Developing the rural health workforce to improve Australian Aboriginal health outcomes: a systematic review

Objective: The aim of this study was to identify evidence based strategies in the literature for developing and maintaining a skilled and qualified rural and remote health workforce in Australia to better meet the health care needs of Australian Aboriginal and/or Torres Strait Islander (hereafter Aboriginal) people. Methods: A systematic search strategy was implemented using the PRISMA statement and checklist. Exclusion and inclusion criteria were applied, and 26 papers were included in the study. These 26 papers were critically evaluated and analysed for common findings about the rural health workforce providing services for Aboriginal people. Results: There were four key findings of the study: the experience of Aboriginal people in the health workforce affects their engagement with education, training, and employment; particular factors affect the effectiveness and longevity of the non-Aboriginal workforce working in Aboriginal health; attitudes and behaviours of the workforce have a direct effect on service delivery design and models in Aboriginal health; and student placements affect the likelihood of applying for rural and remote health jobs in Aboriginal communities after graduation. Each finding has associated evidence-based strategies including those to promote the engagement and retention of Aboriginal staff; training and support for non-Aboriginal health workers; effective service design; and support strategies for effective student placement. Conclusions: Strategies are evidenced in the peer-reviewed literature to improve the rural and remote workforce for health delivery for Australian Aboriginal people and should be considered by policy makers, funders and program managers