Why evaluate aboriginal health initiatives

Prof Kerry Arabena – Chair of Indigenous Health, Director of Indigenous Health Equity Unit, University of Melbourne

There are three main reasons why I believe that we need to be able to do evaluation work incredibly well.  The first is around being accountable to government for the funds that they actually spend in our health services and to the communities who are responsible.  Secondly what we want to do is build our workforce and build our knowledge in the way that we are able to work, and thirdly is understanding the impact that we’re having in key areas that we’re working in so that we can better target interventions for future effort.

As a researcher I am very keen to keep on improving health service delivery, the quality of our services and also improve the ways in which our communities engage with our services through evaluation and quality improvement techniques.

Claire Grealy – Director, Economic and Social Advisory, Urbis

From the evaluator’s point of view the benefit of case studies is that it allows you to go into a community, listen to people's stories and build up a story back.  In health in particular, systems are complex, communities may not want to engage with health services and the health services may not be culturally safe.  These are complex issues and the elements in those communities interact in complex ways.

Prof Kerry Arabena

Evaluation has proved to be enormously beneficial at particular periods of time where you want to do good planning, where you want to make decisions.  It also helps communities understand and engage more in the research process and what it also does then is lend itself well to being generated as a peer reviewed publication, and there is not enough really good evidence out there about the work that we're doing.  I think we've got a lot to really value add, to not only our own experiences but the experiences of other vulnerable Australians.

Claire Grealy

So the case studies ensure that the voice of people who are meant to benefit from this investment are audible in the evaluation and that those voices and those stories are available to policy-makers and funding decision-makers.  Case studies require people to tell us their personal experience and that is an intrusion and that can be a burden, so it's critical that they are confident in the evaluators and that there is a level of trust built in that conversation.

Prof Kerry Arabena

Evaluations at a local level are very powerful mechanisms that engage communities, partners and health service deliverers.  In a process of understanding what you've been able to achieve it helps build the narrative that helps create sustainability for your interactions at that local level.

Claire Grealy

So people need to be confident to find out who is coming, what will they be asked, what will happen to their information, will it be treated respectfully, is there confidentiality, can they change their mind and decide they don't want to participate and what happens then?  Evaluation gets used in lots of different ways and sometimes it is monitoring and auditing, and sometimes it is exploratory and sense-making, and sometimes it's about accountability, and sometimes it's about really working out what's going on and inquiring in a curious way into why something works, how it works and importantly if it's not working for everyone.  That's important for services to know because it might be working for some people, but there may be some that are missing out on the benefit of those changes that are being put in place.

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This video features Professor Kerry Arabena from the University of Melbourne and Claire Grearly from Urbis. The video focuses on the importance of evaluating or engaging in reflective and continuous quality improvement processes specific to Aboriginal health, looking at the benefits for government, organisations and the Aboriginal community of evaluative practices.

Why evaluate aboriginal health initiatives

Prof Kerry Arabena – Chair of Indigenous Health, Director of Indigenous Health Equity Unit, University of Melbourne

There are three main reasons why I believe that we need to be able to do evaluation work incredibly well.  The first is around being accountable to government for the funds that they actually spend in our health services and to the communities who are responsible.  Secondly what we want to do is build our workforce and build our knowledge in the way that we are able to work, and thirdly is understanding the impact that we’re having in key areas that we’re working in so that we can better target interventions for future effort.

As a researcher I am very keen to keep on improving health service delivery, the quality of our services and also improve the ways in which our communities engage with our services through evaluation and quality improvement techniques.

Claire Grealy – Director, Economic and Social Advisory, Urbis

From the evaluator’s point of view the benefit of case studies is that it allows you to go into a community, listen to people's stories and build up a story back.  In health in particular, systems are complex, communities may not want to engage with health services and the health services may not be culturally safe.  These are complex issues and the elements in those communities interact in complex ways.

Prof Kerry Arabena

Evaluation has proved to be enormously beneficial at particular periods of time where you want to do good planning, where you want to make decisions.  It also helps communities understand and engage more in the research process and what it also does then is lend itself well to being generated as a peer reviewed publication, and there is not enough really good evidence out there about the work that we're doing.  I think we've got a lot to really value add, to not only our own experiences but the experiences of other vulnerable Australians.

Claire Grealy

So the case studies ensure that the voice of people who are meant to benefit from this investment are audible in the evaluation and that those voices and those stories are available to policy-makers and funding decision-makers.  Case studies require people to tell us their personal experience and that is an intrusion and that can be a burden, so it's critical that they are confident in the evaluators and that there is a level of trust built in that conversation.

Prof Kerry Arabena

Evaluations at a local level are very powerful mechanisms that engage communities, partners and health service deliverers.  In a process of understanding what you've been able to achieve it helps build the narrative that helps create sustainability for your interactions at that local level.

Claire Grealy

So people need to be confident to find out who is coming, what will they be asked, what will happen to their information, will it be treated respectfully, is there confidentiality, can they change their mind and decide they don't want to participate and what happens then?  Evaluation gets used in lots of different ways and sometimes it is monitoring and auditing, and sometimes it is exploratory and sense-making, and sometimes it's about accountability, and sometimes it's about really working out what's going on and inquiring in a curious way into why something works, how it works and importantly if it's not working for everyone.  That's important for services to know because it might be working for some people, but there may be some that are missing out on the benefit of those changes that are being put in place.