First Peoples
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Final report of the evaluation of the Australian Government’s investment in Aboriginal and Torres Strait Islander primary health care through the Indigenous Australians’ Health Programme
This report sets out the findings and recommendations of a 6-year evaluation of the Indigenous Australians’ Health Programme (IAHP) from 2017 to 2023. The IAHP is the Australian Government’s largest investment in Aboriginal and Torres Strait Islander peoples’ health. The objective of the IAHP is to ensure Aboriginal and Torres Strait Islander people have access to effective, high quality, comprehensive, and culturally appropriate primary health care (PHC) services in urban, regional and remote locations across Australia.
To support improvements to health outcomes for Aboriginal and Torres Strait Islander people, the IAHP provides funding to support the delivery of health care to Aboriginal and Torres Strait Islander people across 5 key themes:
- comprehensive PHC, through funding Aboriginal Community Controlled Health Services (ACCHSs) and other health services
- improving access to PHC
- targeted health activities such as anti-smoking, mental health, eye and ear health, blood borne viruses and sexually transmitted infections, chronic conditions such as diabetes, renal disease, cancer, heart disease, respiratory disease and rheumatic heart disease
- capital works
- governance and system effectiveness.
The aim of the evaluation of the IAHP was to strengthen the appropriateness and effectiveness of comprehensive PHC systems for Aboriginal and Torres Strait Islander people and communities.
The evaluation used a multi-phase iterative mixed method design, employing both qualitative and quantitative methods of research. This approach enabled flexibility and adaptability across the different evaluation phases, sites, and settings to understand the IAHP and its interactions within the wider health system.
The methodology for the evaluation was grounded in:
- co-design processes to involve participants in decisions on the design and implementation of the evaluation
- emergent design to ensure the evaluation remained responsive to changing circumstances and context
- participatory action research to work with participants in generating knowledge, lessons, solutions and actions.
Key findings
- The IAHP provides critical investment in PHC for Aboriginal and Torres Strait Islander people.
- People value comprehensive, holistic, high-quality health care.
- People do not routinely experience health care that aligns with what they value in health care design and delivery.
- ACCHSs carry significant responsibility within their communities.
- Mainstream health settings cannot reproduce the experience of community-driven, place-based care.
- IAHP funding is too low for services to consistently deliver values-aligned care.
- Reporting and administrative burden has improved under the IAHP but remains too onerous for many services.
- Orientation and role of the IAHP in broader primary care system lacks clarity.
- Administration of the IAHP is not well integrated to the broader health policy and funding landscape.
- Client journeys and outcomes are not tracked through data and reporting processes.
- There are complex relationships between primary care activity, social determinants of health and health outcomes.
IAHP primary health care evaluation: Government management response
