Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE (Open Access)

Developing the rural health workforce to improve Australian Aboriginal and Torres Strait Islander health outcomes: a systematic review

Kylie Gwynne A B C and Michelle Lincoln B
+ Author Affiliations
- Author Affiliations

A Poche Centre for Indigenous Health, Sydney Medical School, Rm 223 Edward Ford Building A27, The University of Sydney, NSW 2006, Australia.

B Faculty of Health Sciences, The University of Sydney, Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia. Email: michelle.lincoln@sydney.edu.au

C Corresponding author. Email: kylie.gwynne@sydney.edu.au

Australian Health Review 41(2) 234-238 https://doi.org/10.1071/AH15241
Submitted: 11 November 2015  Accepted: 1 April 2016   Published: 23 May 2016

Abstract

Objective The aim of the present study was to identify evidence-based strategies in the literature for developing and maintaining a skilled and qualified rural and remote health workforce in Australia to better meet the health care needs of Australian Aboriginal and/or Torres Strait Islander (hereafter Aboriginal) people.

Methods A systematic search strategy was implemented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and checklist. Exclusion and inclusion criteria were applied, and 26 papers were included in the study. These 26 papers were critically evaluated and analysed for common findings about the rural health workforce providing services for Aboriginal people.

Results There were four key findings of the study: (1) the experience of Aboriginal people in the health workforce affects their engagement with education, training and employment; (2) particular factors affect the effectiveness and longevity of the non-Aboriginal workforce working in Aboriginal health; (3) attitudes and behaviours of the workforce have a direct effect on service delivery design and models in Aboriginal health; and (4) student placements affect the likelihood of applying for rural and remote health jobs in Aboriginal communities after graduation. Each finding has associated evidence-based strategies including those to promote the engagement and retention of Aboriginal staff; training and support for non-Aboriginal health workers; effective service design; and support strategies for effective student placement.

Conclusions Strategies are evidenced in the peer-reviewed literature to improve the rural and remote workforce for health delivery for Australian Aboriginal people and should be considered by policy makers, funders and program managers.

What is known about the topic? There is a significant amount of peer-reviewed literature about the recruitment and retention of the rural and remote health workforce.

What does this paper add? There is a gap in the literature about strategies to improve recruitment and retention of the rural and remote health workforce for health delivery for Australian Aboriginal people. This paper provides evidence-based strategies in four key areas.

What are the implications for practitioners? The findings of the present study are relevant for policy makers, funders and program managers in rural and remote Aboriginal health.


References

[1]  Holland C. Progress and priorities report 2015: the Close the Gap Campaign Steering Committee. Canberra: The Close the Gap Campaign Steering Committee; 2015.

[2]  Australian Government. Overcoming Indigenous disadvantage: key indicators 2014. Canberra: Productivity Commission; 2014. Available at: http://www.pc.gov.au/research/ongoing/overcoming-indigenous-disadvantage/key-indicators-2014 [verified 1 September 2015].

[3]  Smith JD, O’Dea K, McDermott R, Schmidt B, Connors C. Educating to improve population health outcomes in chronic disease: an innovative workforce initiative across remote, rural and Indigenous communities in northern Australia. Rural Remote Health 2006; 6 606
| 16907625PubMed |

[4]  Australian Government. Census of population and housing: counts of Aboriginal and Torres Strait Islander Australians 2011. 2011. Available at: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/2075.0main+features32011 [verified 1 September 2015].

[5]  Schmidt B, Wenitong M, Esterman A, Hoy W, Segal L, Taylor S, Preece C, Sticpewich A, McDermott R. Getting better at chronic care in remote communities: study protocol for a pragmatic cluster randomised controlled of community based management. BMC Public Health 2012; 12 1017
Getting better at chronic care in remote communities: study protocol for a pragmatic cluster randomised controlled of community based management.CrossRef | 23170964PubMed |

[6]  Weymouth S, Davey C, Wright JI, Nieuwoudt LA, Barclay L, Belton S, Svenson S, Bowell L. What are the effects of distance management on the retention of remote area nurses in Australia? Rural Remote Health 2007; 7 652
| 1:STN:280:DC%2BD2svkvFSltg%3D%3D&md5=c5e38511f90763c55ac58ed7bba50b53CAS | 17665965PubMed |

[7]  Laufik N. The physician assistant role in Aboriginal healthcare in Australia. JAAPA 2014; 27 32–5.
The physician assistant role in Aboriginal healthcare in Australia.CrossRef | 24361653PubMed |

[8]  Lenthall S, Wakerman J, Opie T, Dunn S, Macleod M, Dollard M, Rickard G, Knight S. Nursing workforce in very remote Australia, characteristics and key issues. Aust J Rural Health 2011; 19 32–7.
Nursing workforce in very remote Australia, characteristics and key issues.CrossRef | 21265923PubMed |

[9]  Carson BE, Bailie RS. National health workforce in discrete Indigenous communities. Aust N Z J Public Health 2004; 28 235–45.
National health workforce in discrete Indigenous communities.CrossRef | 15707170PubMed |

[10]  Roche AM, Duraisingam V, Trifonoff A, Battams S, Freeman T, Tovell A, Weetra D, Bates N. Sharing stories: Indigenous alcohol and other drug workers’ well-being, stress and burnout. Drug Alcohol Rev 2013; 32 527–35.
| 23675893PubMed |

[11]  Roche AM, Duraisingam V, Trifonoff A, Tovell A. The health and well-being of Indigenous drug and alcohol workers: Results from a national Australian survey. J Subst Abuse Treat 2013; 44 17–26.
The health and well-being of Indigenous drug and alcohol workers: Results from a national Australian survey.CrossRef | 22425037PubMed |

[12]  Carson D, McConnel F. Indigenous health and community services employment in remote Northern Territory: a baseline examination of 2006 and 2001 Census data. Aust J Rural Health 2011; 19 255–8.
Indigenous health and community services employment in remote Northern Territory: a baseline examination of 2006 and 2001 Census data.CrossRef | 21933368PubMed |

[13]  Keane S, Lincoln M, Smith T. Retention of allied health professionals in rural New South Wales: a thematic analysis of focus group discussions. BMC Health Serv Res 2012; 12 175
| 22726758PubMed |

[14]  Daniels Z, Vanleit BJ, Skipper BJ, Sanders ML, Rhyne RL. Factors in recruiting and retaining health professionalsfor rural practice. J Rural Health 2007; 23 62–71.
Factors in recruiting and retaining health professionalsfor rural practice.CrossRef | 17300480PubMed |

[15]  Humphreys J, Wakerman J, Wells R, Kuipers W, Jones J, Entwistle P, Harvey P. Improving primary health care workforce retention in small rural and remote communities: how important is ongoing education and training? Canberra: Australian Primary Health Care Research Institute; 2007.

[16]  Hegney D, McCarthy A, Rogers-Clark C, Gorman D. Retaining rural and remote area nurses. The Queensland, Australia experience. J Nurs Adm 2002; 32 128–35.
Retaining rural and remote area nurses. The Queensland, Australia experience.CrossRef | 11984243PubMed |

[17]  West R, Usher K, Foster K. Increased numbers of Australian Indigenous nurses would make a significant contribution to ‘closing the gap’ in Indigenous health: what is getting in the way? Contemp Nurse 2010; 36 121–30.
Increased numbers of Australian Indigenous nurses would make a significant contribution to ‘closing the gap’ in Indigenous health: what is getting in the way?CrossRef | 21254828PubMed |

[18]  Nguyen HT, Gardiner A. Indigenous community members as teachers of indigenous health. Aust Fam Physician 2008; 37 1019–21.
| 19142276PubMed |

[19]  Moher DLA, Liberatti A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6 e1000097

[20]  Lowitja Institute. LIt.search frequently asked questions. 2013. Available at: http://www.lowitja.org.au/litsearch-faq#q11 [verified 1 September 2015].

[21]  Butler DC, Petterson S, Bazemore A, Douglas KA. Use of measures of socioeconomic deprivation in planning primary health care workforce and defining health care need in Australia. Aust J Rural Health 2010; 18 199–204.
Use of measures of socioeconomic deprivation in planning primary health care workforce and defining health care need in Australia.CrossRef | 21040081PubMed |

[22]  Scott J, Larson A, Jefferies F, Veenendaal B. Small-area estimates of general practice workforce shortage in rural and remote Western Australia. Aust J Rural Health 2006; 14 209–13.
Small-area estimates of general practice workforce shortage in rural and remote Western Australia.CrossRef | 17032297PubMed |

[23]  Bogossian FE, Long MH, Benefer C, Humphreyes Reid LJ, Kellett SE, Zhao I, Turner C. A workforce profile comparison of practising and non-practising midwives in Australia: baseline data from the Midwives and Nurses e-Cohort Study. Midwifery 2011; 27 342–9.
A workforce profile comparison of practising and non-practising midwives in Australia: baseline data from the Midwives and Nurses e-Cohort Study.CrossRef | 21481994PubMed |

[24]  Walker D, Tennant M, Short SD. An exploration of the priority remote health personnel give to the development of the Indigenous health worker oral health role and why: unexpected findings. Aust J Rural Health 2013; 21 274–8.
An exploration of the priority remote health personnel give to the development of the Indigenous health worker oral health role and why: unexpected findings.CrossRef | 24118150PubMed |

[25]  Browne J, Thorpe S, Tunny N, Adams K, Palermo C. A qualitative evaluation of a mentoring program for Aboriginal health workers and allied health professionals. Aust N Z J Public Health 2013; 37 457–62.
A qualitative evaluation of a mentoring program for Aboriginal health workers and allied health professionals.CrossRef | 24090329PubMed |

[26]  Watson K, Young J, Barnes M. What constitutes ‘support’ for the role of the Aboriginal and Torres Strait Islander child health workforce? Aust Health Rev 2013; 37 112–6.
What constitutes ‘support’ for the role of the Aboriginal and Torres Strait Islander child health workforce?CrossRef | 23257197PubMed |

[27]  Nielsen A-M, Stuart LA, Gorman D. Confronting the cultural challenge of the whiteness of nursing: Aboriginal registered nurses’ perspectives. Contemporary Nurse: J Aust Nurs Profess 2014; 48 190–6.
Confronting the cultural challenge of the whiteness of nursing: Aboriginal registered nurses’ perspectives.CrossRef |

[28]  West R, Usher K, Buettner PG, Foster K, Stewart L. Indigenous Australians’ participation in pre-registration tertiary nursing courses: a mixed methods study. Contemp Nurse 2013; 46 123–34.
Indigenous Australians’ participation in pre-registration tertiary nursing courses: a mixed methods study.CrossRef | 24716770PubMed |

[29]  Lloyd JE, Wise MJ, Weeramanthri T. Changing shape: workforce and the implementation of Aboriginal health policy. Aust Health Rev 2008; 32 174–85.
Changing shape: workforce and the implementation of Aboriginal health policy.CrossRef | 18241162PubMed |

[30]  Wise M, Massi L, Rose M, Nancarrow H, Conigrave K, Bauman A, Hearn S. Developing and implementing a state-wide Aboriginal health promotion program: the process and factors influencing successful delivery. Health Promot J Austr 2012; 23 25–9.
| 22730934PubMed |

[31]  Kowanko I, de Crespigny C, Murray H, Groenkjaer M, Emden C. Better medication management for Aboriginal people with mental health disorders: a survey of providers. Aust J Rural Health 2004; 12 253–7.
Better medication management for Aboriginal people with mental health disorders: a survey of providers.CrossRef | 15615578PubMed |

[32]  Lauw ML, Spangaro J, Herring S, McNamara LD. ‘Talk, talk, cry, laugh’: learning, healing and building an Aboriginal workforce to address family violence. Aust Health Rev 2013; 37 117–20.
‘Talk, talk, cry, laugh’: learning, healing and building an Aboriginal workforce to address family violence.CrossRef | 23237329PubMed |

[33]  Whiteside M, Tsey K, McCalman J, Cadet-James Y, Wilson A. Empowerment as a framework for Indigenous workforce development and organisational change. Aust Soc Work 2006; 59 422–34.
Empowerment as a framework for Indigenous workforce development and organisational change.CrossRef |

[34]  Smedts AM, Campbell N, Sweet L. Work-integrated learning (WIL) supervisors and non-supervisors of allied health professional students. Rural Remote Health 2013; 13 1993
| 23410517PubMed |

[35]  Liaw ST, McGrath B, Jones G, Russell U, Bourke L, Hsu-Hage B. A compulsory experiential and inter-professional rural health subject for undergraduate students. Rural Remote Health 2005; 5 460
| 16313202PubMed |

[36]  Bazen JJ, Kruger E, Dyson K, Tennant M. An innovation in Australian dental education: rural, remote and Indigenous pre-graduation placements. Rural Remote Health 2007; 7 703
| 17696758PubMed |

[37]  Wilson N, Couper I, De Vries E, Reid S, Fish T, Marais B. A critical review of interventions to redress the inequitable distribution of healthcare professionals to rural and remote areas. Rural Remote Health 2009; 9 1060
| 19530891PubMed |


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