Caring for Aboriginal Victorians
Key takeaways:
Aboriginal and Torres Strait Islander peoples are estimated to represent 6.7% of people living with chronic hepatitis B in Australia. Prevalence of hepatitis B among Aboriginal and Torres Strait Islander people is 1.54% – significantly higher than the overall prevalence of 0.78%.
The higher prevalence of hepatitis B among Aboriginal peoples highlights the enduring traumatic legacy of colonisation, recognising the historical disadvantage perpetuated by institutional racism and systemic failures that collectively contribute to health disparities between Aboriginal peoples and non-Indigenous Australians.
Clinicians are encouraged to complete comprehensive cultural safety training (see links below) and understand the importance of providing appropriate and culturally safe care. Aboriginal communities are diverse, so it is important that cultural safety activities respect and respond to local protocols. Learning about cultural safety for non-Aboriginal clinicians is not a one-off training session, but an ongoing process of education and reflection.
Quick Links
Aboriginal Cultural Safety Training | Website | Victorian Aboriginal Community Controlled Health Organisation
AIDA’s Cultural Safety Training | Website | Australian Indigenous Doctors Association (AIDA)
On this page
As a clinician looking after Aboriginal peoples, it is important to be aware of a holistic approach to health and wellbeing and the relationship between these and cultural determinants of health. Good health and wellbeing may involve various aspects, encompassing physical, social, emotional, spiritual and ecological wellbeing. This holistic approach considers the individual and Community, going beyond a strictly biomedical understanding of health.
It is imperative that a culturally safe environment is provided, where cultural values and strengths are recognised and respected. Clinicians are encouraged to reflect on their attitudes, behaviours, and conscious and unconscious biases to work towards delivering safe and responsive healthcare.
Quick Links
What are the relevant health guidelines for Aboriginal Victorians?
The National guide to a preventative health assessment for Aboriginal and Torres Strait Islander people is a practical resource intended for all health professionals delivering primary healthcare to Aboriginal peoples.
This includes information on sexual health and blood-borne viruses, liver cancer prevention and pregnancy.
The Aboriginal and Torres Strait Islander cultural safety framework has been developed to help mainstream Victorian health, human and community services and the Department of Health to create culturally safe environments, services and workplaces.
It is recognised that these guidelines and frameworks have been developed in partnership with Community and the Aboriginal Community-controlled health sector. Their advice and expertise have contributed to making these valuable resources.
Quick Links
National guide to a preventative health assessment for Aboriginal and Torres Strait Islander people | PDF | RACGP & NACCHO
Australian Consensus STI Testing Guideline for Aboriginal and Torres Strait Islander People | PDF | ASHM
The Aboriginal and Torres Strait Islander cultural safety framework | Website | Victorian Government Department of Health
What health services are available for Aboriginal people living with hepatitis B?
Care for hepatitis B can be delivered in a number of different settings. Where clinically appropriate, patient choice must be taken into consideration. Care is available via primary care and hospital specialist settings. However, there are dedicated Aboriginal Community Controlled Health Organisations (ACCHOs) – see details and locations below.
For information on other care pathways for hepatitis B see here.
The Victorian Aboriginal Health Service is an ACCHO based in metropolitan Melbourne which provides a comprehensive range of medical, dental and social services for Community.
Other ACCHOs are available in regional Victoria. See the list of members here.
Supporting social and emotional wellbeing (SEWB) is part of the wrap-around ACCHO health service. In Victoria, most ACCHOs have SEWB workers who can assist with emotional and social support for families to remain linked into care. Many ACCHOs also have transport and telehealth options for patients. This is important as hepatitis is still very stigmatised in Aboriginal communities. A full list of services can be found on each ACCHO website but often include:
- Transport
- Delivery of medicines
- Aboriginal Health Workers and Practitioners
- General practice and community nurses
- Chronic disease nurses
- Visiting medical specialists
- Family services
- Social and emotional wellbeing workers
- Mental health and support for users of alcohol and other drugs
- Justice workers
Quick Links
The Victorian Aboriginal Health Service | Website
Members of VACCHO | Website & PDF | Victorian Aboriginal Community Controlled Health Organisation
As the medications for hepatitis B are an s100 medication they are not currently covered under the co-payment program.
This may change from 1 July 2024 and may be dependent on legislation passing. This section will be updated as required.
You can support eligible patients to register for the program via the Services Australia Health Professional Online Services (HPOS) portal. This is a one-off registration and will provide access to the program for other prescriptions. For information on eligibility and other information see here.
Quick Links
The Closing the Gap (CTG) – PBS Co-payment Program | Website | Australian Government Department of Health and Aged Care
Documenting Aboriginal and Torres Strait Islander status
Recording Aboriginal and Torres Strait islander status is vital to meeting health needs as it:
- ensures the care and services offered and provided are both clinically and culturally responsive
- improves monitoring and evaluation of health outcomes, services, programs and funding
- improves future health outcomes through service planning and targeted investment
- enables relevant and timely reports back to Community on specific health concerns.
How to ask and record status
- Ask the patient: “Are you of Aboriginal and/or Torres Strait Islander origin?” Ask all patients irrespective of appearance, country of birth or how well the staff know the client or their family background.
- Explain to your patient why this is relevant to their consultation. Refer to the National best practice guidelines for collecting Indigenous status in health data sets for examples of how to explain this to your patient.
- Record responses in your system.
A response should be a mandatory requirement when registering or entering client details in electronic data recording systems.
It is also important to record the status of non-Indigenous patients.
Further Information
National best practice guidelines for collecting Indigenous status in health data sets | Website | Australian Institute of Health and Welfare
How do I support Aboriginal patients with hepatitis B?
When supporting and providing health care to Aboriginal Victorians, clinicians are encouraged to seek out resources and avenues of support, and consider how you can support a holistic approach to health and wellbeing.
See below for a list of relevant community resources.
Further Information
Hep B is everyone’s business | PDF| LiverWELL
Yarning about hepatitis B | PDF | Hepatitis NSW
Auntie May and the dodgy tattoo (the story of Iluka, Janalli, Miro and Bindi as they learn about the hepatitis B virus) | Website | Hepatitis QLD
B Stronger | Website | Hepatitis QLD
Hepatitis B: The basics | PDF | Young, deadly, free
The Hep B Story App (available in English, Yolŋu, Anindilyakwa, Warlpiri, Tiwi, Arrernte, Kinwinjku, Pitjantjatjara, Burarra & Kriol | Web-based app | Menzies School of Health Research
What you need to know about hepatitis B | Video | Western Australian Government Department of Health
