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The targets set by the Council of Australian Governments (COAG) to 'close the gap' in Indigenous disadvantage are ambitious and challenging to measure. In order for these targets to be properly monitored and put into action, COAG identified a number of building blocks that need to be addressed; these building blocks are outlined in the National Indigenous reform agreement . The building blocks are interconnected and address several targets; they adopt a holistic view of health, addressing many of the underlying social determinants that influence and affect health.
Young Indigenous children need equal opportunities to learn, develop and socialise. Equal access to quality early childhood education and care services, and child care and family support services (such as parenting programs and supports) is an imperative. It is also important that young Indigenous children have access to appropriate facilities and physical infrastructure, a sustainable early childhood education and health workforce, learning frameworks, and opportunities for parental engagement. To address the gaps in Indigenous childhood mortality and early development, the building block includes maternal, antenatal, postnatal and early childhood health.
Responsive and appropriate education is a key element of human development; this is why schooling is an important component of the COAG commitments. This building block implies adequate and appropriate infrastructure, workforce (including sufficient high quality teachers and school leaders), curriculum, literacy and numeracy achievement, opportunities for parents to engage, and school/community partnerships. The COAG commitments also focus on enabling transition pathways into schooling and into work, and post-school education and training. Access to schooling is not only for children; literacy and numeracy skills are relevant at all ages to best access employment opportunities. Life-long learning is promoted and adults constitute an important recipient in this second COAG building block.
Indigenous access to adequate, preventive and comprehensive primary health care is essential to reduce excess deaths and to close the gaps in early childhood mortality and life expectancy. The COAG commitments in this area recognise the importance of all parts of the health sector. A key component of the commitments is the responsiveness of, and accountability for, achieving government and community health priorities. In its health building block, COAG focuses on prevention, including the promotion of healthy lifestyles at all ages and the related management and treatment of chronic diseases.
This building block forms an important component of the Closing the gap campaign, focusing on enhancing employment opportunities, including jobs outside the Community Development Employment Project, business creation opportunities, economic independence (as opposed to welfare dependence) and wealth creation. There are many financial, structural and social incentives that can assist disadvantaged job seekers and these tools contribute to economic participation and community engagement. Coupled with policies addressing barriers to participation (such as desirability of welfare dependency, gambling, etc.), attention to this building block can contribute to establishing factors for positive social norm development. These two goals are seen to be important for adults and parents to become effective role models within the community and family spheres, and for the reform to be sustainable.
This building block, which recognises that a healthy home is fundamental to the health of a population, focuses on improving current poor living conditions, including water and sewage systems, waste collection, and electricity and housing infrastructure. Children are particularly vulnerable to disease transmission in overcrowded and unhygienic houses and form a priority group of the building block.
Everyone has the right to be safe from violence, abuse and neglect. It is to secure this state of safety that COAG has committed to improving the law and justice system (including an accessible and effective police and court system), victim support, child protection, and preventive approaches to violence (including perpetrator programs, anger management, alcohol and substance abuse management).
Strong governance is essential for sustainable and effective outcomes for communities. In this context, Indigenous communities need to be engaged in the development of reforms within the Closing the gap framework. This building block recognises the importance of skill development for Indigenous people to exercise their rights and responsibilities and to take effective control over the development and implementation of policies that affect their lives.