The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects of assessment:

The individual being assessed must provide evidence of specified essential knowledge as well as skills

Consistency of performance should be demonstrated over the required range of situations relevant to the workplace

Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible

Conditions of assessment:

This unit includes skills and knowledge specific to Aboriginal and/or Torres Strait Islander culture

Assessment must therefore be undertaken by a workplace assessor who has expertise in the unit of competency or who has the current qualification being assessed and who is:

Aboriginal or Torres Strait Islander him/herself

or:

accompanied and advised by an Aboriginal or Torres Strait Islander person who is a recognised member of the community with experience in primary health care

It is critical that in assessing this unit, consideration is given to the sensitive nature of some aspects of the unit, particularly as they apply to Aboriginal and/or Torres Strait Islander history and culture

Assessment methods should be sensitive to emotional reactions of individuals being assessed, and it is highly recommended that access be made available as required to support, such as counselling in social and emotional well-being

Context of assessment:

Competence should be demonstrated working individually, under supervision or as part of a primary health care team working with Aboriginal and/or Torres Strait Islander clients

Assessment should replicate workplace conditions as far as possible

Related units:

This unit may be assessed independently or in conjunction with other units with associated workplace application

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge:

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

Social, cultural, political and environmental determinants of Aboriginal and/or Torres Strait Islander health, including:

traditional Aboriginal and/or Torres Strait Islander cultural practices and lifestyle and their impact on Aboriginal and/or Torres Strait Islander health

importance of land, tradition and cultural practice to Aboriginal and/or Torres Strait Islander health

impact of socio-economic factors on health

social and political factors that perpetuate disadvantage

importance of personal achievement, education and supportive family / social networks

impact of environmental factors on health

barriers to improving environmental determinants of ill-health

impact of loss, grief and trauma on health in relation to individual, historical and cultural events and past and current policies

issues of food security / access (ie. quantity and quality of food sufficient to meet requirements for unrestricted growth and development of all individuals at all times)

Means to address access and equity issues, such as:

strategies Aboriginal and/or Torres Strait Islander families may employ to maintain strong culture and supportive social networks and maximise educational, employment and social opportunities for their children

understanding the political context of health care system and access to benefits such as Medicare and pharmaceutical benefits

community development initiatives

Aspects of Aboriginal and/or Torres Strait Islander health, including:

relevant definitions of 'health' (such as those of the World Health Organisation, NACCHO)

Aboriginal and/or Torres Strait Islander community perceptions of major health issues affecting them and underlying causes

perceptions of non-Aboriginal and/or Torres Strait Islander people relating to major Aboriginal and/or Torres Strait Islander health issues and underlying causes

Key health statistics (national, state and/or local) for Aboriginal and/or Torres Strait Islander people compared to those of non-Aboriginal and/or Torres Strait Islander population (such as expectation of life at birth, infant mortality rate, age standardised mortality ratios for selected health conditions)

continued ...

Essential knowledge(continued):

Aboriginal and/or Torres Strait Islander history, including:

history, social structures, beliefs and values of traditional and contemporary Aboriginal and/or Torres Strait Islander communities in Australia

effects of colonisation as experienced by Aboriginal and/or Torres Strait Islander people

historical dilemmas faced by Aboriginal and/or Torres Strait Islander people (acknowledge or deny Aboriginality)

Impacts of government policies and legislation and their impact on Aboriginal and/or Torres Strait Islander communities, families and individuals

Lifestyle and behavioural factors Aboriginal and/or Torres Strait Islander health and their relationship to the social determinants of health

Strategies to address these factors, including:

nutrition, physical activity, rest and sleep in relation to holistic health

known behaviours that pose a significant risk to Aboriginal and/or Torres Strait Islander people

Aboriginal and/or Torres Strait Islander lifestyle practices and the effects on health

education and promotion of healthy lifestyle practices

principles of well-being applied to work and study practices

Primary health care model, including:

WHO Primary Health Care model and Ottawa Charter principles

comparison of primary health care model and conventional western 'medical' model

development of Aboriginal and/or Torres Strait Islander health services in Australia

community control in relation to health service delivery to Aboriginal and/or Torres Strait Islander people

Issues in implementation of health services at local, state/territory and national levels

Social determinants of health as per World Health Organisation's 'The Solid Facts':

the social gradient: What you do; How much you earn; Who you are; Where you live

stress

early life

social exclusion

working conditions

unemployment

social support

addiction

food

transport

Essential skills:

It is critical that the candidate demonstrate the ability to:

Identify and promote understanding of the social determinants of health for Aboriginal and/or Torres Strait Islander clients

Apply their awareness of the social determinants of health at an operational level in implementing strategies to address Aboriginal and/or Torres Strait Islander health issues

In addition, the candidate must be able to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

Research and clarify social, political, economic and environmental factors impacting on the health of Aboriginal and/or Torres Strait Islander clients

Explain policies and practices related to social determinants of health that apply to own work

Explain how social determinants impact health and how their impact may be reduced

Apply strategies, policies and resources relevant to improving the health of Aboriginal and/or Torres Strait Islander communities through addressing the social determinants of health

Contribute to health service delivery aspects of community development initiatives

Establish relationships with community groups, agencies and organisations involved in community development initiatives

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Cultural respect

This competency standard supports the recognition, protection and continued advancement of the inherent rights, cultures and traditions of Aboriginal and Torres Strait Islander peoples

It recognises that the improvement of the health status of Aboriginal and Torres Strait Islander people must include attention to physical, spiritual, cultural, emotional and social well-being, community capacity and governance

Its application must be culturally sensitive and supportive of traditional healing and health, knowledge and practices

Community control

Community participation and control in decision-making is essential to all aspects of health work, and the role of the health worker is to support the community in this process

Supervision

Supervision must be conducted in accordance with prevailing state/territory and organisation legislative and regulatory requirements

References to supervision may include either direct or indirect supervision of work by more experienced workers, supervisors, managers or other health professionals

A person at this level should only be required to make decisions about clients within the organisation's standard treatment protocols and associated guidelines

Legislative requirements

Federal, state or territory legislation may impact on workers' practices and responsibilities. Implementation of the competency standards should reflect the legislative framework in which a health worker operates. It is recognised that this may sometimes reduce the application of the Range of Variables in practice. However, assessment in the workplace or through simulation should address all essential skills and knowledge across the Range of Variables

Aboriginal and/or Torres Strait Islander Health Workers may be required to operate in situations that do not constitute 'usual practice' due to lack of resources, remote locations and community needs. As a result, they may need to possess more competencies than described by 'usual practice circumstances'

Under all circumstances, the employer must enable the worker to function within the prevailing legislative framework

Social determinants of health may include:

Socio-economic factors, including:

income inequality

employment, job availability/security

working conditions

education

housing, overcrowding and access to food.

Social inclusion and exclusion, including:

level of poverty and unemployment relative to the whole society.

isolation of communities located remotely from centres of high employment, education and services.

exacerbation by factors such as gender, age, ability, sexual orientation, culture and religion.

Contribution to the social economy

Early childhood care and education

Specific risk factors, including:

rates of substance misuse and abuse

poorer nutrition

incidence of family violence

Legacy of past (and current) practices:

removal from land

cultural dislocation

family separation

discrimination

Strategies to address social determinants of health may include:

Policies of social inclusion to reduce social, economic and environmental inequities and barriers to access and equity.

Promotion of full employment, job security and healthy working conditions.

Facilitation of access to a high quality health system that recognizes and addresses mental, social and spiritual health, including health promotion, disease prevention and health protection.

Facilitation of access to quality education, with early childhood education and care, and opportunities for meaningful experiences in lifelong learning and employment training.

Facilitation of access to adequate housing and food.

Reduction of income disparities to allow access to the basic necessities for healthy living.

Agencies and organisations involved in community development initiatives may include:

Community controlled health providers

Women's/men's centres

Government health services

Welfare agencies

Emergency services

Police

Education and training organisations

Non-government and private enterprise

Community government councils

Elected community organisations

Homeland/outstation service providers

Aboriginal and/or Torres Strait Islander health bodies, strategies, policies and resources may include:

National, state/territory and regional Aboriginal and/or Torres Strait Islander health strategies, policies, joint planning bodies

The National Aboriginal and Torres Strait Islander Health Council

The National Aboriginal Community Controlled Health Organisation (NACCHO) and its state/territory affiliates

Resources available nationally, locally and at the state/territory level

National Aboriginal Health Strategy (1989)

ABS publications

Barriers to access and equity in relation to Aboriginal and/or Torres Strait Islander health may include:

Racism, including community and institutionalised racism

Discrimination

Socio-economic status

Access to essential services and infrastructure

Lack of co-ordination of government at all levels

Inadequate resources/funding

Lack of community control and ownership

Lack of political leverage

Language barriers

Disease focus of mainstream health care delivery

Differences in concept of ill health

Geographic access to Primary Health Care and specialist health services

Cultural barriers, such as poison cousin and kinship barriers