Evaluation of the National Guide to preventive healthcare for Aboriginal and Torres Strait Islander people
The Royal Australian College of General Practitioners Limited (RACGP)
Who funded the project
RACGP, Australia’s largest general practice organisation, and National Aboriginal Community Controlled Health Organisation(NACCHO), the peak body for 145 Aboriginal Community Controlled Health Organisations, work to support high-quality, culturally safe primary healthcare for Aboriginal and Torres Strait Islander peoples. Since 2014, they have partnered under a formal Memorandum of Understanding, guided by a co-designed Ways of Working Framework, to strengthen preventive care, clinical practice, and culturally safe service delivery. A key outcome of this partnership is the NACCHO–RACGP National Guide (now in its 4th edition), which provides evidence-based preventive health guidance and nationally endorsed life-stage health check templates to support consistent and responsive care across the life course.
Karabena Consulting was commissioned by the RACGP–NACCHO Partnership to undertake an evaluation examining what was achieved between 2019 and 2025, how and why outcomes were realised, for whom, and what lessons can be learned to inform future editions of the National Guide, health check recommendations, and the partnership overall. The evaluation focused on three key areas: the development and review of health check recommendations since 2019, the development and publication of the fourth edition of the National Guide, and the effectiveness of NACCHO–RACGP partnership governance, including its strengths and weaknesses.
A mixed-methods evaluation design was used, combining a document review with stakeholder consultations. The document review examined key background materials relevant to the partnership, its governance, and the development of the National Guide and health check recommendations. This was complemented by consultations with stakeholders involved across all facets of the partnership and its activities, providing insight into experiences, perspectives, and implementation in practice.
Two phases of evaluation reports were delivered.
Phase 1: Contractual delivery, accountability and governance assurance (document analysis)
Phase 2: Stakeholder lived-experience insights (consultations)
Through our evaluation work and reports, KCT identified key successes and challenges, and provided clear, practical recommendations to strengthen current approaches and guide future initiatives.
Summary
The evaluation aimed to gain insights into:
Successes: Identifying what worked well
Challenges: Understanding areas that were less effective
Opportunities for improvement: Providing recommendations for enhancing current and future initiatives
Project Aims
To complete the evaluation, Karabena adopted an Indigenist methodological position in conjunction with Western methodologies.
Key elements included
Privileging Aboriginal and Torres Strait Islander knowledge, collective and relational ways of working
Paying attention to cultural, emotional and structural labour
Using lived experience as a source of evidence
Reflexivity in interpretation
Interviews, group consultations, surveys and document analysis
Methodologies
Outputs
Two phases of evaluation reports were delivered.
Phase 1, informed by document analysis, confirmed that all contractual milestones were achieved and in several areas exceeded, with reporting obligations, governance requirements, and financial management standards met, providing the Department of Health with a clear line of accountability and assurance.
Phase 2, informed by the lived experiences of stakeholders, detailed the impacts of evidence hierarchies, labour inequities, digital infrastructures, workforce pressures, and governance uncertainties on the partnership and its activities.
The evaluation found that the NACCHO–RACGP Partnership is underpinned by a long-standing collaboration grounded in cultural authority, clinical expertise, and a shared commitment to improving preventive healthcare for Aboriginal and Torres Strait Islander people. This strong relational foundation has been a key success factor and enabling condition for the Partnership’s work.
However, significant structural constraints impede development outcomes. These include incompatibility between Western evidence hierarchies and Indigenous knowledge systems, workforce and resourcing constraints marked by unpaid and under-recognised Indigenous health labour, uneven distribution of clinical knowledge, and digital interoperability challenges.
Any future initiative, including a new edition, must therefore be built on a redesigned development architecture that explicitly incorporates these insights.
Project Outcomes
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