Evaluation and Implementation Science Unit, Centre for Health Policy, Melbourne School of Population & Global Health, The University of Melbourne, 4/207 Bouverie Street, South Carlton, VIC, 3053, Australia.
School of Humanities and Social Sciences, Deakin University, Burwood, VIC, 3125, Australia.
BMC Public Health. 2020 Dec 3;20(1):1856. doi: 10.1186/s12889-020-09983-w.
Stated principles in government policy documents serve as a set of values outlining how governments intend to work. As such, health planning principles should be reflected in health policy across the cycle of planning, implementation and evaluation. Such principles should be reflected in the process of governments commissioning and funding evaluation, and in the work of those commissioned to do evaluation on behalf of governments.
We reviewed health planning policy documents to identify principles Australian State and Territory and National governments stated as being important to the work they do within Aboriginal and Torres Strait Islander health contexts. Evaluation tenders and reports relating to Aboriginal and Torres Strait Islander health policy, programs and service for the period 1-Jan-2007 to 1-Jan-2017 were retrieved and assessed as to whether they embedded principles governments state as important.
In Aboriginal and Torres Strait Islander health planning policy contexts, Australian governments outline shared responsibility, cultural competence, engagement, partnership, capacity building, equity, a holistic concept of health, accountability, and evidence-based as fundamental principles that will underpin the work they will do. In total, we identified 390 publicly advertised evaluation tenders, but were only able to retrieve 18 tenders and 97 reports. Despite strong rhetoric placing importance on the abovementioned principles, these were not consistently embedded in tenders released by government commissioners, nor in reports largely commissioned by governments. Principles most widely incorporated in documents were those corresponding to Closing the Gap - accountability, evidence-based and equity. Principles of holistic concept of health, capacity building, cultural competence and partnership do not appear well applied in evaluation practice.
Notwithstanding the tensions and criticism of current practice that sees dominant governments policing Aboriginal and Torres Strait Islander populations and defining what principles should inform health policy and evaluation practice, this paper reveals shortcomings in current evaluation practice. Firstly, this paper reveals a lack of transparency about current practice, with only 2% of tenders and 25% of reports in the public domain. Secondly, this paper reveals that governments do not 'walk the talk', particularly when it comes to principles relating to Aboriginal participation in health.
政府政策文件中的既定原则可作为一套价值观，阐明政府的工作意图。因此，卫生规划原则应体现在规划、实施和评价周期内的各项卫生政策中。这些原则应体现在政府委托和资助评价的过程中，以及受政府委托进行评价的人员的工作中。
我们查阅了卫生规划政策文件，以确定澳大利亚州和地区以及国家政府在涉及原住民和托雷斯海峡岛民健康的工作中所认为的重要原则。检索了 2007 年 1 月 1 日至 2017 年 1 月 1 日期间与原住民和托雷斯海峡岛民卫生政策、计划和服务有关的评价招标和报告，并评估其是否包含政府所强调的重要原则。
在原住民和托雷斯海峡岛民卫生规划政策背景下，澳大利亚政府概述了共同责任、文化能力、参与、伙伴关系、能力建设、公平、整体健康概念、问责制和循证等基本原则，这些原则将成为其工作的基础。我们总共确定了 390 份公开招标的评价招标，但仅检索到 18 份招标和 97 份报告。尽管言辞强硬地强调了上述原则，但政府招标机构发布的招标中并未始终嵌入这些原则，政府委托编写的报告中也大多没有嵌入这些原则。在文件中广泛纳入的原则是与缩小差距相关的原则，包括问责制、循证和公平。整体健康概念、能力建设、文化能力和伙伴关系等原则在评价实践中似乎并未得到很好的应用。
尽管当前实践存在紧张局势和批评，即占主导地位的政府监管原住民和托雷斯海峡岛民人口并定义应告知卫生政策和评价实践的原则，但本文揭示了当前评价实践中的不足之处。首先，本文揭示了当前实践缺乏透明度，只有 2%的招标和 25%的报告在公共领域。其次，本文揭示了政府言行不一，特别是在涉及原住民参与健康的原则方面。
