Factors informing funding of health services for Aboriginal and Torres Strait Islander children: perspectives of decision-makers

Shingisai Chando; Martin Howell; Michelle Dickson; Allison Jaure; Jonathan C. Craig; Sandra J. Eades; Kirsten Howard

doi:10.1071/PY24054

RESEARCH ARTICLE (Open Access)

Next Contents Vol 30(5)

Factors informing funding of health services for Aboriginal and Torres Strait Islander children: perspectives of decision-makers

Shingisai Chando

^A ^B ^* , Martin Howell ^A ^C , Michelle Dickson ^A ^B , Allison Jaure ^A ^D , Jonathan C. Craig ^E , Sandra J. Eades ^F and Kirsten Howard ^A ^C

+ Author Affiliations

- Author Affiliations

^A Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.

^B Poche Centre for Indigenous Health, The University of Sydney, Sydney, NSW, Australia.

^C Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.

^D Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, NSW, Australia.

^E College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.

^F Faculty of Medicine, The University of Melbourne, Melbourne, Vic, Australia.

^* Correspondence to: Shingisai.Chando@sydney.edu.au

Australian Journal of Primary Health 30, PY24054 https://doi.org/10.1071/PY24054

Submitted: 2 May 2024 Accepted: 9 September 2024 Published: 30 September 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

The factors informing decisions to fund health services for Aboriginal and Torres Strait Islander children are unclear. This study’s objective aimed to describe decision-makers’ perspectives on factors informing decisions to fund health services for Aboriginal and Torres Strait Islander children.

Methods

We conducted semi-structured interviews with 13 participants experienced in making funding decisions at organisational, state, territory and national levels. Decision-makers were from New South Wales, Northern Territory, Queensland, Victoria and Western Australia. Transcripts were analysed thematically following the principles of grounded theory.

Results

We identified five themes, each with subthemes. First, prioritising engagement for authentic partnerships (opportunities to build relationships and mutual understanding, co-design and co-evaluation for implementation). Second, valuing participant experiences to secure receptiveness (cultivating culturally safe environments to facilitate acceptability, empowering for self-determination and sustainability, strengthening connectedness and collaboration for holistic care, restoring confidence and generational trust through long-term commitments). Third, comprehensive approaches to promote health and wellbeing (linking impacts to developmental milestones, maintaining access to health care, broadening conceptualisations of child health). Fourth, threats to optimal service delivery (fractured and outdated technology systems amplify data access difficulties, failure to ‘truly listen’ fuelling redundant policy, rigid funding models undermining innovation). Fifth, navigating political and ideological hurdles to advance community priorities (negotiating politicians’ willingness to support community-driven objectives, pressure to satisfy economic and policy considerations, countering entrenched hesitancy to community-controlled governance).

Conclusion

Decision-makers viewed participation, engagement, trust, empowerment and community acceptance as important indicators of service performance. This study highlights factors that influence decisions to fund health services for Aboriginal and Torres Strait Islander children.

Keywords: Aboriginal and Torres Strait Islander children, child health services, evaluation reporting, health services, health services funding, health services policy, Indigenous health services, primary health care.

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