Maam-darrundaygam daalbirrwirr gamambigu: Embedding Cultural Safety in Health Professional Child Protection Responses for Aboriginal Children.

Aboriginal children remain overrepresented in child protection, justice, and welfare systems. Many health professionals are uncertain about how best to support Aboriginal children and families when they present to hospital with an injury.

The good news is there are culturally appropriate tools available, endorsed by AbSec (NSW Child, Family and Community Peak Aboriginal Corporation) that aim to embed cultural safety in health professional child protection responses for Aboriginal children.

However, with the overrepresentation of Aboriginal children in child protection and intergenerational trauma from Colonisation, the challenge is that parents are often wary of bringing a child to hospital for treatment.

NSW Regional Health Partners supported research to develop and embed an evidence-based Framework and Model of Care to guide health professionals and health services in providing culturally appropriate care for Aboriginal families who have children involved, or at risk of becoming involved, with child protection services.

The project was a success!

The Framework and Model of Care together have led to:

Improved healthcare

A modified ISBAR (a WHO endorsed tool for Identifying and Solving Barriers to effective clinical handover) was developed to assist in culturally safe patient handover between health professionals. It uses culturally appropriate tools to engage and support Aboriginal families more effectively and heath care workers are reporting greater confidence in supporting Aboriginal children and their families on presentation to hospital. It is the first evidence-based Model of Care in Australia to guide health professionals and hospitals in providing culturally appropriate care for Aboriginal families who have children involved, or at risk of becoming involved, with child protection services. It has been designed to be successfully implemented across a range of settings and has been endorsed by AbSec. Further, the clinical utility and feasibility of implementing the Framework and Model of Care has been demonstrated by clinicians, doctors, nurses and allied health staff from Coffs Harbour Hospital, Port Macquarie Hospital, The Children’s Hospital Westmead, and the Sydney Children’s Hospital.

Improved policy

The Model of Care and Framework has been submitted for endorsement to the Senior Executive Teams and Governing Boards of the Mid North Coast Local Health District and Sydney Children’s Hospitals Network. Once endorsed, the Model will immediately be incorporated into mandatory staff training in these districts.

Social impact

Conducting the study has itself had positive outcomes for the Aboriginal people involved through its application of the principles of the AIATSIS Code of Ethics for Aboriginal and Torres Strait Islander Research (2020): Indigenous self- determination, leadership, impact and value, and sustainability and accountability. The co-design process has ensured an appropriate and effective Model that promotes cultural safety in clinical practice, evidenced by the endorsement of AbSec, and the model has the ongoing support of Aboriginal and mainstream stakeholders and organisations. The stronger partnerships built between the health services, Aboriginal Community Controlled Health Organisations (ACCHO), and Aboriginal community members will continue to support evidence based, culturally-safe care for Aboriginal families and their children on the NSW Mid North Coast.
Further, the three Aboriginal Project Officers involved in the project have each secured permanent, senior positions in the health service. This will further strengthen the opportunities for Indigenous-led research.

This project was supported by the Australian Government’s Medical Research Future Fund (MRFF) as part of the Rapid Applied Research Translation program.


Flemington, T., Lock, M., Shipp, J. et al. Cultural Safety and Child Protection Responses in Hospitals: a Scoping Review. Int. Journal on Child Malt. 4, 5–33 (2021).