The National Framework for Indigenous Health: A Critical Analysis

The Australian government has made efforts to address the health disparities faced by indigenous populations through various national frameworks and programs. The National Aboriginal and Torres Strait Islander Health Strategy (NAHS) is a key initiative aimed at improving the health and wellbeing of these communities. The strategy focuses on social and emotional wellbeing, primary healthcare services, disease prevention, and strategic research and data analysis to inform policy and practice. The portfolio for health provided by the COAG has been instrumental in assuming responsibility for the treatment of health concerns in these communities since 1995. The overall agenda is to develop a competent workforce, focus on social and emotional wellbeing, and eliminate cultural barriers to healthcare.

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Culture of Ill Health Amongst the Aboriginals in Australia
Student’s name
Institution

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Culture of Ill Health Amongst the Aboriginals in Australia
Introduction:
The indigenous population is essentially one of the most prominent yet unsolicited populations
across several regions in the world [1]. The Pacific Ocean lines a few of the most prominent
islands and coasts across the world including continents such as North and South America,
Africa, Asia, and Australia [1]. Most of these continents possess the highest number of
indigenous people in the regions lined by the Pacific Ocean [1]. Approximately 28% of the globe
is covered by the Pacific Ocean, which is higher than the land mass in the entire geography of
the globe [1]. These regions are predominantly occupied by populations of indigenous
communities [1]. The indigenous populations contribute to the highest population in the world
[1]. These populations are mostly diverse and are composed of several indigenous diversities [1].
The current essay primarily focuses on the definition of the communities of the indigenous
populations in Australia [1]. Additionally, it focuses on the definition of the traditional practices
of the Australian Continent along with rationalizing the efforts of the Australian government and
the State regulations that attempt to bridge the gap between the Western medicine and the
indigenous traditional practices in the health sector [1].
The Council of Australian Governments (COAG) has formulated several bodies and policies that
govern the effective functioning of the medical services and the ‘Closing the Gap’ program that
focuses on extending the services of the medical health care arena to the Aboriginals and Torres
Strait Islander peoples of Australia [1].
Indigenous populations: Indigenous communities of Australia are primarily grouped as
Aboriginals and the Torres Strait Islander peoples community [1, 2]. The definition of these

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communities is of a debatable nature and a specific categorization of these communities has not
been possible in literature [1, 2]. There are several prominent definitions in literature that attempt
to define the term ‘indigenous population’ with complete understanding of the various factors
that contribute to the categorization [1, 2]. The most important basis for the definition of the
indigenous population includes the political categorization of people belonging to these
communities [1, 2]. There is a presence of colonization in these communities according to the
subordination of these populations to the political formulation [1, 2]. A few of the definitions
outlined primarily place emphasis on the characteristic dynamics of the sociocultural existences
of these populations [1, 2]. The continent of Australia primarily includes the Aboriginal
populations that are form the prominent population of the nation [1, 2]. The medical services
thus need to be extended to the indigenous population as well as the non-indigenous individuals
of the mainstream population [1, 2]. The difficulty in the conveyance of these services to the
indigenous populations has to be essentially eliminated [1, 2]. The COAG and the health sector
faces the challenge of streamlining the policies, education, services, and the awareness to the
indigenous population because of an obvious disparity between these two systems [1, 2]. It is
essential to understand the traditional practices of the indigenous populations including the
medical beliefs of these populations [1, 2].
Traditional health care practices of the indigenous communities: Most of the health
practitioners and health providers face the primary challenge of providing health care services to
the indigenous community [3, 4]. The most important reason for the difficulty of providing the
various services of health care includes the disparity in the health beliefs of these populations [3,
4]. There are several beliefs of these communities in terms of the causation of the disease, its
prevention, and the treatment protocols of most diseases [3, 4]. The cultural differences in the

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perspectives surrounding the health care of an individual increase the effectiveness of Western
medical interventions in these communities [3, 4]. In case of nursing in a cross-cultural setting, it
is often difficult to handle the different difficulties in providing healthcare to these populations
[3, 4]. The Aboriginal population primarily possesses the specific cultural beliefs and various
systems of illness and health in most populations [3, 4]. The beliefs of health care and illness
causation are perceived as traditional practices [3, 4]. The health beliefs are an important aspect
of the trajectories of health and illness in these individuals [3, 4]. The illnesses that lead to the
death of the individual are also perceived in a traditional manner and treated by means of
traditional healing [3, 4]. Most of the information available about these populations is sourced
from the rural regions of the Australian continent and not much information is present from the
urban regions [3, 4]. The indigenous knowledge is primarily composed of various models
outlining the causation factors for the illness trajectory, intervention of supernatural forces,
adherence to community and social obligations, and the traditional healing methods outlined in
the Aboriginal community [3, 4].
The traditional system of health beliefs includes a series of explanations for health and illness in
a human being [3, 4]. These beliefs are based on the core belief that the supernatural forces
intervene to provide ill health as a consequence of non-adherence to various social and cultural
obligations [3, 4]. Depending on the various diversities present amongst these populations, the
taboos and accepted norms also vary radically [3, 4]. The death and illness occurrences are
followed up by various beliefs surrounding the prevention of illness by following certain norms
[3, 4]. Most traditional models of health system in the Aboriginals focus on understanding the
mechanism of disease causation according to these belief systems [3, 4]. The beliefs of these
communities on the causation of illness primarily constitute non-adherence to land, region,

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obligations decided according to the kinship, and various other social factors [3, 4]. The systems
of the sociocultural aspects along with the belief systems of the medical care are an essential part
of the development of various medical care strategies [3, 4]. Most of these traditional beliefs
outline that when an individual successfully fulfils the various responsibilities that he holds for
the society and the religion or the community [3, 4]. The key aspects that attribute health and
lack of illness to an individual form the core of the traditional medical practice amongst the
Aboriginals [3, 4]. Individuals are primarily categorized into the following classes: i) Strong –
Normal health condition along with having the ability to deal effectively with the daily tasks of
mental and physical involvement; ii) Weak – the minority of individuals who suffer from
specific short-term illnesses such as headache, cold, or fever for a specific time period; iii) the
wounded – individuals having physical wounds and injuries and ailments such as cuts or bruises;
and iv) Sick – individuals having illnesses caused due to influences of the supernatural forces or
spiritual non-fulfilment; these people cannot be cured without assistance [3].
Intervention of the supernatural: Sorcery and the impact of Supernatural forces is an
important part of the Aboriginal medical practice [3, 4]. Most chronic illnesses and life-
threatening conditions along with death in infants are regarded as being interventions of the
supernatural [3, 4]. Disease co-morbidity and mortality resulting from illness is considered as
being a decision of a Supernatural power [3, 4]. Treatment of the medical conditions is mainly
carried out by traditional healers who practice traditional methods of treating a disease [3, 4].
The traditional system of medical care in the Aboriginal community includes the following
aspects:
1) Preventive care for illnesses: prevention of illness is one of the most important aspects of the
traditional medical practice in these indigenous communities [3, 4]. The most critical

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requirement for the prevention of illness is strict adherence to the social and religious
responsibilities and local taboos [3, 4]. Non-adherence of these beliefs and obligations is
believed to result in illness [3, 4]. The discharge of formal duties of kinship, rituals, observance
of traditional practices, and avoidance of unapproved behaviours is the most essential part of
avoiding illness [3, 4]. The most common methods of healing include bush medicine, traditional
healers, singing or chanting, and external remedies and practices [3, 4].
Western medication and the Aboriginals:
The most important challenge in providing medical care to the Aboriginals is the lack of
knowledge of western medication along with a cultural barrier and uncertainty caused from the
disparity [3, 4]. Most often, the patients belonging to indigenous communities find it difficult to
place trust in the Western medical practices because the western medical philosophy focuses on
the identification of the appropriate cause of the disease along with attempting to treat the
condition [3, 4].
Interaction between the Aboriginals and the health practitioners:
Most health practitioners face several challenges whilst communicating with the Aboriginal and
indigenous patients [3, 4]. The health professionals mostly offer explanations and causes of the
illness that disagree with the opinions of the patients [3, 4]. The conflicts of the core system of
belief increase difficulty of treatment intervention [3, 4]. It is of utmost importance, therefore, to
circumvent the popular beliefs of the indigenous individuals in order to carry out effective
treatment interventions [3, 4]. The conception of the disease condition and the ultimate treatment
all need to be incorporated within a proper framework for the appropriate intervention [3, 4].

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National strategies and policies including the ‘Closing the Gap’ program for the Aboriginal
health:
The National Aboriginal Health Strategy (NAHS) and the bodies of the COAG are primary
contributors to the health reforms in the Australian continent for the indigenous communities [4,
5]. The program ‘Closing the Gap’ is a prominent step in the reforms that were rolled out by the
COAG [4, 5]. This program primarily focused on the identification of the various disease
conditions present in the Aboriginals and the Torres Strait Islander peoples of Australia [4, 5].
Following the identification of the most common diseases present in these populations, the
‘Closing the Gap’ program aimed at providing commitment to the various targets in order to
address the indigenous disadvantage [4, 5]. The national strategies and the inter-sectoral policies
focus on the elimination of the indigenous disadvantage [4, 5]. The portfolio for health provided
by the COAG assumed the primary responsibility of treatment of health concerns in these
communities since 1995 [4, 5]. The national programs have been associated with the Aboriginal
and Torres Strait Islander Commission (ATSIC) [4, 5]. The collaboration and intensive planning
of the platforms of the policies of inter-governmental communities primarily involve the
engagement of the Aboriginal community and the non-health sector included under the COAG
[4, 5]. The key elements that comprise the National framework include:
 Multi-party agreements including responsibilities of the COAG and the State and
territory for the carrying out of the guidelines of the ATSIC for the health of indigenous
communities [4, 5].
 Joint sectors and the contribution of the different forums in the health plan [4, 5]. The
jurisdiction and the State legislation govern the policies of this sector [4, 5].

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The NAHS has an important contribution in the provision of the health plans formulated
for the indigenous populations [4, 5]. The social and emotional well being is the most
important aspect of the framework of the government regulations [4, 5]. The primary
agenda of the strategy of the Aboriginal and Torres Strait health plan include the
following:
1) Development of primary health care services to the working classes of the indigenous
populations [4, 5].
2) Development of specific strategies of the development of disease and focusing on the
risk factors of the health plan [4, 5].
3) Improved policies and practices for strategic researching and identification of health
concerns by specific data collection and analysis [4, 5].
Conclusion: Indigenous populations are a major part of the population of Australia. The
mainstream health services need to be reached out to these populations by eliminating disparity
between the cultures. The Council of Australian government has made several efforts such as the
formulation of the National Framework, several policies of strategic health planning, and the
‘Closing of Gap’ program to eliminate cultural barriers to healthcare in these populations. The
overall agenda is to develop a competent workforce and focus on the social and emotional
wellbeing of the community by analysing the data, resources, evidence, finances, and
accountability of the indigenous populations.

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References:
1) Anderson, I, Crengle, S, Kamaka, ML, Chen, TH, Palafox, N, and Pulver, LJ. (2006).
Indigenous health in Australia, New Zealand, and the Pacific. Lancet 367, 1775–1785.
2) Maher, P. (1999). A review of ‘traditional’ aboriginal health beliefs. Aust. J. Rural Health 7,
229–236.
3) National Indigenous Reform Agreement, Closing the Gap; Council of Australian
Governments. Retrieved from
<http://www.federalfinancialrelations.gov.au/content/npa/health/_archive/indigenous-reform/
national-agreement_sept_12.pdf>
4) Anderson, IPS. (2004). Recent developments in national Aboriginal and Torres Strait Islander
health strategy. Australia and New Zealand Health Policy 1:3.
5) Dwyer J, Silburn K, Wilson G. (2004). National strategies for improving Indigenous health
and health care, consultant report no 1 for the review of the Australian Government's Aboriginal
and Torres Strait Islander primary health care program. Canberra: Commonwealth of Australia;
6) Harrison, BT, Gibberd, RW, and Hamilton, JD. (1999) Med J Aust, 170(9), 411-415.