Unit of competency details

HLTAHW301B - Work in Aboriginal and/or Torres Strait Islander Primary Health care context (Release 1)

Summary

Releases:
ReleaseStatusRelease date
1 1 (this release)Current 25/Mar/2011

Usage recommendation:
Superseded
Mapping:
MappingNotesDate
Is superseded by HLTAHW005 - Work in an Aboriginal and/or Torres Strait Islander primary health care contextNew unit in HLT Training Package Release 1.0. Significant changes to elements and performance criteria. New evidence requirements for assessment, including volume and environment requirements 30/Jun/2013

Training packages that include this unit

Classifications

SchemeCodeClassification value
ASCED Module/Unit of Competency Field of Education Identifier 061305 Indigenous Health  

Classification history

SchemeCodeClassification valueStart dateEnd date
ASCED Module/Unit of Competency Field of Education Identifier 061305 Indigenous Health  04/Nov/2011 
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Modification History

Not Applicable

Unit Descriptor

Unit Descriptor 

This unit deals with the skills and knowledge required to deliver primary health care services within the context of Aboriginal or Torres Strait Islander health

Application of the Unit

Application 

This unit is basic to the delivery of any aspect of health services or health support services to members of Aboriginal or Torres Strait Islander communities

The unit applies to those working individually (eg. in isolated practice) and as part of a team (eg. in a clinic or hospital), whether the services are delivered through visits to the community, in Aboriginal or Torres Strait Islander community clinics or in mainstream health services

Licensing/Regulatory Information

Not Applicable

Pre-Requisites

Not Applicable

Employability Skills Information

Employability Skills 

This unit contains Employability Skills

Elements and Performance Criteria Pre-Content

Elements define the essential outcomes of a unit of competency.

The Performance Criteria specify the level of performance required to demonstrate achievement of the Element. Terms in italics are elaborated in the Range Statement.

Elements and Performance Criteria

ELEMENT 

PERFORMANCE CRITERIA 

1. Work in the context of Aboriginal health and history 

1.1 Take into account the national/local history of Aboriginal and Torres Strait Islander people as a factor in health work

1.2 Consider the impact of social , political , spiritual , economic and environmental factors on the health of Aboriginal and /or Torres Strait Islander people 

1.3 Reflect in work practice Aboriginal and/or Torres Strait Islander community-control and current strategies, programs and models that address Aboriginal and/or Torres Strait Islander Primary Health Care issues

2. Apply Primary Health Care principles

2.1 Ensure Primary Health Care principles underpin service delivery

2.2 Deliver services that support Aboriginal and/or Torres Strait Islander people and communities to be self-determining and empowered

2.3 Demonstrate commitment to achieving access and equity in health services for Aboriginal and/or Torres Strait Islander people

2.4 Establish and maintain networks with health care agencies and associated services (eg. housing agencies) to support Aboriginal and/or Torres Strait Islander health care

3. Work in a culturally safe manner

3.1 Deliver health services safely in line with organisation policies , regulatory requirements and community protocols

3.2 Consider and respect local community values, beliefs and gender roles when providing health care to Aboriginal and/or Torres Strait Islander people

3.3 Apply cultural safety protocols in the implementation of government policies, research and data collection and the delivery of services to Aboriginal and/or Torres Strait Islander people

3.4 Identify cultural factors  that produce stress and have a potential to impact own work practices and report to organisation as appropriate to support service delivery and personal well-being

4. Apply Aboriginal and/or Torres Strait Islander health policies and resources

4.1 Identify relevant aspects of Aboriginal and/or Torres Strait Islander health strategies, policies, bodies and resources

4.2 Apply policies and resources in line with identified need of Aboriginal and/or Torres Strait Islander people and communities

4.3 Identify barriers to access and equity in relation to Aboriginal and/or Torres Strait Islander health

4.4 Take available opportunities to advocate on behalf of Aboriginal and/or Torres Strait Islander people and/or communities

4.5 Maintain confidentiality of client information

Required Skills and Knowledge

REQUIRED SKILLS AND KNOWLEDGE 

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge :

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

  • Aboriginal and/or Torres Strait Islander health, including:
  • relevant definitions of 'health' (such as those of the World Health Organisation, NACCHO)
  • Aboriginal and/or Torres Strait Islander community perceptions of major health issues affecting them and underlying causes
  • perceptions of non-Aboriginal and/or Torres Strait Islander people relating to major Aboriginal and/or Torres Strait Islander health issues and underlying causes
  • key health statistics (national, state and/or local) for Aboriginal and/or Torres Strait Islander people compared to those of non-Aboriginal and/or Torres Strait Islander population (such as expectation of life at birth, infant mortality rate, age standardised mortality ratios for selected health conditions)
  • Aboriginal and/or Torres Strait Islander history, including:
  • history, social structures, beliefs and values of traditional and contemporary Aboriginal and/or Torres Strait Islander communities in Australia
  • effects of colonisation as experienced by Aboriginal and/or Torres Strait Islander people
  • historical dilemmas faced by Aboriginal and/or Torres Strait Islander people (acknowledge or deny Aboriginality)
  • impacts of government policies and legislation and their impact on Aboriginal and/or Torres Strait Islander communities, families and individuals
  • Social, cultural and environmental determinants and strategies to address Aboriginal and/or Torres Strait Islander health status, including:
  • traditional Aboriginal and/or Torres Strait Islander cultural practices and lifestyle and their impact on Aboriginal and/or Torres Strait Islander health
  • importance of land, tradition and cultural practice to Aboriginal and/or Torres Strait Islander health
  • impact of socio-economic factors on health
  • social and political factors that perpetuate disadvantage
  • importance of personal achievement, education and supportive family/social networks
  • strategies Aboriginal and/or Torres Strait Islander families may employ to maintain strong culture and supportive social networks and maximise educational, employment and social opportunities for their children
  • Impact of environmental factors on health
  • Barriers to improving environmental determinants of ill-health

continued  ...

Essential knowledge  (contd ):

  • Lifestyle and behavioural determinants Aboriginal and/or Torres Strait Islander health and strategies to address them, including:
  • Nutrition, physical activity, rest and sleep in relation to holistic health
  • Known behaviours that pose a significant risk to Aboriginal and/or Torres Strait Islander people
  • Aboriginal and/or Torres Strait Islander lifestyle practices and the effects on health
  • Education and promotion of healthy lifestyle practices
  • Principles of well-being applied to work and study practices
  • Primary health care model, including:
  • WHO Primary Health Care model and Ottawa Charter principles
  • Comparison of Primary Health Care model and conventional Western 'medical' model
  • Development of Aboriginal and/or Torres Strait Islander health services in Australia
  • Community control in relation to health service delivery to Aboriginal and/or Torres Strait Islander people
  • Issues in implementation of health services at local, state/territory and national levels
  • Relevant aspects of health care system, including:
  • Access to Medicare benefits
  • Pharmaceutical benefits
  • Related social benefits

Essential skills :

It is critical that the candidate demonstrate the ability to:

  • Work consistently in a culturally safe manner with and on behalf of Aboriginal and/or Torres Strait Islander clients in line with identified community needs and workplace requirements
  • Apply the principles of Primary Health Care in the delivery of health care services
  • Work with an understanding of the impact of historical, social, political, spiritual and environmental factors on the health of Aboriginal and/or Torres Strait Islander people

In addition, the candidate must be able to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

  • Take into account social, political and environmental factors that influence the health of Aboriginal and/or Torres Strait Islander clients
  • Conduct an accurate and effective holistic assessment of the health of Aboriginal and/or Torres Strait Islander clients, including:
  • taking and recording relevant details of client's history, including body language
  • observation and assessment of client's health, using appropriate tests and instrumentation
  • using a structured approach to assessment
  • Communicate effectively and establish a relationship of trust with clients
  • Initiate appropriate actions in response to assessment and in accordance with organisation procedures and protocols for commonly presented health conditions
  • Engage the client in self-management principles and practices
  • Make appropriate referrals, providing accurate and relevant details to clients and referral agencies
  • Reflect on and improve own level and application of skills and knowledge to achieve desirable outcomes and maintain own capabilities

Evidence Guide

EVIDENCE GUIDE 

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects of assessment :

  • The individual being assessed must provide evidence of specified essential knowledge as well as skills
  • Consistency of performance should be demonstrated over the required range of situations relevant to the workplace
  • Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible

Conditions of assessment :

This unit includes skills and knowledge specific to Aboriginal and/or Torres Strait Islander culture

Assessment must therefore be undertaken by a workplace assessor who has expertise in the unit of competency or who has the current qualification being assessed and who is:

  • Aboriginal or Torres Strait Islander him/herself

or:

  • accompanied and advised by an Aboriginal or Torres Strait Islander person who is a recognised member of the community with experience in primary health care

It is critical that in assessing this unit, consideration is given to the sensitive nature of some aspects of the unit, particularly as they apply to Aboriginal and/or Torres Strait Islander history and culture and to the culture of the person or group being assessed

Assessment methods should be sensitive to emotional reactions of individuals being assessed, and it is highly recommended that access be made available as required to support, such as counselling in social and emotional well-being

Context of assessment :

Competence should be demonstrated working individually, under supervision or as part of a primary health care team in a clinical care environment, with Aboriginal and/or Torres Strait Islander clients.

Where applicable, assessment should replicate workplace conditions as far as possible.

Related units :

This unit may be assessed independently or in conjunction with other units with associated workplace application

Range Statement

RANGE STATEMENT 

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Cultural respect 

This competency standard supports the recognition, protection and continued advancement of the inherent rights, cultures and traditions of Aboriginal and Torres Strait Islander peoples

It recognises that the improvement of the health status of Aboriginal and Torres Strait Islander people must include attention to physical, spiritual, cultural, emotional and social well-being, community capacity and governance

Its application must be culturally sensitive and supportive of traditional healing and health, knowledge and practices

Community control 

Community participation and control in decision-making is essential to all aspects of health work, and the role of the health worker is to support the community and/or key decision-makers in this process

Aboriginal and/or Torres Strait Islander community control is:

  • the guiding principle and model for the delivery of holistic primary health care services to Aboriginal and Torres Strait Islander people
  • a sector of the Australian health industry with its own history
  • a practice which underpins Aboriginal community strengthening and survival
  • a statement of self-determination

Supervision 

Supervision must be conducted in accordance with prevailing state/territory and organisation legislative and regulatory requirements

References to supervision may include either direct or indirect supervision of work by more experienced workers, supervisors, managers or other health professionals

A person at this level should only  be required to make decisions about clients within the organisation's standard treatment protocols and associated guidelines

Legislative requirements 

Federal, state or territory legislation may impact on workers' practices and responsibilities. Implementation of the competency standards should reflect the legislative framework in which a health worker operates. It is recognised that this may sometimes reduce the application of the Range of Variables in practice. However, assessment in the workplace or through simulation should address all essential skills and knowledge across the Range of Variables

Aboriginal and/or Torres Strait Islander Health Workers may be required to operate in situations that do not constitute 'usual practice' due to lack of resources, remote locations and community needs. As a result, they may need to possess more competencies than described by 'usual practice circumstances'

Under all circumstances, the employer must enable the worker to function within the prevailing legislative framework

The history of Aboriginal and /or Torres Strait Islander people includes :

  • Aboriginal and/or Torres Strait Islander customs and lifestyle before European colonisation
  • Aboriginal and/or Torres Strait Islander experience of colonisation and invasion
  • Post-colonial legacy of social and economic disadvantage
  • Survival and maintenance of culture, kinship and connection with the land
  • Evolution and scope of the role of the Aboriginal Health Worker up to the contemporary context

Cultural safety refers to :

  • Maintaining the traditional and contemporary protection of Aboriginal and/or Torres Strait Islander communities':
  • intellectual property
  • human rights
  • resources
  • ownership of materials
  • Community and self-protection of Aboriginal and/or Torres Strait Islander Health Workers.

Cultural factors that may produce stress include :

  • Community and/or own expectations that may involve, for example:
  • extended work hours
  • functions outside health work role
  • unrealistic accountability/responsibility for resolving community problems
  • family pressures
  • Multiple accountabilities to employer, family, personal and community
  • Motor vehicle accidents

Social , political , economic and environmental factors that impact on Aboriginal and /or Torres Strait Islander health include :

  • Health outcomes
  • Stolen generations
  • Colonisation and invasion
  • Land rights and native title
  • Dispossession
  • Acts of government including assimilation policies
  • Racism and discrimination
  • Media
  • Employment
  • Poverty
  • Mortality/morbidity
  • Police-community relations
  • Housing
  • Education
  • Substance misuse
  • Acculturation and
  • Political leverage

Diseases and injuries responsible for high levels of death or disability in Aboriginal and /or Torres Strait Islander populations include :

  • Coronary heart disease
  • Respiratory infection
  • Diabetes
  • Kidney disease
  • Suicide/self-harm, family violence/homicide and accidents
  • Substance misuse (alcohol and other drugs)
  • Failure to thrive (infants)
  • Pregnancy and lactation problems
  • Cardiovascular disease
  • Cancers
  • Sexually transmitted diseases
  • Mental health problems
  • Oral diseases

Agencies associated with health care services may include :

  • Community controlled health providers
  • Women's/men's centres
  • Government health services
  • Welfare agencies
  • Emergency services
  • Police
  • Education and training organisations
  • Non-government and private enterprise
  • Community Government Councils
  • Elected community organisations
  • Homeland/outstation service providers
  • Churches

Aboriginal and /or Torres Strait Islander health bodies , strategies , policies and resources may include :

  • National, state/territory and regional Aboriginal and/or Torres Strait Islander health strategies, policies, joint planning bodies
  • The National Aboriginal and Torres Strait Islander Health Council
  • The National Aboriginal Community Controlled Health Organisation (NACCHO) and its state/territory affiliates
  • Resources available nationally, locally and at the state/territory level
  • National Aboriginal Health Strategy (1989)
  • ABS publications

Barriers to access and equity in relation to Aboriginal and /or Torres Strait Islander health may include :

  • Racism, including community and institutionalised racism
  • Discrimination
  • Socio-economic status
  • Access to essential services and infrastructure
  • Lack of co-ordination of government at all levels
  • Inadequate resources/funding
  • Lack of community control and ownership
  • Lack of political leverage
  • Language barriers
  • Disease focus of mainstream health care delivery
  • Differences in concept of ill health
  • Geographic access to Primary Health Care and specialist health services
  • Cultural barriers, such as family and kinship barriers
  • Language/literacy

Organisation policies and regulatory requirements may include :

  • Privacy and confidentiality guidelines
  • Treatment manuals
  • OH and S guidelines
  • Infection control guidelines

Unit Sector(s)

Not Applicable

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