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Health Plan Review: Koolin Balit


The health plan under review is the “Koolin Balit: Victorian Government strategic directions for Aboriginal health 2012–2022.” Koolin Balit defines the strategic directions that Victoria government undertakes between 2012 and 2012 for Aboriginal health. It defines the roles and responsibilities of different stakeholders including the Aboriginal communities and Department of Health in closing the health provision gap. The aim of this report is to summarise the Koolin Balit health plan and highlights the priority areas and some at-risk populations. The at-risk population discussed are the children and the parents to these children. The three determinants of health that are discussed in the report include biological and genetics determinants, social determinants, and health services determinants.

Overview of the Health Plan

The report plan covers the period 2012-2022 aimed at advancing the requirements of health for the Aboriginal communities that have been disadvantaged for long (Department of Health, 2012). It brings together different stakeholders with the purpose of improving the length and quality of health. The government employs different strategies including closing the gap in life expectancy, reduce the difference in health and improve access to health services.

The design and implementation of the health program are grouped into six priority areas. The areas are a healthy start to life, healthy childhood, healthy transition to adulthood, caring for older people. Addressing risk factors and managing care better with effective services (Department of Health, 2012). The decisions in classification into priorities are premised on identified key policy documents, the data and evidence highlighting its significance and the advice from the community on what is important. In addition, the division into priority areas is aimed at ensuring high-quality services is provided based on available evidence.

Numerous factors combine in affecting the health of communities and individuals. Circumstances and environments influence the health and are commonly referred as determinants of health. The determinants of health include the physical environment, the social and economic environment, and the persons’ individual behaviours and characteristics (Department of Health, 2012). The determinants of health influencing the Aboriginal communities include the physical environment, social support networks, health services, gender, living and working conditions, water and sanitation, unemployment, education, work environment, and housing.

The population groups, which are targeted in the plan are the pregnant women, children of different ages, teenagers facing community and social pressures, the elderly, drug users and risk behaviour population (Department of Health, 2012). The decision to target specific groups is to provide customised services based on their expectations and requirements. Generalisation of the services and products may not be effective, and the solution is creating smaller groups, which are easier to provide services and evaluate the effectiveness of the processes.

Priority Areas and At-Risk Population Groups

The key priority 1: healthy childhood. Childhood is an important period of establishing positive social and healthy behaviors, and skills through the community, social and family environments (Department of Health, 2012). Health childhood along with biological factors influences a child educational achievements, social development, and risk behaviors in adulthood, physical and psychological health (Jacoby et al. 2011). The actions aimed at achieving these requirements includes improving accesses to health services such as immunization, assessment, and screening for Aboriginal children, the creation of awareness through the provision of appropriate information on lifestyle and health behaviours. In addition, strengthening links between initiatives and programs across departments, and supporting local strategies champing mental and physical health and wellbeing of Aboriginal children.

The target populations are the children and the parents (Campbell et al., 2011). The children will receive the health assistance and services while the parents will be tasked to support the health provision. For example, the parents will be informed on negative behaviour and characteristics that derail health development and other socioeconomic factors, which have to be adjusted (White et al. 2010). The children require appropriate healthcare, and the children receive the appropriate medication, and analysis can be done on the children. The children may be experiencing poor health care because of development and socioeconomic factors. The parents may face the same challenges including living conditions, housing, and employment opportunities.

Determinants of Health and At-Risk Population Groups

The at-risk population is the children while the three determinants of health under discussion are the health services, social factors, and biology and genetic factors. The children are exposed to numerous social determinants, which affects their respective health (Department of Health, 2012). The social determinants include quality of schools, socioeconomic conditions such as concentrated poverty, social interactions, and social attitudes and norms such as discrimination (Marmot, 2011). Exposure to social disorder, violence, and crime affects the health conditions of the children. Moreover, availability of appropriate resources such as healthful foods and education. Ineffective alignment of these social determinants with the growth of the child creates development problems and challenges.

The quality of health services and access to health services influences health. Numerous barriers to accessing health are many and affects negatively the development of the child (Bourke et al. 2012). Some of these barriers include the high cost of health care, limited language accesses, lack of insurance coverage and lack of availability of health services (Tsey et al. 2010). The consequences of these barriers to health include hospitalisations that would have been prevented, challenges to get preventive service, receiving appropriate care delays, and unmet health needs.

Children are also vulnerable to health conditions because of biological and genetic factors (Department of Health, 2012). The Aboriginal children are exposed to different biological and genetic determinants of health include a family history of heart disease, genes increasing risk for ovarian and breast cancer, inherited conditions such as cystic fibrosis, haemophilia, and sickle cell anaemia, HIV status, sex and age (Shah et al. 2011). The levels and amounts of the impact of the biological and genetic factors are different, and some of these factors can be addressed through implementation of policies. Without addressing these issues, the children health outcome is affected, and the children growth may face numerous challenges.


In the health care, different communities and individuals face numerous challenges and opportunities. Some communities have advantages to health care because of socioeconomic factors while others face challenges because of education and awareness problems. The Koolin Balit aims to improve health care provision to the Aboriginal communities. The Koolin Balit health plan has six priorities targeting different populations but aimed at advancing the health requirements. The priority area discussed is Healthy Childhood in which the health of the child is championed through addressing challenges and implementing measures to improve the health of the children. The health determinants affecting the children include the social determinants, biological and genetic determinants, and health services. Streamlining these determinants towards the improvement of children’s health is important and results in efficiency and effectiveness in health delivery.


Bourke, L., Humphreys, J. S., Wakerman, J., & Taylor, J. (2012). Understanding rural and remote health: a framework for analysis in Australia. Health & Place, 18(3), 496-503.

Campbell, D., Burgess, C. P., Garnett, S. T., & Wakerman, J. (2011). Potential primary health care savings for chronic disease care associated with Australian Aboriginal involvement in land management. Health Policy, 99(1), 83-89.

Department of Health. (2012). Koolin Balit: Victorian Government strategic directions for Aboriginal health 2012–2022. Melbourne: Victoria State Government.

Jacoby, P., Carville, K. S., Hall, G., Riley, T. V., Bowman, J., Leach, A. J., … & Kalgoorlie Otitis Media Research Project Team. (2011). Crowding and other strong predictors of upper respiratory tract carriage of otitis media-related bacteria in Australian Aboriginal and non-Aboriginal children. The Pediatric Infectious Disease Journal, 30(6), 480-485.

Marmot, M. (2011). Social determinants and the health of Indigenous Australians. Med J Aust, 194(10), 512-513.

Shah, P. S., Zao, J., Al-Wassia, H., Shah, V., & Knowledge Synthesis Group on Determinants of Preterm/LBW Births. (2011). Pregnancy and neonatal outcomes of aboriginal women: a systematic review and meta-analysis. Women’s Health Issues, 21(1), 28-39.

Tsey, K., Whiteside, M., Haswell‐Elkins, M., Bainbridge, R., Cadet‐James, Y., & Wilson, A. (2010). Empowerment and Indigenous Australian health: a synthesis of findings from Family Wellbeing formative research. Health & Social Care in the Community, 18(2), 169-179.

White, A., Wong, W., Sureshkumur, P., & Singh, G. (2010). The burden of kidney disease in indigenous children of Australia and New Zealand, epidemiology, antecedent factors and progression to chronic kidney disease. Journal of Paediatrics and Child Health, 46(9), 504-509.