How this strategy will include priority populations
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Introduction Aboriginal and Torres Strait Islander (First Nations) peoples People with disability Culturally and linguistically diverse people (including migrants and refugees) People ineligible for Medicare Lesbian, gay, bisexual, transgender and queer people and people with innate variations of sex characteristics and other sexuality or gender diverse people (LGBTQIA+ people) People living in rural and remote areas People experiencing family, domestic and sexual violence and coercionThe Framework and Data Strategy recognise the importance of equitable access to sexual and reproductive health care and outcomes.
A range of social, cultural, geographic and structural factors influence differences in people’s access to services and their experiences of care and health outcomes. It is essential to clearly identify these differences to inform policy, service planning and resource allocation.
Stakeholders emphasised the importance of ensuring that priority populations are clearly reflected in how sexual and reproductive health data are collected, analysed and reported. This section responds to that feedback by strengthening the focus on equity, while recognising the limitations of currently available data sources.
For the purposes of this strategy, priority populations include people who face greater barriers in accessing sexual and reproductive health services or who experience poorer sexual and reproductive health outcomes.
Priority populations are not mutually exclusive. Many people experience multiple forms of disadvantage, which can compound barriers to care and impact outcomes. Where data allow, the Data Strategy will support analysis that considers these intersecting factors.
These priority populations were identified through literature reviews and the consultation process. They include (but are not limited to):
Aboriginal and Torres Strait Islander (First Nations) peoples
First Nations peoples may experience greater severity and complexity of symptoms (for example, higher rates of underlying health conditions can increase symptom severity and make management more complex), as well as barriers to treatment, timely diagnosis and culturally safe care. National data are limited and vary across jurisdictions. Where possible, the strategy will report data disaggregated by Indigenous status. Limitations related to identification, coverage and data quality will be clearly stated.
Through this strategy, the AIHW is committed to implementing the Framework for Governance of Indigenous Data and its 4 guidelines: working in partnership with First Nations peoples, building data-related capabilities, providing knowledge of data assets, and building an inclusive data system.
Leadership from and partnership with Aboriginal Community Controlled Health Organisation (ACCHOs) are essential to improving sexual and reproductive health data for First Nations peoples.
People with disability
People with disability can face challenges in accessing care and being involved in decisions about their care. They may need extra support to recognise health issues and get the right treatment.
Existing data sources rarely capture disability status, or do not do so consistently. Disability status will be reported where feasible and limitations clearly stated.
Culturally and linguistically diverse people (including migrants and refugees)
People from culturally and linguistically diverse backgrounds may face language barriers and cultural differences that make it more difficult to navigate the health system and access culturally safe care. Existing data sources provide limited capacity for disaggregation by cultural and linguistic background. Reporting will be undertaken where feasible and limitations clearly stated.
People ineligible for Medicare
People without access to Medicare may experience financial and system barriers and have reduced access to affordable health care. This population is poorly captured in administrative data sets. The data strategy will acknowledge these limitations and explore alternative data sources as they become available.
Lesbian, gay, bisexual, transgender and queer people and people with innate variations of sex characteristics and other sexuality or gender diverse people (LGBTQIA+ people)
LGBTQIA+ people may have distinct sexual and reproductive health needs that are not well reflected in existing data. Most national data sets do not capture information on sexual orientation, gender diversity or diversity of sex characteristics. LGBTQIA+ people may also find it difficult to access respectful and appropriate sexual and reproductive health care. Reporting will use inclusive language and clearly note data constraints.
People living in rural and remote areas
People living in rural and remote areas may have reduced access to sexual and reproductive health services and experience delays in diagnosis. Geographic disaggregation will be prioritised where data allow. Results will be interpreted in the context of service availability.
People experiencing family, domestic and sexual violence and coercion
People experiencing family, domestic and sexual violence, including reproductive coercion and abuse, may face barriers to accessing safe, timely and appropriate sexual and reproductive health care. These experiences can affect decision-making, autonomy and health outcomes across the life course. Available data are limited and inconsistent across national data sources. Reporting will be undertaken where feasible, with limitations clearly stated, and will aim to interpret these experiences within broader social and health contexts.
The Framework includes the full scope of priority populations for inclusion in the monitoring of sexual and reproductive health (including people living in closed settings and people living with chronic and/or complex health needs).
While the initial focus is on the individual, it’s important to note that a person’s sexual and reproductive health conditions and experiences may also affect their partner and family. For example, a person’s sexual and reproductive health condition may affect their daily functioning and wellbeing and the care and support they need from partners and families. Decisions and experiences may also involve partners and families. Data on these impacts are limited because most national data collections focus on individuals accessing care. Initial reporting will therefore focus on individual experiences, with opportunities to better understand impacts on partners and families explored over time.