Health Workforce Australia 2013 Conference Adelaide 19 November 2013 Growing our Aboriginal and Torres Strait Islander Health Workforce Ms Janine Milera CEO, Congress of Aboriginal and Torres Strait Islander Nurses and Midwives Mr Romlie Mokak CEO, Australian Indigenous Doctors Association

Why an Indigenous Health Workforce? “There is a substantial body of research evidence indicating that the development of a skilled and professional Indigenous health workforce is an essential prerequisite for improvements in Indigenous health” Dr Mick Gooda, Social Justice Commissioner 'In good hands with Dr Shibasaki', Koori Mail 454 p.54

A brief history of CATSINaM First meeting held August 1997 to establish CATSIN1998 Report of the Indigenous Nursing Education Working Group, 2002: ‘Getting Em and Keeping Em’ Submitted to DoHA and OATSIH Recommendations to overcome challenges facing Aboriginal and Torres Strait Islander Nurses Still largely relevant today – CATSINaM continuing to advocate on this Since 2012 changes in: governance, name and Secretariat location New CEO appointed in 2013

National Picture In 2011, a total of 2,212 (0.8%) nurses and midwives employed in Australia identified as Aboriginal and/ or Torres Strait Islander 1414 were registered nurses, 798 were enrolled nurses and 60 Indigenous midwives were employed across Australia

“My Aunty works as a nurse and I want to be just like her” “Nurses do the Yucky work” "Counsellors just talk to people. That's not really a health job...is it?"

Pursuing study in nursing and/or midwifery: s tudy in nursing and/or midwifery: Lack of support Family commitments Travel Financial hardship Lack of mentoring Educational factors such as not completing high school, financial, geography, family. CATSINaM Member

Completing their studies in nursing and/or midwifery: Family commitments Away from home Racism Financial burden Practical help with essay writing Mentoring and role modeling “Financial disadvantage, not understanding university processes and requirements, family obligations, Racism, Not University ready.” CATSINaM Member

What do we know about nursing and midwifery students? What do we know about Aboriginal and Torres Strait Islander nursing and midwifery students? Commencements have increased however, still remain below parity Progression – 16.6% difference Attrition – 10.1% difference Completion – 28.3% difference Pattern is consistent for data from

Completion rates for Aboriginal and Torres Strait Islander nursing students West, R, Buttner, P, Foster, K, Usher, K & Stewart, L, 2013, Indigenous Australians' participation in pre-registration tertiary nursing courses: A mixed methods study, Contemporary Nurse, Aug 4. [Epub ahead of print]

Dr Roianne West suggests the following strategies: 1.Appoint an Indigenous nurse academic in all schools of nursing. 2.Development and implementation of resilience building training tailored for Indigenous nursing students. 3.Develop partnerships between Schools of Nursing and Indigenous Education Support Units. 4.Develop and implement a cross-cultural training program specifically for academics in Schools of Nursing, 5.Development of a critical nursing curriculum. 6.Development of pathways from school through the VET sector and University sectors.

Continuing on in their profession Mentoring and support Racism Lack of understanding of cultural and family matters Cultural safety “Cultural safety of the nursing and midwifery profession in general. Lack of value for the innate understanding of the socio-cultural issues that some Aboriginal and Torres Strait Islander nurses and midwives have that has significant benefit when caring for our mob. Lack of leadership development opportunities.” CATSINaM Member

“I have experienced clients being racist to other people, in which they are sharing a room with on the ward, saying out aloud to me how the particular Aboriginal woman 'stinks'. Because I had fair skin I assume she thought it was alright to say it to me. I have also seen colleagues inadvertently being racist, denying certain people such as Aboriginals and Torres Strait islanders’ privileges and then allowing non indigenous clients these services. Mainly in older aged nurses though rather than in the younger and middle aged nurses.” CATSINaM member “This occurred while as a clinician in previous roles, mostly ignorance and covert racism. This reflects a deficit of the other about Aboriginal and Torres Strait Islander people and our shared history. It is burdensome dealing with this on a daily basis sometimes.” CATSINaM member

AUSTRALIAN INDIGENOUS DOCTORS ASSOCIATION: A SNAPSHOT 1983Professor Helen Milroy graduates 1993Under ten graduates 1998AIDA established 2002Secretariat in Canberra 2005Collaboration Agreement with Medical Deans Australia and New Zealand 2010Indigenous Governance Award Finalist 2010Moved into Old Parliament House 2012Collaboration Agreement with Confederation of Medical Education Councils 2012Hosted PRIDoC in Alice Springs doctors, 260 students (enrolment parity) 2013Collaboration Agreement with Committee of Presidents of Medical Colleges

7 -12 R E TENTION

HIGHER EDUCATION HEALTH RELATED COURSE ENROLMENTS 2006

Key Intervention Points Build the secondary school pipeline Build the articulation between the VET sector, health workforce & higher education Increase higher education completions Performance measurement Health system strategies for retention

MURRA MULLANGARI – PATHWAYS ALIVE AND WELL In the language of the Ngambri people, Murra is the path and Mullangari is health and wellbeing coming from ceremonies, including the Bogong Moth Ceremony.

OVERVIEW History Murra Mullangari 2013 Indigenous leadership and partnership Findings of the 2013 program

MURRA MULLANGARI – PATHWAYS ALIVE AND WELL In the language of the Ngambri people, Murra is the path and Mullangari is health and wellbeing coming from ceremonies, including the Bogong Moth Ceremony.

MURRA MULLANGARI : PATHWAYS ALIVE AND WELL History Murra Mullangari 2013 Indigenous leadership and partnership Findings of the 2013 program

AUSTRALIAN CONTEXT Addressing gaps in the Aboriginal and Torres Strait Islander Health workforce Improving the health status of our people Incorporating all health disciplines Indigenous leadership

OTHER PROGRAMS Culture Indigenous Leadership Indigenous Leadership Career Education Health Murra Mullangari – Pathways Alive and Well

MURRA MULLANGARI – PATHWAYS ALIVE AND WELL

2013 Murra Mullangari Program Partnerships

PROGRAM APPLICANTS BY DESIRED CAREER Frequency

PERCENTAGE OF PROGRAM APPLICANTS & PARTICIPANTS BY SCHOOL YEAR

EVALUATION FINDINGS Increased knowledge of health careers Increased knowledge of pathways Increased awareness of cultural strength and identity

“I think having more Indigenous midwives is important to make pregnant Indigenous women feel comfortable when they have their baby” Murra Mullangari program participant, aged 16

We have made progress. We need accelerated growth in the future.

ACKNOWLEDGEMENTS Murra Mullangari – Pathways Alive and Well partner organisations, members and staff The Murra Mullangari program participants, their families and communities Ngambri Elder - Aunty Matilda House Group Leaders - Mr Guy Dennis, Ms Sheree Enderby, Ms Alyce Merritt and Ms Kate Richards Facilitator - Mr Gregory Phillips Funding for the project was provided by the Commonwealth Department of Education, Employment and Workplace Relations CONTACT INFORMATION Ms Jasmin Hunter, Pathways Officer