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Aboriginal and Torres Strait Islander Health Workers

Overview

This page provides information and data on the Aboriginal and Torres Strait Islander Health Worker workforce.

Aboriginal and Torres Strait Islander Health Workers and Practitioners play a significant role in meeting the health needs of Aboriginal and Torres Strait Islander communities. The roles that they perform vary and are dependent on the needs of the community they serve, and they often work in collaboration with a range of clinical health practitioners, allied health practitioners and many other types of workers across the health sector to ensure the needs of individuals are adequately met.

The Aboriginal and Torres Strait Islander Health Worker Training Package Products are being updated in consultation with sector stakeholders. An area of particular focus involves the examination of the skills needs of the workforce with the current qualifications to help identify and determine what updates are required to ensure training is aligned with industry needs for job roles.

The Aboriginal and Torres Strait Islander Health Worker Industry Reference Committee (IRC) is responsible for seven qualifications, packaged in the HLT – Health Training Package.

For information on other health-related training and employment, visit the Health industry page and the various sectors.

All data sources are available at the end of the page.

Employment trends

Employment snapshot

In 2021, there are approximately 1,800 Aboriginal and Torres Strait Islander Health Workers. This number is projected to decline to 1,300 by 2025.

Training trends

Training snapshot

Program enrolments in Aboriginal and Torres Strait Islander Health Worker-related qualifications increased between 2016 and 2018, but began to decline in 2019. In 2020, there were approximately 1,460 program enrolments. Program completions remained largely stable between 2016 and 2019 before declining to 260 in 2020. The majority of program enrolments (about 66%) were at certificate IV level. The intended occupation for all training was Aboriginal and Torres Strait Islander Health Worker.

Approximately 59% of training was provided by TAFE institutes and 33% by private training providers. The majority of training (91%) was government funded.

Queensland had the highest proportion of students enrolled in Aboriginal and Torres Strait Islander Health Worker-related qualifications in 2020, with 32%, followed by New South Wales with 26% and the Northern Territory with 15%.

Approximately 31% of training was delivered in Queensland, followed by 26% in New South Wales and 17% in the Northern Territory.

There were insufficient enrolments in apprenticeships or traineeships to allow analysis.

For more data specific to your occupation, industry group or training package, visit NCVER’s Data Builder.

For more data specific to your region please visit NCVER’s Atlas of Total VET.

If you are interested in extracting NCVER data to construct tables with data relevant to you, please sign up for a VOCSTATS account.

Industry insights

Industry insights on skills needs

The Aboriginal and Torres Strait Islander Health Worker IRC's Skills Forecast – 2020 Update (hereafter the 2020 Annual Update) identified the top five short-to-medium term skills considered extremely important across the Aboriginal and Torres Strait Islander Health workforce are communication, teamwork, self-management, flexibility, and problem solving and critical thinking. Skills involved in the early detection and intervention of health needs are also important for the future workforce.

According to the job vacancy data, the top requested attributes and skills by employers in the sector were Aboriginal and/or Torres Strait Islander descent and communication skills. The most advertised occupations were Aboriginal Health Worker, followed by Aboriginal Mental Health Worker. The top employers were the New South Wales Government and the Government of Western Australia.

In 2019, the Aboriginal and Torres Strait Islander Health Worker IRC identified several workforce challenges, summarised as a lack of career progression opportunities, government policy and legislation changes, and skills and workforce supply shortages. More recently, in the 2020 Annual Update, the IRC included the impact of COVID-19 and regulatory developments regarding capability requirements, as well as other remaining workforce challenges. Further information about the impact of COVID-19 is below.

Regulatory developments

From 1 June 2020, the Accreditation standards: Aboriginal and Torres Strait Islander health practice (2019) came into effect. These standards apply to any Aboriginal and/or Torres Strait Islander Primary Health Care Practice program where graduates expect to qualify for registration with the Aboriginal and Torres Strait Islander Health Practice Board of Australia. The accreditation standards refer to the Professional capabilities for registered Aboriginal and Torres Strait Islander health practitioners. These capabilities identify the knowledge, skills and professional attributes needed to safely and competently practise as an Aboriginal and Torres Strait Islander health practitioner, and establish the threshold level of professional capability needed for registration in Australia.

The new National Agreement on Closing the Gap represents a different approach to the delivery of government services, with all Australian governments working with Aboriginal and Torres Strait Islander people, their communities, organisations and businesses. The Commonwealth Closing the Gap Implementation Plan provides a snapshot of the Commonwealth’s existing actions, strategies and frameworks that contribute to Closing the Gap. This includes the National Aboriginal and Torres Strait Islander Health Plan 2021-2031 which recognises the need for structural reform to improve access, address racism and enhance cultural safety across the whole health system. The newly released National Aboriginal and Torres Strait Island Health Workforce Strategic Framework and Implementation Plan and the National Medical Workforce Strategy will also work together to build a health workforce that is equipped to provide culturally safe, high quality care across all locations.

Staff shortages

The 2020 Annual Update reports there are shortages in skilled Aboriginal and Torres Strait Islander Health Workers, with employers experiencing difficulties in hiring appropriate staff. A lack of applicants, low wages, remote location, and the job being perceived to be unattractive are some of the key reasons why it is difficult to find new staff.

Further, shortages in other areas, such as a lack of Allied Health Assistants, has seen Aboriginal and Torres Strait Islander Health Workers take on responsibilities of organising Allied Health Clinics. In turn, this impacts on the provision of core role duties, including health promotion and education.

Supply of skilled workers also remains an issue, with low completion of training. Related to training, stakeholders indicated there are challenges in developing clinical skills and the difference in rural/remote and metropolitan facilities and services (for example, libraries, internet access, the availability of tutors and assessors) which are also contributing to supply of appropriately trained people. According to the 2020 Annual Update, the Australian Government Department of Health is leading the development of a Workforce Plan that focuses on attracting, training and retaining the Aboriginal and Torres Strait Islander Health workforce across Australia.

Retention of staff

The SkillsIQ’s 2020 Future Skills Survey, undertaken in early 2020, found one workforce challenge was the retention of staff. Separately, the National Rural Health Commissioner Final Report published in October 2020, provides an overview of challenges with retention of health workers in rural areas. According to the 2020 Annual Update, stakeholder feedback indicates this is in part due to an ageing workforce approaching retirement, who have high levels of skills, knowledge and experience. There are concerns about the next generation of workers who will fill these roles, with suggestions for more government funding to support the mentoring of less experienced workers.

Beyond parity in Aboriginal and Torres Strait Islander Health Workforce Planning: Achieving equity through needs-based and strengths-based approaches investigates workplace planning methods based on the healthcare needs of Aboriginal and Torres Strait Islander people in view of the National Agreement on Closing the Gap. The Agreement recognises that achieving better Aboriginal and Torres Strait Islander health outcomes requires equity in the health system investment, system-wide workplace reforms and strength-based approaches that emphasise partnerships with Indigenous organisations and communities. Yet, there is no national commitment at present to achieving an equitable number of Aboriginal and Torres Strait Islander people within a culturally safe and responsive workforce. As such, the report shows what is required for needs-based workforce planning and addressing low retention rates of Aboriginal and Torres Strait Islander health professionals.

Strengthening cultural safety of care is a vital challenge for the health sector. The article “We’re very much part of the team here”: A culture of respect for Indigenous health workforce transforms Indigenous health care, show how two cancer services and their affiliated hospitals demonstrate positive patient outcomes and a strong Indigenous health workforce can be achieved.

Retention is also an issue within the Aboriginal and Torres Strait Islander mental health workforce. This underrepresentation of Indigenous Australians in the mental health workforce is a key barrier to engagement with mental health services, according to Improving Indigenous Mental Health Outcomes with an Indigenous Mental Health Workforce. The report, published by the Australian Institute of Health and Welfare, finds that Aboriginal and Torres Strait Islander people have more cultural safety and trust in mental health services delivered by Aboriginal and Torres Strait Islander mental health workers and professionals, who can deliver culturally relevant mental health services, with holistic social and emotional wellbeing perspective. The NSW Aboriginal Mental Health and Wellbeing Strategy 2020-2025 provides an example for working that aims to underpin change that supports the national Agreement for Closing the Gap in Aboriginal health outcomes.

Career pathways

One way to help to attract and retain workers into the sector is to develop clear career pathways. The Career Pathways Project, by the Lowitja Institute, aims to provide insight and guidance to enhance the capacity of workplaces and they health system more broadly, to retain and support the development and careers of Aboriginal and Torres Islander people in the workforce.

Training quality

The 2020 Annual Update reports stakeholder feedback expressed concerns about the quality of trainers and training, and level of skill and knowledge shared with students. Aboriginal and Torres Strait Islander heath workers require a wide range of knowledge to be well-prepared and capable in the role and there are concerns this may be undermined if good quality trainers and training is not available. Another challenge identified in the 2020 Annual Update is the development of learning resources which align with training requirements.

Suitability of job roles

Stakeholder feedback emphasises Aboriginal and Torres Strait Islander Health Worker training and job roles need to be fit-for-purpose and specifically address Aboriginal and Torres Strait Islander health concerns, rather than being portable to broad health concerns. Aboriginal and Torres Strait Islander Job roles, for example, need to ensure a focus on being agents of change, such as being a point of contact in the early detection and intervention of Aboriginal and Torres Strait Islander health issues.

COVID-19 impact

COVID-19 has impacted the Aboriginal and Torres Strait Islander health workforce, as well as respective job roles in different ways, according to the IRC’s 2020 Annual Update. As such, it reports that many workplaces have implemented additional measures to improve or reinforce practices to improve infection control and help keep patients and workforce safe in response to the pandemic.

The 2020 Annual Update also states the focus on infection control will continue to be an area of concern for the foreseeable future, with the IRC saying this may need to be considered in future reviews of the Aboriginal and Torres Strait Islander Health Worker Training Package.

COVID-19: Resources for Aboriginal and Torres Strait Islander Health Professionals published by the National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners, provides a guide to being prepared, looking after oneself, and resources for helping keep communities safe. Up-to-date information about COVID-19 and links to relevant resources for Aboriginal and Torres Strait Islander Heath workers are also available through NAATSIHWP e-news.

In considering public policy perspectives in response to the COVID-19 crisis on Indigenous Australians, the Centre for Aboriginal Economic Policy and Research (CAEPR) reflects on the Indigenous health workforce (see pages 18-20). It states that during pandemics Aboriginal and Torres Strait Islander people in the health workforce play a vital role in addressing the significant risks to Indigenous communities. They mitigate risks, reduce impacts and improve health outcomes by providing culturally relevant information and culturally safe forms of care. The number of Indigenous health professionals are increasing, but too slowly. CAEPR concludes important lessons will emerge in addressing the impacts of COVID-19 for supporting and growing this crucial workforce in the future.

Over 30 Indigenous leaders in mental health and wellbeing contributed to A National COVID-19 Pandemic Issues Paper on Mental Health and Wellbeing for Aboriginal and Torres Strait Islander Peoples. This report calls for a coordinated response based on best practice research in Indigenous mental health and wellbeing. Indigenous governance must be prioritised to manage the COVID-19 recovery in communities through equitable, needs-based funding to support strengths-based, place-based, Indigenous-led, and community-led initiatives that address the social and cultural determinants of health and wellbeing.

More information may also be available from the Australian Government Department of Health and the Australian Heath Practitioner Regulation Agency.

Links and resources

Below is a list of industry-relevant research, organisations and associations. Hyperlinks have been included where available.

IRC and skills forecasts

 

Relevant research

A National COVID-19 Pandemic Issues Paper on Mental Health and Wellbeing for Aboriginal and Torres Strait Islander Peoples – Patricia Dudgeon, Kate Derry, Kerry Arabena et al

Accreditation standards: Aboriginal and Torres Strait Islander health practice – Aboriginal and Torres Strait Islander Health Practice Accreditation Committee

Beyond parity in Aboriginal and Torres Strait Islander Health Workforce Planning: Achieving equity through needs-based and strengths-based approaches – J Lahn, S Puszka, Y Dinku, N Nichols and F Markham

Career Pathways Project – Project leaders, Erin Lew Fatt and Dr Sally Nathan

Commonwealth Closing the Gap Implementation Plan – Commonwealth of Australia

COVID-19: Resources for Aboriginal and Torres Strait Islander Health Professionals – National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners

Improving Indigenous Mental Health Outcomes with an Indigenous Mental Health Workforce – Penney Upton, Linda Ford, Ruth Wallace, Sarah Jackson, Jenna Richard and Dominic Upton

Indigenous Australians and the COVID-19 Crisis: Perspectives on Public Policy – F Markham, D Smith and F Morphy

NAATSIHWP e-news – National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners

NSW Aboriginal Mental Health and Wellbeing Strategy 2020-2025 – NSW Ministry of Health

Professional capabilities for registered Aboriginal and Torres Strait Islander health practitioners – Aboriginal and Torres Strait Islander Health Practice Board

National Rural Health Commissioner Final Report – National Rural Health Commissioner

We’re very much part of the team here”: A culture of respect for Indigenous health workforce transforms Indigenous health care – Emma Taylor, Marilyn Lyford, Lorraine Parsons, Toni Mason, Sabe Sabesan and Sandra Thompson

 

Government departments and agencies

ACT Health

Australian Government Department of Health

Northern Territory Government Department of Health

NSW Health

Queensland Health

SA Health

Tasmanian Government Department of Health

Victoria Government Department of Health and Human Services

Western Australia Government Department of Health

 

Peak and industry associations

Aboriginal Health & Medical Research Council of New South Wales (AH&MRC)

Aboriginal Health Council of South Australia (AHCSA)

Aboriginal Health Council of Western Australia (AHCWA)

Aboriginal Medical Services Alliance Northern Territory (AMSANT)

National Aboriginal Community Controlled Health Organisation (NACCHO)

Queensland Aboriginal and Islander Health Council (QAIHC)

Royal Australian College of General Practitioners (RACGP)

Tasmanian Aboriginal Corporation trading as Tasmanian Aboriginal Centre (TAC)

Victorian Aboriginal Community Controlled Health Organisation (VACCHO)

 

Health professionals’ organisations

National Aboriginal and Torres Strait Islander Health Worker Association (NATSIHWA)

 

Employee associations

Australian Nursing and Midwifery Federation (ANMF)

Health Services Union (HSU)

United Workers Union

 

Regulators

Aboriginal and Torres Strait Islander Health Practice Board of Australia

Data sources and notes

Department of Employment 2021, Employment Projections, available from the Labour Market Information Portal

  • by ANZSCO, selected occupations, employment projections to May 2025
    • 4115 Indigenous Health Workers.

Australian Bureau of Statistics 2021, 6291.0.55.001 - EQ08 - Employed persons by Occupation unit group of main job (ANZSCO), Sex, State and Territory, August 1986 onwards, viewed 1 August 2021, https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-australia-detailed/may-2021

  • Employed total by ANZSCO 4 digit occupations, 2001 to 2021, May quarter
    • 4115 Indigenous Health Workers.

Training data has been extracted from the National VET Provider Collection, Total VET Students and Courses from the following training package or qualifications:

  • HLT – Health Training Package
    • HLT20113 - Certificate II in Aboriginal and/or Torres Strait Islander Primary Health Care
    • HLT21307 - Certificate II in Aboriginal and/or Torres Strait Islander Primary Health Care
    • HLT21312 - Certificate II in Aboriginal and-or Torres Strait Islander Primary Health Care
    • HLT30113 - Certificate III in Aboriginal and/or Torres Strait Islander Primary Health Care
    • HLT33207 - Certificate III in Aboriginal and/or Torres Strait Islander Primary Health Care
    • HLT33212 - Certificate III in Aboriginal and-or Torres Strait Islander Primary Health Care
    • HLT36115 - Certificate III in Indigenous Environmental Health
    • HLT40113 - Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care
    • HLT40213 - Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care Practice
    • HLT43907 - Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care (Practice)
    • HLT44007 - Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health (Community Care)
    • HLT50113 - Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care
    • HLT50213 - Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care Practice
    • HLT52107 - Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care (Practice)
    • HLT52207 - Diploma of Aboriginal and/or Torres Strait Islander Primary Health (Community Care).

 

This includes superseded qualifications and training packages.

Data covers a range of selected student and training characteristics in the following categories and years:

  • 2016 to 2020 program enrolments
  • 2016 to 2020 program completions.

 

Total VET students and courses data is reported for the calendar year. Program enrolments are the qualifications, courses and skill-sets in which students are enrolled in a given period. For students enrolled in multiple programs, all programs are counted. Program completion indicates that a student has completed a structured and integrated program of education or training. Location data uses student residence. Subject enrolment is registration of a student at a training delivery location for the purpose of undertaking a module, unit of competency or subject. For more information on the terms and definitions, please refer to the Total VET students and courses: terms and definitions document.

Low counts (less than 5) are not reported to protect client confidentiality.

Percentages are rounded to one decimal place. This can lead to situations where the total sum of proportions in a chart may not add up to exactly 100%.

HLT – Health Training Package apprentice and trainee data has been extracted from the National Apprentice and Trainee Collection, including:

  • 2011 to 2020 commencements
  • 2011 to 2020 completions
  • apprentices and trainees in-training October to December 2020 collection, by qualification and state and territory of data submitter.

 

Job vacancy data have been extracted from Burning Glass Technologies 2021, Labor Insight Real-time Labor Market Information Tool, Burning Glass Technologies, Boston, viewed July 2021, https://www.burning-glass.com.

Data shown represent most requested generic skills and occupations according to internet job postings in Australia between July 2018 and June 2021 filtered by ANZSIC and ANZSCO classification levels listed below.

ANZSCO occupations have been used as industry filters because they provide more relevant job vacancy data for this sector.

  • Generic skills / Occupations / Employers
    • 4115 Indigenous Health Workers.
Updated: 08 Nov 2021
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