Indigenous Australians experience a greater burden of sexually transmitted infections, however are less likely than the general population to access sexual health services. We examined the effectiveness of an Indigenous cultural appropriateness audit in assessing a sexual health clinic with low rates of Indigenous clients.
The audit was developed to identify cultural barriers within a health service and offer recommendations to address these. The data collection process involved an interview with the director of the clinic (conducted by Indigenous health workers independent of the clinic) and an online survey of all staff. The objectives were to examine the cultural appropriateness of the clinic’s policies and procedures, consultation processes, physical environment, promotional materials, community engagement and staff training. The Indigenous workers analysed the data and provided recommendations.
Recommendations included completing an Aboriginal Health Impact Statement, ensuring Indigenous status is correctly recorded in all client files, including Indigenous service providers in service planning, requiring all staff attend cultural respect training, increasing Indigenous employment opportunities, circulating a monthly Indigenous performance report and implementing an Indigenous client feedback process. Support was provided to assist the clinic in implementing these recommendations. The quarterly percentages of Aboriginal and Torres Strait Islander clients increased from 1.7% of all clinic clients six months prior to 6.2% six months post commencing implementation of audit recommendations. These changes have been sustained at one year post project and occasions of service for indigenous clients continue to increase.
Performing a cultural audit of a clinical service can lead to increased engagement and awareness of Aboriginal and Torres Strait Islander peoples and their needs. The project outcomes demonstrate the efficacy of such an audit in initiating sustainable cultural improvements.
