Supporting self-determined Indigenous health and wellbeing through cross-sector action
Health and wellbeing are shaped by much more than the health system. Housing, education, employment, transport, the environment, justice and other social and economic factors all influence health outcomes. Health in All Policies (HiAP) is a cross-sector approach designed to bring health considerations into government policymaking and encourage collaboration across sectors.
This HEAL Innovation Fund project explored how the HiAP approach could be strengthened by centring Indigenous ways of knowing, being and doing, and better supporting Indigenous self-determined health and wellbeing. The project was nested within the NHMRC-funded Stronger Together As Unified Nations for Community-led Health (STAUNCH) research program.
What did the project involve?
The project examined the existing evidence and policy landscape through three complementary phases:
- A rapid state-of-play review of research on multisectoral approaches to Indigenous health and wellbeing.
- An analysis of Australian government policy across five jurisdictions, examining how governments articulate and approach multisectoral action.
- A roundtable discussion bringing together Indigenous Nation representatives, researchers and policymakers to reflect on experiences of working across sectors.
The research assessed this work against the World Health Organization’s HiAP 4 Pillars Model, which focuses on governance and accountability; leadership; ways of working; and resources, financing and capabilities.
What did the research find?
The literature review identified 15 studies examining multisectoral approaches to Indigenous health and wellbeing. Three recurring principles were particularly important: centring Indigenous ways of knowing, being and doing; acting on the Indigenous Determinants of Health; and supporting approaches that are by Indigenous people, for Indigenous people.
The review also highlighted gaps in existing approaches. While leadership and whole-of-government planning were relatively well represented, governance, ways of working, resources and enabling mechanisms were less developed. The findings suggest that sustainable multisectoral action requires more than high-level commitments — governments also need the relationships, tools, resources and capabilities to put those commitments into practice.
The policy analysis examined 33 Australian government policy documents from the Commonwealth, Queensland, New South Wales, the Northern Territory and South Australia. It found that health, environment and Aboriginal affairs sectors are increasingly recognising the value of multisectoral action, but policy documents alone cannot demonstrate how effectively this work is being implemented in practice.
Building a stronger approach
The project’s roundtable brought these findings together with the experiences of Indigenous Nations and policymakers. A key insight was that effective action needs to occur across three interconnected levels of governance: within and between Indigenous Nations, in relationships between Indigenous Nations and governments, and through governments working collaboratively across sectors.
The findings are informing the next stage of the STAUNCH research program, which will continue exploring intergovernmental relationships and multisectoral government action. The longer-term goal is to strengthen collaborative, sustainable and self-determined approaches to Indigenous health and wellbeing.
Researchers
- A/Prof Veronica Matthews — University of Sydney
- Dr Yonatal Tefera — University of Adelaide
The project was led through the Centre for Health in All Policies Research Translation (CHiAPRT) and contributed to the broader STAUNCH research program.
