Mutual obligation, shared responsibility agreements & indigenous health strategy

Area of Science:

• Public Health
• Indigenous Health Policy
• Health Services Management

Background:

• Australian government reforms in Indigenous affairs since 2004.
• Shift in policy from 'self-determination' to 'mutual obligation'.
• Introduction of Shared Responsibility Agreements (SRAs) under the new framework.

Purpose of the Study:

• To describe the parameters of the Indigenous affairs reform program.
• To review processes supporting national Indigenous health strategy implementation.
• To analyze the impact of new arrangements on Indigenous health planning.

Main Methods:

• Policy analysis of the Howard Coalition government's reforms.
• Review of administrative arrangements for Indigenous health.
• Case study of the Mulan Shared Responsibility Agreement (SRA).

Main Results:

• The reform program introduced a 'mutual obligation' framework replacing 'self-determination'.
• Shared Responsibility Agreements (SRAs) are a key mechanism of this new policy.
• The Mulan SRA illustrates difficulties in aligning new arrangements with existing Indigenous health planning.

Conclusions:

• The new policy arrangements present significant challenges for Indigenous health planning and strategy.
• Current approaches to Indigenous health strategy implementation may be hindered by the new framework.
• Further attention is needed to address the problems posed by these 'new arrangements'.