Supporting reorientation of health services in Indigenous Australian communities: the health promotion systems assessment tool

Few tools and mechanisms exist to assist the reorientation of health services, especially in the Indigenous Australian health context; where improving health status and life expectancy is a priority. We developed a health promotion systems assessment tool (HPSAT) to provide health services with the information and support they need to drive health system change. Tool development occurred using a participatory, iterative approach that included a literature review, expert input by Indigenous and non-Indigenous stakeholders and annual group workshops in four Indigenous Australian primary health care (PHC) services. Four health system components: (i) organizational environment; (ii) service delivery systems; (iii) information systems and decision support; and (iv) adaptability and integration, form the framework of the tool. A scoring system monitors system change over time. The HPSAT provides a constructive framework to support health services to collectively assess and support reorientation in Indigenous Australian PHC services. Participation of key stakeholders with an intimate knowledge about the local context was pivotal in developing a user-friendly and fit-for-purpose tool. Maximum benefits of the tool are likely to be gained when used as part of a continuous quality improvement intervention.

Automated summary

To improve the health status and life expectancy of Indigenous Australians, a health promotion systems assessment tool (HPSAT) was developed. The tool was created through a participatory and iterative process, involving literature review, expert input, and group workshops. It consists of four components and includes a scoring system to monitor system change over time. HPSAT offers a constructive framework for Indigenous Australian primary health care services to collectively assess and support reorientation, with the participation of key stakeholders being crucial for its development. Its maximum benefits are likely to be achieved when used as part of continuous quality improvement intervention.