Educating for Indigenous public health competence – how do we stack up in Australia?

Abstract

Objective: Internationally, work is underway to develop or revise public health graduate competencies, of which Indigenous public health competencies are a subset in Australia. This paper outlines the summative results from a review of Master of Public Health (MPH) programs undertaken to determine the level of coverage of Indigenous health in core content and to explore factors that influence the extent of integration. Methods: Of the 22 Australian universities offering an MPH program at the commencement of this study, seven were eventually reviewed using a mixed methods approach. Results: Results showed varying levels of relevant content in both core and elective subjects. Not all reviewed universities taught all the competencies in their core curriculum and some universities did not cover all the competencies in either the core or elective subjects. Conclusion: These findings highlight the need for inclusion of the Indigenous public health competencies to be made obligatory in MPH programs. Implications for public health: Significant gaps remain in public health curricula enabling students to develop competencies that enable them to become judgement safe practitioners when working with Indigenous peoples and communities. A revised curriculum framework document provides a range of useful strategies and resources to remedy these omissions.

The growth of Australian public health graduates and courses, 2001‐2018: implications for education and employment opportunities

“…The PHERP review suggested several reasons for a low participation rate, including a lack of Indigenous content in curriculum and a lack of support for Indigenous graduates, and there has been some notable work in this area, including the development of curriculum frameworks for Aboriginal and Torres Strait Islander public health education 18 . However, a recent review of Australian public health courses suggests Indigenous health competencies are not always covered 19 . This decline may be reflective of increased barriers within public health education, or increased access to other degrees, and future research should determine which of these is the case.…”

Addressing the knowledge gap of Indigenous public health: reflections from an Indigenous public health graduate

“…Each competency within public health begins with an introduction of the underpinning knowledge around public health history and the rationale of appropriate study designs and research methods (Coombe et al ., 2019). Yet, without embedding Indigenous historical and current social conditions that continue to further sustain inequitable power dynamics and legitimise a violent health system, it is all but meaningless (Durey and Thompson, 2012).…”

“…Public health needs to equip graduates with a criticality about it as a discipline which includes an understanding that ‘Indigenous health’ as conceived through public health has failed Indigenous peoples, thus enabling ‘less leeway for systemic or interpersonal bias in public health and clinical decision-making’ (Paradies et al ., 2008). The limited capacity of non-Indigenous academics teaching Indigenous health to engage in this disciplinary criticality impacts their ability to constructively comprehend and address challenges of systematic failures, thus subsequently affecting their willingness and ability to integrate Indigenous content (Coombe et al ., 2019). Consequently, future public health professionals will not be well-equipped to critically evaluate and reflect on how the values, norms and practices of contemporary structures and institutions consider one group superior to others (Bastos et al ., 2018).…”

“…Despite the overwhelming evidence that health inequalities, including those experienced by Indigenous peoples are socially determined, there remains limited engagement with the social sciences and for that matter the social world of Indigenous peoples. Not only are there significant gaps in the framework; the situation is worse in institutions with a shortage of Indigenous public health expertise, knowledges and perspectives among teaching staff and within primary programs in the school (Coombe et al ., 2019). Primary components for both Indigenous and non-Indigenous students in preparation for work in the field of public health and future engagement with Indigenous peoples is more than understanding and applying core competencies; it demands an understanding of Indigenous knowledges, cultures, historical contexts and the contemporary concerns and matters that directly impact communities (Harvey and Russell-Mundine, 2019).…”

“…The provision of culturally safe practice and culturally competent health professionals requires a sustained focus of Indigenous ways of knowing and teaching. Integrating an Indigenist strengths-based training approach across public health competencies within the program is fundamental to addressing the identified gap in Indigenous health (Coombe et al ., 2019). A challenge is the lack of willingness to embed a decolonised approach of Indigenous health knowledge as well as address how racism works within public health education.…”