The Fixing Houses for Better Health (FHBH) program is one of the Australian government initiatives to improve Indigenous housing. It was established in the year 1999. The program was originally under the administration of the Aboriginal and Torres Strait Islander Commission (ATSIC) until 2001 after which its administration was transferred to the Department of Family and Community Services (FACS). The program is presently under the administration of the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) where FHBH forms an integral share of the Program 7.2: Indigenous Housing and Infrastructure (Australian Government 2009). The development of national framework in 1999 stressed the significance of Healthy Living Practices. This paper thus seeks to interrogate and critically analyze the FHBH program by describing what the program intends to do and critiquing the rationales FHBH offers for such a need and approach chosen.
FHBH program is aimed at contributing to enhanced health in the Indigenous communities. FHBH is a small-size program which targets at individual households level in chosen Indigenous communities/cohorts of communities. The FHBH program undertakes the assessment and repair to houses to promote a healthier living environment based on a standardized methodology which prioritizes making a house safe to reside in, and moves a notch higher to improve water supplies, sanitation as well as areas for food preparation. The program is anticipated to lead to enhanced health results for specific communities by making such improvements to houses.
Indigenous housing programs delivery is increasingly thought-provoking. The needs for housing increasingly tend to differ from a communities to another and further amongst houses within communities. Responses have to be usually customized to particular communities for efficiency and effectiveness. Housing construction alongside maintenance services in remote regions face extra barriers established by distance as well as restraints in domestic resources alongside capacity and capability. The program pursued to speak to such encounters via the deliberate involvement of communities’ members in both repair alongside maintenance projects, and by directing energies towards a level of household. Simultaneously, program remained effectively intended to permit a consistency level to be accomplished crossways communities via utilization of a standardized assessment alongside an operative work prioritization model.
The program’s delivery is done via a contract between FaHCSIA and the Service Provider (a national service provider). Till year 2009, the contractual prearrangement was supported by the funding contract between FaHCSIA and suitable state alongside Northern Territory agencies of government for the delivery of its projects in various communities. In certain instances, FaHCSIA further engaged in funding deals with Indigenous Community Housing Organization to deliver required services through various projects. Beginning year 2009, the program’s projects were being delivered under the management of one contract with Service Provider (national provider), with territory besides state administration being buttressed to incorporate and integrate the program approach’s principles into corresponding individual jurisdictions. Following table presents the effective seven stages for the program project delivery in a community:
National Planning stage effectively encompass the consultation between the Service Provider and FaHCSIA to efficiently establish resourcing as well as focus areas for the given year as well as to deliberate on emerging issues. This is an important phase since it guarantees reliable project procedures are created crossways the jurisdictions. The selection of the communities is done by FaHCSIA based on effective consultation with relevant jurisdictional government agencies.
After, effective selection of the communities to receive the FHBH project, effective planning process follows. This efficiently survey to make essential repairs to each house, whereby possible, under given communities. The program also effectively uses competent project teams that encompass community members alongside tradespeople already excellently trained in such processes to undertake efficient initial survey of every house and then proceed to make minor repairs as they go from a house to another (the survey/fix 1 or SF1 process/stage). Major repairs acknowledged in the survey are finished in the following 6 months.
After the completion of the work, a 2nd ‘survey or fix’ (SF2) is effectively undertaken to efficiently finish any unresolved trivial issues of maintenance. This 2nd survey is further effective and imperative as it measures the improvement level in health-hardware accomplished in 1st and 2nd survey. Such a process is imperative and efficient as it avails a “before (proactive) and after (reactive)” strategy to effectively measure the impacts of FHBH program activities with respect to each house.
In reporting phase, the Service Provider will effectively review as well as analyze the information from each phase, prior to the provision of the individual community reports alongside an amalgamated ultimate report. Such review and analysis are effective as they identify the gaps and opportunities to be carried forward to the next projects hence ensuring the FHBH meets its intended purposes.
FHBH fully engages/involves the community in both design and operation. The program addresses the housing challenges by deliberately involving and engaging the members of community in both maintenance and repair projects and via the emphasis at a level of household. Through its effective work prioritization model and use of standardized assessment, the communities are integral partners in addressing the housing challenges. For instance, the project teams are drawn from the community including tradespeople and community member. This group is then excellently trained in process to undertake 1st survey of every house as well as make trivial repairs along the way, a procedure known as survey or fix 1 or SF1. National Indigenous Housing Guide (the housing guide) publication is an effective resource that help in designing, constructing as well as maintaining Indigenous housing by emphasizing on significance of health hardware and the Health Living Practices. In addition to the housing guide, the group’s training, offers effective mechanisms suitable for appropriate information/educational material dissemination and research transfer (National Indigenous Housing Guide 2007). For example, the information gathered by tradespeople and community members are disseminated to inform the completion of the major repairs identified in SF1. The knowledge is transferred that help boost:
The FHBH has been able, on a modest resource base, to arrive at core health-linked enhancements, as schemed, to more than two-thousand houses in thirty-four communities between year 2005, July and year 2009 June. Such communities remained dispersed geographically in primarily far-flung regions of 5 states alongside the Northern Territory. Via FHBH’s targeted accomplishments, it has enhanced the degree of health hardware operation or functioning in houses.
FHBH also intended to enhance health-hardware in as several community dwellings as feasible. The coverage degree remains imperative as underlying rationale for health remains “…to accomplish health outcomes, most houses in a given community must have health hardware which functions most of the time”. As has been demonstrated by FHBH performance info, whereas the degree of enhancement in independent houses remained subject to certain differences, as remained the degree to which enhancement in individual Healthy Living Practices (HLP) there stood a general enhancement crossways FHBH in a manner in which houses performed in respective abilities to buttress HLP.
Whereas the general association between public health and environmental health and remains well-grounded, it is never true to assume that each program alongside approaches remain correspondingly effective in contributing to enhanced health of individuals. Certain particular program’s comparative efficiency remains valuable for FaHCSIA to boost its corresponding knowledge of how various programs alongside interventions are able to contribute to anticipated results that guarantee sustainability. This will remain a growingly imperative issue for FaHCSIA provided the substantially augmented funding being availed to Indigenous housing under the NPA on Remote Indigenous Housing (RIH) alongside the COAG expects’ contribution to enhance environment health in communities.
To be sustainable, FHBH must embrace the areas of improvement adopted by ANAO including; focusing on the improvement of strategy to monitor the program and evaluate its environmental health’s contribution. The program must also build the capacity of the department for effective assessment of improvement to the native health surfacing from its projects and support management of NPA to remain sustainable (Szava, Moran, Walker and West 2007).
In respect of service delivery mechanisms, it should be noted that well-designed as well as efficiently manage contracts remain key to operative FHBH program management and the expected outcomes’ delivery. Albeit the FHBH service delivery mechanisms design of the 2005-2009 alongside 2009-2011-agreements with Service Provider is anchored on, and narrowly bring into line with, the Service Provider’s methodology, having the advantage of offering clarity regarding Service Provider’s outputs, targets and activities is obliged to render, it has increasingly acted a s a barrier thereby limiting the FaHCSIA’s active contract’s management. This has seen the payments under such contracts generally remaining unclearly connected to the specific deliverables achievement whereas the contracts’ structure continuously working against the timely provision of suitable analytical information (Tietz 2009). FaHCSIA needs to advance the monitoring and management of agreements and contracts and established for FHBH to effectively position itself for making informed programming decisions.
The FHBH’s performance measuring arrangements have primarily been designed to solely report on functioning and conditions of houses. This design of the performance framework for FHBH, however, fails to enable assessment of ongoing performance in the part of FHBH approach integration into territory alongside state systems. The performance frameworks also excludes capacity to collect as well as assess performance info with respect to overall intention of FHBH that stood to provider improved health in native community (Pholi 2009).
Without this critical performance information, it remains a hurdle/barrier for FaHCSIA to effectively guide the administration on efficiency alongside effectiveness of FHBH approach and compare such an approach to potential alternatives. Being a small program, FHBH faces constraints on the comprehensiveness level which is able to be integrated in framework for the performance framework. However, potential openings exist for FaHCSIA to carry out additional work in such a region aimed at consolidation its comprehension of connections between particular mechanism of buttressing the HLP and enhanced health (Porter 2009).
Regarding FHBH’s management arrangements, inherent tensions are manifested in the development of an appropriate management framework, proportionate to the FHBH’s size, which can help agencies to effectively target resources for thoroughgoing influence and to supplement additional programs. Despite the methodology of Service Provider providing comprehensive approach to FHBH’s strategy alongside implementation, slight inducement for FaHCSIA to advance comprehensive strategies for implementation guidelines remains a key barrier (Parnell and Seemann 2005).
Even though such a barrier hasn’t essentially impaired the FHBH’s performance in accomplishing specific output targets the government has set for house repairs, it has led to discrepancies in the manner FHBH purposes are being reported in public as well as explicated in various agreements for funding, alongside FaHCSIA’s weaknesses in its ability to monitor and report consistently on FHBH performance. These are pointers towards a situation in which the FHBH program has never been connected to vaster policy goals; additionally, prospects for FaHCSIA to consider ways of management consolidation of small-size programs are ripe to offer an increasingly tactical outlook (Osborne, Baum and Brown 2013).
The ANAO has acknowledged various areas of FHBH improvement capable of being made in the present program phase to benefit the future program’s management. Essentially, the improvement in FHBH program should stress on the improvement of the approach to monitoring the program as well as evaluating its contribution to the environmental health (McPeakea and Pholerosb 2007). Also, there is a need to increasingly build the environmental capacity to efficiently assess improvements to the Indigenous health emerging from FHBH housing activities to further support the management of the program’s National Partnership Agreement (NPA).
The program should consider the NPA on Remote Indigenous Housing. This is because NPA is intended to eventually culminate in improvements in Indigenous health through the provision of better dwelling environments. Whereas NPA’s operation entails substantial large budget compared to FHBH program, and remains a distinct program with a dissimilar methodology, NPA shares with FHBH an approach anchored on seeking improvement via an emphasis on Healthy Living Practices’ support (Fien, Charlesworth, Lee, Morris, Baker, and Grice 2008). Thus, there is a potential value in FaHCSIA considering its FHBH program management experience, particularly, the hurdles of assessing the connections between activities of the program besides enhanced health, to inform the efficient monitoring alongside evaluation arrangements’ development for NPA.
Conclusion
FHBH has shown the ability to enhance a house capability to buttress Healthy Living Practices by effectively focusing its attention towards the improvement of physical equipment (health hardware) essential for healthy and hygienic living. Health hardware links to water supply, food preparation and sanitation areas of the house. FHBH has been a core mechanism in contributing towards safe and healthy housing in Indigenous communities by implementing a housing repair alongside maintenance system anchored on Healthy Living Practices’ application.
References
Australian Government. 2009. Closing the Gap on Indigenous Disadvantage: The Challenge for Australia, p. 21.
Fien, J., Charlesworth, E., Lee, G., Morris, D., Baker, D.C. and Grice, T., 2008. Towards a design framework for remote Indigenous housing.
McPeakea, T. and Pholerosb, P., 2007. Fixing houses for better health in remote communities. Improving the lives of Australians.
National Indigenous Housing Guide, third edition 2007, p. 11.
Osborne, K., Baum, F. and Brown, L., 2013. Closing the gap. What works? A review of actions addressing the social and economic determinants of Indigenous health.
Parnell, M. and Seemann, K., 2005, October. Developing lifecycle models for sustainable investment in desert communities. In Proceedings of the Building for Diversity National Housing Conference 2005 (pp. 337-347).
Pholi, K., 2009. Is’ Close the Gap’ a useful approach to improving the health and wellbeing of Indigenous Australians? Australian Review of Public Affairs: Journal, 9(2).
Porter, R., 2009. From community housing to public housing in Northern Territory remote Aboriginal communities: the policy context. Alice Springs: Desert Knowledge CRC.
Szava, A., Moran, M., Walker, B. and West, G., 2007. The Cost of Housing in remote Indigenous Communities: Views from the Northern Territory Construction Industry. Centre for Appropriate Technology, Alice Springs.
Tietz, C., 2009. Stirring appetites in design: a user centered product design approach to improve environmental health in remote Indigenous communities in Australia. Verified OK.
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