Embedding cultural safety in health professional child protection responses to Aboriginal families in NSW paediatric care settings

What is the problem?

Aboriginal children are over-represented in child protection services. The reasons for this are complex.

Previous research has found that clinicians’ and organisational responses to Aboriginal children and their families in healthcare facilities is not always appropriate or culturally safe, and that clinician documentation and referral of suspected child abuse cases is sub-optimal. This research also revealed that health professionals and health organisations do not feel adequately prepared to respond to a child presenting to Emergency with a non-accidental injury. An integrated, culturally-centred approach for Aboriginal children and their families was identified as a potential solution.

About the research translation program

Maam-darrundaygam daalbirrwirr gamambigu (Embedding Cultural Safety in Health Professional Child Protection Responses for Aboriginal Children) builds the capacity of hospital staff in NSW’s Mid North Coast to provide culturally competent care for Aboriginal children and families who are at risk of becoming involved with the child protection system.

This project comprises the development, implementation and evaluation of an evidence-based framework to guide hospital processes and clinical practice. Developed in consultation with Aboriginal and non-Aboriginal health workers, the framework is based on the four key strengths of Australian Aboriginal cultural practices in family life, namely

    • A collective community focus on child rearing helps children;
    • Children need the freedom to explore and experience the world;
    • Elderly family members are important to family functioning; and
    • Spirituality helps families cope with challenges.

The project is assisting healthcare professionals in Port Macquarie and Coffs Harbour Base Hospitals to better communicate and work with Aboriginal families, and help embed cultural safety in health professional and child protection responses to Aboriginal families in NSW paediatric care settings. It is also determining the usefulness and uptake of a child injury protocol, and whether the protocol improves clinician documentation and referral of suspected child abuse cases.

What will be the impact?

It is anticipated that this project will lead to an increased awareness among clinicians and hospital staff of culturally safe healthcare for Aboriginal patients, as well as increased partnership between health professionals and Aboriginal children and their families, particularly around communication and decision making. This will result in better care for Aboriginal children and their families.

Culturally appropriate modifications of a child injury checklist in the ED will improve patient care and provide a mechanism for data collection and for monitoring the experiences of Aboriginal children and their families in the health service. For instance, this data will show how often the hospital Aboriginal Liaison Officer is involved when Aboriginal children present to the ED with an injury, as well as the prevalence of non-accidental injury in this cohort.

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