the AH&MRC and the NSW Coalition of Aboriginal Peak Organisations (CAPO), as well as Aboriginal Affairs NSW, will be essential for NSW Health and partners to effectively operationalise the strategies set out for each priority reform area and strategic direction in the NSW Aboriginal Health Plan.
In 2019 a mid-term evaluation (MTE) of the NSW Aboriginal Health Plan 2013-20239 was undertaken. It found progress against the strategic directions of the plan was moderate overall and a set of recommendations were made to guide implementation of the plan for its remaining years. In 2023, a final review of the plan was undertaken, and this was focussed predominantly on the implementation of the MTE recommendations.
An extensive consultation process co-designed with the Centre for Aboriginal Health (CAH) and the AH&MRC was then undertaken. Both face-to-face and virtual engagement occurred in urban and regional areas of NSW. The MTE, final review and consultation findings informed the development of this Aboriginal Health Plan.
Development of this plan was led by a partnership between the CAH within NSW Ministry of Health and the AH&MRC. It was guided by an Aboriginal Health Plan Advisory Committee that comprised senior leaders from Aboriginal Community Controlled Health Organisations (ACCHOs) and LHDs across NSW, as well as Aboriginal specialist leaders from within the NSW Ministry of Health, along with representation from NSW Regional Alliances, Stolen Generations, First Peoples Disability, Advocate for Children and Young People and Aboriginal LGBTIQ+ community organisations.
Lowitja Institute was engaged by the CAH to develop the detailed content, drawing on key priorities and concerns highlighted in the consultation, as well as an analysis of a broad evidence base, relevant national and state-level strategies, and LHD plans targeted at Aboriginal health.
Priority domains of action were mapped between these documents to maximise alignment of the NSW Aboriginal Health Plan and support effective coordination of activities in the implementation phase.
Before finalising the NSW Aboriginal Health Plan, the CAH and the AH&MRC shared the final draft priorities, directions, objectives and strategies directly with
NSW Health and Aboriginal Community Controlled Health organisation leadership across the state and incorporated subsequent feedback.