Embedding Cultural Safety in Health Professional Child Protection Responses to Aboriginal Families in NSW Paediatric Care Settings

Status: Project complete

What is the problem?

On a national level, Aboriginal children are over-represented in child protection services and they are 11 times more likely to be in Out of Home Care (OOHC).  Locally, although only 6% of the population on the Mid North Coast of NSW is Aboriginal, 60% of children in OOHC are Aboriginal.

Previous research by the Daalbirrwirr Gamambigu team revealed health professionals and organisations in child protection settings are unprepared to respond to Aboriginal children and their families.

It found that the responses of clinicians and healthcare organisations to Aboriginal children and their families are not always appropriate or culturally safe. 

Clinician documentation and referral of suspected child abuse cases is also sub-optimal. This is contributing to the over-representation of Aboriginal children in child protection settings.

About the research translation program

The Daalbirrwirr Gamambigu Project comprised the development, implementation and evaluation of an evidence-based framework, and accompanying model of care, to guide hospital processes and clinical practice.

Developed in consultation with Aboriginal and non-Aboriginal health workers, the project sought to:

    1. Ensure every Aboriginal family with a child identified as being at risk receives culturally competent care;
    2. Build health workforce capacity to deliver culturally competent care;
    3. Build strong and trusting relationships with Aboriginal communities;
    4. Create a framework and resources to guide organisations and health providers to deliver culturally appropriate care;
    5. Assess the impact and return on investment of the project; and
    6. Demonstrate the value of implementing the model of care.

What were the findings?

The project created two Aboriginal-designed products – a model of care and a framework that can be used by clinicians to deliver culturally appropriate care.

The framework provides the background to the development of the resources and the values and principles that underpin the initiative.

The model of care is a practical resource that guides providers on how best to manage an Aboriginal child and their family on their journey from presentation in the Emergency Department or Outpatients through to potential admission and discharge planning.

A key recommendation is to continue to source funding to implement this model of care to achieve the other worthwhile aims of the project.


Flemington, T., Lock, M., Shipp, J., Hartz, D., Lonne, B., & Fraser, J. A. (2021). Cultural safety and child protection responses in hospitals: a scoping review. International journal on child maltreatment: research, policy and practice4(1), 5-33. doi: 10.1007/s42448-020-00065-3


For more information, contact Dr Tara Flemington – tara.flemington@health.nsw.gov.au or Dr Jennifer Fraser – Jennifer.Fraser@sydney.edu.au