Multicultural health action plan 2023–27

Victoria is home to one of the most culturally diverse societies in the world. Victorians come from more than 300 ancestries, speak more than 290 languages and follow more than 200 different faiths. Our diversity is one of our greatest strengths and brings many social and economic benefits.

We recognise the strength and resilience of multicultural communities that settle in Victoria and the deep social, cultural and economic contributions every person brings to our state.

Our culture shapes our communities, our daily interactions and our way of life. Culture goes to the heart of who we are and how we connect with others; it defines our sense of identity and belonging. Culture also shapes our health and wellbeing and how we experience health care.

It is important that every Victorian can access high-quality health care when they need it, regardless of who they are, where they live, their language, culture, ethnic or religious background, age, gender, sexuality, ability or circumstance.

Everyone deserves to be treated with dignity and respect.

The Department of Health is responsible for ensuring all Victorians can access health care and health information that is inclusive, accessible and safe.

As a major employer in Victoria, the Department of Health must ensure our workplace and the policies, programs and services we design, commission and manage are not only free from discrimination and racism but also culturally competent. This will ensure we can respond to people’s diverse cultural, ethnic, linguistic and religious backgrounds, needs and preferences.

Working to improve health inequities is our core business. But we need a plan to guide our efforts and to hold us accountable to the communities we serve.

It is my pleasure to present the Department of Health multicultural health action plan 2023–27. Alongside our department’s current and forthcoming action plans for gender equality, disability, LGBTIQA+ inclusion and Aboriginal inclusion, the new multicultural health action plan will enhance our focus on health equity across many aspects of our work.

The new plan continues our longstanding commitment to multicultural communities. It will help showcase good practice and put a plan of action in place. This will better address the health and wellbeing disparities Victoria’s multicultural communities currently experience.

It is crucial that all staff of the department, together with our many partners, embrace the actions this plan puts forward to achieve better health outcomes for multicultural communities.

I look forward to your support in implementing the plan over the next four years.

Professor Euan Wallace

Secretary

Department of Health

Victoria is home to significant cultural diversity, making our state stronger, more dynamic and setting us apart from other cities.

My parents migrated to Australia to forge a new future and contribute to this great state. It’s a familiar story, shared with almost half of Victorians who were either born overseas or have a parent born overseas.

Appreciating the value of this diversity and the importance of assisting our whole community to thrive, it is vital we support people from every background and culture to improve their health outcomes.

In order to do this, we must recognise that our multicultural communities still face significant health inequality. Their experiences in the health sector can be impacted by attitudes, systems and structures which can interact to create exclusion.

Both established and new migrant communities feel the impact of these factors. For those who are newly arrived, learning a new language, securing housing, accessing employment or education, and navigating complex service systems are just some of the many challenges faced when starting a new life in Victoria.

Drawing on the deep community connections that already exist in Victoria and the cultural knowledge and wisdom of our many multicultural communities, we can empower our services to be culturally competent, more accessible, and free from discrimination and racism.

We have a responsibility to improve health equity in Victoria, which is why the Department of Health has launched its Multicultural Health Action Plan 2023–27. It is a roadmap to support Victorians from diverse backgrounds to access safe, equitable and culturally competent healthcare through targeted policies and programs, better data collection and evidence, and strengthened engagement with communities.

The Plan is one of several initiatives and resources designed to support health services and health professionals to deliver services that are inclusive and culturally appropriate.

I encourage you to familiarise yourself with the Department’s Action Plan and support its strategic objectives that promote social cohesion and aim to create better outcomes for Victoria’s multicultural communities.

Yours sincerely,

Kat Theophanous MP

Parliamentary Secretary for Women’s Health and Member for Northcote

Acknowledgement of Traditional Owners

The Department of Health acknowledges the Traditional Owners of Country throughout Victoria and pays respects and recognises the contribution from their Elders past and present.

We proudly acknowledge the strength and resilience of Aboriginal people as the world’s oldest living culture and the contribution of generations of Aboriginal leaders who have fought tirelessly for the rights of their people and communities.

We recognise that we have a long way to go in understanding and addressing the intersections of racism and the ongoing effects of dispossession and colonisation.

Aboriginal and Torres Strait Islander recognition statement

The Department of Health pays respect to and recognises the contribution of all Aboriginal and Torres Strait Islander people living in Victoria. Throughout this document the term ‘Aboriginal’ is used to refer to both Aboriginal and Torres Strait Islander people.

We recognise the diversity of Aboriginal peoples living throughout Victoria. While Aboriginal people commonly use the terms ‘Koorie’ or ‘Koori’ stead to describe Aboriginal people in southeast Australia, we have used the term ‘Aboriginal’ to include all Aboriginal and Torres Strait Islander peoples living in Victoria.

Treaty and truth in Victoria

We acknowledge the impact of colonisation to this day and seek ways to rectify past wrongs, including through truth-telling and the development of treaty.

We are deeply committed to Aboriginal self-determination and to supporting Victoria’s treaty and truth-telling processes. We acknowledge that treaty will have wide-ranging impacts for the way we work with Aboriginal people living in Victoria. We seek to create respectful and collaborative partnerships and develop policies and programs that respect Aboriginal self-determination and align with treaty aspirations.

We acknowledge that Victoria’s treaty process will provide a framework for transferring decision-making power and resources to support self-determining Aboriginal communities to take control of matters that affect their lives. We commit to working proactively to support this work in line with the aspirations of the First Peoples’ Assembly of Victoria.

Language statement

Language is an effective tool for changing community attitudes and promoting inclusion.

We know language is always changing, and we recognise that words are powerful and can have different meaning for different people. Our language continues to evolve.

In this plan, the term ‘multicultural communities’ refers to the vast number of diverse cultural, linguistic, ethnic and faith groups in Victoria. We recognise that everyone has different preferences for how they describe their identity. There is no universal conceptualisation of cultural, ethnic, linguistic and religious identity, but we hope that providing some insight into definitions and key terms in Appendix 1 will help promote inclusive language.

The Department of Health multicultural health action plan 2023–27 outlines our commitment and action to improve the health and wellbeing of multicultural communities over the next four years. It sets out improvement goals and actions to embed cultural competency into all our services, programs and policies.

The plan outlines our vision, as well as practical resources and supports, good practice principles and examples. It describes the actions our department will take over the next four years across six improvement goals:

1. Invest in targeted policies, programs and services that improve health equity.
2. Design and deliver accessible and culturally competent mainstream policies, programs and services.
3. Provide language services and accessible communications.
4. Strengthen community engagement, capacity building and lived experience representation.
5. Enhance cultural competency through workforce capability and inclusive leadership.
6. Build evidence-based approaches through data, research and evaluation.

The plan offers practical guidance for the department’s internal workforce on how to meet the needs of multicultural communities across policy, program and service development, as well as commissioning, management and evaluation work.

The plan builds on our existing efforts through the (former) Department of Health and Human Services’ Delivering for diversity: cultural diversity plan 2016–19 and lessons learnt through the COVID-19 pandemic.

Our progress in implementing the plan will be reported through the Victorian Government’s annual report on achievements in multicultural affairs, which is tabled each year in parliament.

To address the ongoing impacts of colonialism, culturally unsafe practice and structural racism within the health and wellbeing system, Victoria has partnered with the Aboriginal community-controlled health sector to develop the Aboriginal health and wellbeing partnership agreement and action plan 2023–25. The Multicultural health action plan 2023–27 does not detail this important work, but we recognise that Aboriginal people, families and communities in Victoria are diverse and are part of our culturally diverse society.

Victoria is home to one of the most culturally diverse societies in the world and we are among the fastest growing and most diverse states in Australia. Victoria’s rich cultural, religious and linguistic diversity is one of our greatest strengths and brings many social and economic benefits.

Below is a snapshot of Victoria’s cultural diversity, with a detailed breakdown of demographics, language maps and community profiles available on the Multicultural Affairs webpage.

Snapshot of Victoria’s diversity

• Victorians come from more than 300 ancestries, speak more than 290 languages and dialects and follow over 200 faiths.
• In 2021, 30% of Victoria’s population were born overseas, an increase from just over 28% in 2016, and greater than the national percentage of more than 27%.
• Over 49% of Victorians were either born overseas or have a parent born overseas. More than 41% of Victorians reported having both parents born overseas.
• The proportion of overseas-born Victorians who come from non-main English-speaking countries is 77.7% – the highest of any Australian state or territory.
• Over 27% of Victorians speak a language other than English at home.
• Of Victoria’s population, 54% follow one of more than 140 different faiths.

Source: Australian Bureau of Statistics 2021, Housing: Census, ABS

Diversity and intersectionality within Victoria’s multicultural communities

There is a wealth of diversity in multicultural communities, with multiple and overlapping characteristics across the life course that can shape a person’s identity, experience and needs.

‘Intersectionality’ refers to the ways in which different aspects of a person’s identity can expose them to overlapping forms of discrimination and marginalisation¹. As outlined in Figure 1, many factors can intersect to shape identity, health and wellbeing needs and access to services including people’s cultural, ethnic, faith and linguistic backgrounds, as well as their age, sex/gender identity, sexuality, ability, socioeconomic status and many other factors.

Figure 1: Intersectional factors that affect health and wellbeing

• Aboriginality
• sex
• gender
• gender identity
• sexual orientation
• ethnicity
• colour
• nationality
• language
• migration or visa status
• refugee or asylum seeker background
• religion
• ability
• age
• mental health
• socioeconomic status
• housing status
• geographic location
• medical record
• criminal record

Source: Victorian Government 2021, Understanding intersectionality

Attitudes, systems and structures in society and organisations can interact to create inequality and result in exclusion. These include sexism, racism, homophobia, biphobia, transphobia, intersex discrimination, ableism, ageism and stigma.

Community strengths, cultural knowledge and leadership

Multicultural communities demonstrate strength and resilience in starting a new life in Victoria. It takes tenacity to:

• adapt to a new environment
• learn a new language
• secure housing, employment and education
• navigate complex new service systems.

The department acknowledges the invaluable social, cultural and economic contributions of multicultural communities that shape our state. We must continue to draw on the deep community connections, cultural knowledge, wisdom and leadership in Victoria’s multicultural communities, as well as people’s strong desire to support one another and give back to the community.

Taking a strengths-based approach means we focus on the capacity, skills, knowledge, connections and potential in people and communities. It means we provide the supports and services required to enable people to thrive during their settlement journey.

Why a multicultural health action plan matters

The department has a responsibility to improve health equity

It is our responsibility as system steward to ensure the health system is culturally competent, inclusive, accessible and safe.

The department funds a wide range of targeted and tailored services, as well as mainstream services. The breadth and reach of the department’s service footprint means we have a unique opportunity to make a significant and enduring impact on people’s health and wellbeing, but also on their sense of belonging, security, connectedness and trust in our service systems.

Victorian government departments have a longstanding history of promoting and celebrating the benefits of cultural, ethnic, linguistic and religious diversity, reflected in Appendix 2.

The plan enables the department to uphold legislative and policy obligations

This plan enables the department to:

• uphold obligations under the Multicultural Victoria Act 2011
• report annually on progress against the department’s cultural diversity plan
• address culturally competent service delivery to Victoria’s communities.

It also enables the department’s work to be well positioned within many other international, national, state and local legal and policy frameworks, as outlined below and detailed in Appendix 3.

Alignment with broader policies that promote health equity and inclusion

The plan has been developed alongside a number of new departmental policies and strategies to improve health equity including:

• Department of Health strategic plan 2023–27
• Victorian public health and wellbeing plan 2023–27
• Partnering in healthcare: a framework for better care and outcomes
• Victorian cancer plan 2020–2024
• Victorian sexual and reproductive health and viral hepatitis strategy 2022–30
• Policy and funding guidelines for health services 2023–24

New plans and strategies being released shortly including:

• an Aboriginal health and wellbeing partnership agreement and action plan 2023–25
• a Victorian cancer plan 2024–2028
• a Wellbeing in Victoria: a strategy to promote good mental health 2024–34
• a Victorian suicide prevention and response strategy 2024–34
• a Diverse communities mental health and wellbeing framework 2024–34.

The plan builds on, complements and helps progress the actions of the following Victorian Government strategies that promote inclusion:

• Victorian. And proud of it: Victoria’s multicultural policy statement 2017
• Pride in our future: Victoria’s LGBTIQA+ strategy 2022–2032
• Inclusive Victoria: state disability plan 2022–2026
• Our equal state: Victoria’s gender equality strategy and action plan 2023–2027
• Our promise, your future: Victoria’s youth strategy 2022–2027
• Ageing well in Victoria: an action plan for strengthening wellbeing for senior Victorians 2022-2026.

Multicultural communities experience significant health and wellbeing disparities

Compared with the Australian-born population:

• Australians born in some overseas countries have a higher prevalence of dementia, heart disease, stroke, diabetes and kidney disease, particularly for people born in Polynesia, South Asia and the Middle East. Higher rates of chronic disease are associated with low English proficiency and over 10 years of settlement in Australia.²
• Higher potentially preventable hospitalisation rates for people born in Oceania and Antarctica, North Africa and the Middle East compared with the Australian-born population, with over double the average preventable hospitalisation rates for Syria, Somalia, Sudan and Samoa.³
• 89% of refugees experienced traumatic events before arriving in Australia. Over 40% experienced mental health problems in the first five years of settlement.⁴
• Refugee background children and adults have very low immunisation completion rates of 0–19%.^{5, 6}
• People born overseas have a higher prevalence of some infectious diseases, representing 92% of hepatitis B cases⁷, 13% of hepatitis C cases⁸, more than 40% of new diagnoses of HIV9 and over 86% of tuberculosis notifications.10
• People born overseas were 2.5 times more likely to die from COVID-19 in 2022. During the Delta wave, over 70% of people who died from COVID-19 were born overseas.¹¹
• Women born overseas are less likely to have their first antenatal visit in the first trimester (76.2% compared with the Victorian average of 80.7%).¹² Women of refugee background experience barriers in accessing and engaging in antenatal care and have higher rates of stillbirth and perinatal mortality than Australian-born women.^13,14
• Children from a language background other than English are more likely to be developmentally vulnerable than children from an English-only language background (25.3% compared with 20.8%).¹⁵
• People from multicultural communities have a similar level of disability as Australian-born people but much lower disability services utilisation.¹⁶
• People from multicultural communities are more likely to experience vision and hearing loss but less likely to access vision and hearing services.^{17, 18}
• Refugee children and adults experience poorer oral health such as dental caries, missing teeth and periodontal disease.^{19, 20} Predisposing factors and language and cultural barriers compound disparities in oral health care use.²¹
• People born in regions including New Zealand, Oceania, North Africa and the Middle East have higher rates of smoking (16.6 and 16.9% respectively, compared with 15.4% Australian-born average).²²
• People from multicultural communities have lower participation rates in breast, bowel and cervical cancer screening, with poorer mortality and survival outcomes.^{23, 24}
• People from multicultural communities are at higher risk of nutritional deficiencies such as low vitamin D and anaemia due to previous deprivation and food insecurity.²⁵

Pre- and post-settlement challenges affect health and wellbeing

A significant and growing body of research highlights the challenges that can affect health and wellbeing for multicultural communities. These include:

• language barriers, communication issues and diverse cultural understandings of health²⁶
• experiences of stigma, discrimination, racism and exclusion^{27, 28}
• low health literacy, low digital literacy and challenges navigating unfamiliar health and social service systems, both physically and digitally^{29, 30}
• inadequate or restricted access to culturally competent universal health services^31,32, and negative experiences within health and mental health services^{33, 34}
• social isolation and lack of family and community support on arrival in Victoria
• competing priorities in early settlement such as learning English, gaining stable housing and employment, and arranging childcare and/or schooling
• financial stress and vulnerability, as well as food and energy insecurity,³⁵ unstable working conditions, potential for exploitation, violence and risks to safety
• anxiety, distrust or fearfulness of interacting with government services, particularly for at-risk cohorts such as undocumented migrants and humanitarian arrivals³⁶
• unequal impacts of the COVID-19 pandemic on multicultural communities affecting COVID-19 recovery, including emerging evidence that some multicultural communities are at higher risk of long COVID.^{37, 38}

Refugees and people seeking asylum face unique challenges that further affect health outcomes such as:

• a high burden of diseases and illnesses, combined with a history of poor and interrupted health care, prolonged deprivation in extreme living conditions and marginalisation³⁹
• inconsistent or restricted eligibility for Commonwealth safety net supports for people seeking asylum (such as Medicare, income support, Low Income Health Care Card, work rights and casework support)
• social determinants of health including financial vulnerability, destitution, homelessness, job insecurity and risk of exploitation⁴⁰
• mental health impacts of war, torture, trauma, persecution, loss of and/or separation from family, human rights abuses, prolonged uncertainty due to visa processing and detention.^{41, 42}

Our multicultural health approach

Our approach builds on existing multicultural health efforts

Multicultural communities use a combination of mainstream and targeted health services that are funded privately and through a mix of local, state and Commonwealth government funding.

The department funds a range of tailored and targeted multicultural health programs that provide specialised care such as torture and trauma counselling and refugee health nursing.

The department also funds sector coordination, engagement and capability-building activities to complement and build the capacity of mainstream services. These initiatives often connect health professionals in mainstream health settings to specialised multicultural health programs for referral, secondary consultation, partnership, professional development and training.

The department also has policies and programs in place to ensure mainstream health services are accessible and culturally competent. These include language services and access policies to ensure people seeking asylum can access free hospital and ambulance services without a Medicare card.

Key components of Victoria’s multicultural health approach are:

• Tailored and targeted multicultural health programs
• Accessible and culturally competent mainstream health services
• Coordination, engagement and capability-building programs

Targeted multicultural health policies, programs and services are detailed in Appendix 4.

Our approach considers priority populations and intersectional community support needs

Some priority populations will need more targeted and tailored support to respond to the unique circumstances of their migration and settlement experience. These include:

• women experiencing vulnerability such as Woman at Risk visa holders; women on provisional spouse visas who leave violent relationships; women who have been trafficked or subject to exploitation; and pregnant women who have been exposed to trauma and violence
• children and young people, particularly unaccompanied minors and children on bridging visas who have experienced trauma, loss, upheaval and deprivation, and children and young people exposed to child abuse and neglect with significant unmet health needs⁴³
• people who are Lesbian, Gay, Bisexual, Trans and gender diverse, Intersex, Queer, Questioning and Asexual (LGBTIQA+) who may be socially isolated, disconnected and stigmatised by their community, their family and/or the LGBTIQA+ community⁴⁴
• adults and children with pre-existing disability, mental illness, acute or complex health diseases, chronic health conditions or infections (such as latent tuberculosis, HIV or hepatitis B)
• older people from multicultural communities who may experience social isolation due to less opportunity to develop and keep social connections, added communication needs and multiple complex and chronic health issues that impede daily activities^{45, 46}
• people from refugee backgrounds who are not part of the Humanitarian Programme (such as the Family Migration Program) and do not receive casework to connect into essential services
• newly arrived refugees with exposure to torture, trauma or war, such as people evacuated from Afghanistan
• people seeking asylum on bridging visas in the community who have variable access to work rights, Medicare and casework and are not eligible for Commonwealth income support (people who have been in detention for long periods may experience significant mental and physical health impacts, especially children;^47,48 many people seeking asylum have been waiting in the Victorian community more than 10 years for a visa outcome)
• temporary migrants experiencing financial hardship (such as international students, temporary skilled migrants) who have limited access to government health services or income safety nets
• undocumented migrants and people seeking asylum on expired bridging visas who have limited access to services and may fear interacting with government services.

Our vision and aim

The department’s vision is that Victorians are the healthiest people in the world, as outlined in the Department of Health strategic plan 2023–27. To achieve this, we must ensure multicultural communities access culturally competent health care and experience equitable health outcomes.

Our improvement goals and actions

The actions we commit to in this plan are organised around six improvement goals:

1. Invest in targeted policies, programs and services that improve health equity.
2. Design and deliver accessible and culturally competent mainstream policies, programs and services.
3. Provide language services and accessible communications.
4. Strengthen community engagement, capacity building and lived experience representation.
5. Enhance cultural competency through workforce capability and inclusive leadership.
6. Build evidence-based approaches through data, research and evaluation.

Improvement goals are interconnected. Collective advancement across all goals is essential to improve health outcomes for multicultural communities and achieve the department’s vision.

Good practice principles for the department are outlined below for each goal, as well as the flagship initiatives and new and continuing actions we will deliver over the course of this plan.

Monitoring and reporting

Approval and oversight from the Executive Board, with progress reported through the Victorian Government’s annual report on achievements in multicultural affairs, which is tabled each year in parliament.

The department is:

• investing in sustainable, long-term targeted programs and services that meet unique or complex needs – for example, linked to interrupted access to health care, eligibility barriers, cultural and communication needs, impacts of torture and trauma, and experiences of discrimination, racism, disadvantage and social isolation
• actively engaging multicultural community organisations to design and deliver programs in response to urgent or emerging issues or evidence of health disparities, disadvantage and exclusion experienced by and within multicultural communities
• promoting trusted partnerships and referral pathways between multicultural community organisations, mainstream health services and other support services
• advocating to the Commonwealth, local government and other state departments on insights provided by multicultural community organisations.

Practical resources and supports

• The department’s diversity policy teams including:
  • Diversity and Access in Hospitals and Health Services
  • Mental Health and Wellbeing Promotion Office
• Annual Victorian Government report in multicultural affairs
• Multicultural health sector partners in Appendix 4 such as Centre for Culture, Ethnicity and Health, Victorian Refugee Health Network, Refugee Health Program, Refugee Fellows Program, Victorian Foundation for Survivors of Torture, Multicultural Centre for Women’s Heath, Ethnic Communities Council of Victoria and Action on Disability within Ethnic Communities (ADEC).

Actions we will take

Good practice principles

The department is:

• developing and maintaining policies and strategies that improve access to mainstream services such as fee waivers and priority access policies, particularly for recently arrived refugees and people seeking asylum without a Commonwealth safety net or Medicare
• embedding cultural competency requirements and inclusion considerations into design, commissioning and delivery so all mainstream programs and services are welcoming, safe, trauma-informed and meet diverse needs related to culture, ethnicity, language, race, religion, visa status and other experiences or forms of disadvantage
• enabling health services to undertake service improvement and engagement projects to better address the needs of multicultural communities experiencing poorer health outcomes
• ensuring all forms of discrimination are prevented and eliminated in the department and its funded services, in line with the Charter of Human Rights and Responsibilities Act 2006
• advocating to the Commonwealth, local government and other state departments to eliminate access barriers and improve the cultural competency of mainstream services.

Practical resources and supports

• Department of Health:
  • Refugee and asylum seeker access policies and fee waivers in public hospitals, ambulance services, community health, dental services, catch up immunisation, and other health services
  • Designing for Diversity resources on inclusive policy, program, and service design
  • Refugee and asylum seeker health services: Guidelines for the community health program
• Whole of Victorian Government universal design policy and Victorian Health Building Authority universal design policy
• Centre for Culture, Ethnicity and Health cultural competence assessment for organisations, training and tip sheets
• Victorian Equal Opportunity and Human Rights Commission Reducing Racism Hub resources.

Actions we will take

Good practice principles

The department is:

• promoting and monitoring adherence to the department’s Language services policy and guidelines, including ensuring all health services in Victoria provide certified interpreters and quality translations so multicultural communities can make informed choices about their own health care
• actively co-designing translated and plain English information and resources to meet language, literacy and cultural needs and preferences, including ensuring resources are produced in a range of accessible visual formats
• planning for language services, including analysing data on language services needs and use and adding interpreting and translation costs into all services and program budgets
• disseminating health information through multicultural community networks, relevant social media and media channels, and the Health Translations online directory
• advocating to the Commonwealth, local government and other state departments to improve language services and accessible communication.

Practical resources and supports

• Department of Health: Language services policy and guidelines
• Victorian Government: Language maps of multicultural Victoria and Better practice guide for multicultural communications
• Health Translations online directory of over 28,000 resources
• Centre for Culture, Ethnicity and Health cultural consultancy and language services training
• Multicultural community networks such as Victorian Multicultural Commission, Ethnic Communities Council of Victoria and Victorian Refugee Health Network.

Actions we will take

Good practice principles

The department is:

• partnering with multicultural communities to co-design and co-deliver health promotion and education activities that empower people to manage their own health and wellbeing and build trust in the health system
• engaging multicultural communities in consultation and evaluation activities to elevate the voice of people who are excluded and build on their unique strengths and connections
• ensuring governance structures reflect the diversity of the community by supporting multicultural communities to actively take part in committees, boards and advisory groups
• ensuring multicultural community representation reflects priority cohorts and the diversity within communities, including across culture, ethnicity, language, religion and other aspects of identity and experience such as age, ability, sexuality, sex/gender, rurality and experience of homelessness and family violence
• providing financial recognition for community contributions and engaging formal and informal community leaders, recognising that multicultural communities are not homogenous
• doing what we say we will do, understanding that trusting relationships between government and multicultural communities requires time, resources and consistency
• developing engagement frameworks and plans that identify priority multicultural communities and effective ways of engaging and empowering them.

Practical resources and supports

• Victorian Government: Diversity on Victorian Government boards guidelines and Victorian appointment and remuneration guidelines
• Safer Care Victoria: Partnering in healthcare: a framework for better care and outcomes and co-design and partnering workshops
• Department of Health: Mental health lived experience engagement framework
• Engagement with the Victorian Multicultural Commission and multicultural community organisations such as Ethnic Communities Council of Victoria and Victorian Refugee Health Network.

Actions we will take

Good practice principles

The department is:

• promoting culturally competent environments that are respectful, inclusive and free from bias, discrimination and racism, and have processes in place to address any incidents
• setting clear expectations on cultural competency for staff and funded services in service guidelines, commissioning practices, service agreements, quality standards and accreditation
• building knowledge, skills and capabilities of staff on cultural competency, language services and fostering a human rights culture through:
  • information and resources to support inclusive service and policy design and delivery
  • targeted workforce training and professional development programs
  • commissioning advice, education and resource development by multicultural services
• improving recruitment, retention and progression of a culturally diverse workforce that reflects the diversity of the Victorian community at all levels of the organisation, including through targeted recruitment practices and specialised roles that draw on people’s lived experience and connection to community
• embedding clear expectations on workforce diversity to funded services into procurement processes, grants and service agreements.

Practical resources and supports

• The department’s Inclusion team in People and Culture and internal diversity and inclusion training programs
• CareerSeekers refugee and asylum seeker internship program
• Victorian Public Service (VPS) networks such as the VPS Women of Colour Network and the VPS African-Australian Network
• Victorian Public Sector Commission resources on workforce diversity
• Centre for Culture, Ethnicity and Health cultural competency resources
• Multicultural health sector training providers detailed in Appendix 4.

Actions we will take

Good practice principles

The department is:

• mandating that health services accurately and consistently collect data on cultural and linguistic diversity including country of birth, preferred/main language spoken at home, interpreter requested, interpreter provided and year of arrival to ensure consistency with the national ABS Data Standards for Statistics on Cultural and Linguistic Diversity
• using evidence to plan and design culturally competent programs and policies that address health inequities, including population-level data and research, settlement data, health service uptake, interpreter use data and community consultation findings
• measuring and monitoring long-term health outcomes for multicultural communities by analysing administrative data, using data linkage and supporting research partnerships
• routinely monitoring, analysing and evaluating funded service performance, program effectiveness and consumer experience to ensure continuous quality improvement
• regularly reporting on multicultural health outcomes to improve public accountability and transparency while also ensuring specific community groups are not stigmatised
• advocating for changes to national data definitions and standards on cultural, linguistic, ethnic and/or religious identity and implementing any changes in Victorian health datasets.

Practical resources and supports

• Outcomes frameworks and internal data dashboards for:
  • Department of Health strategic plan 2023–27
  • Mental health and wellbeing outcomes and performance framework
  • Victorian public health and wellbeing plan 2023–27
• Centre for Evaluation and Research Evidence resources
• Stronger Futures Know our story: a toolkit for social equity and inclusion
• Department of Health: Cultural diversity data sources factsheet
• Victorian Government: Language maps of multicultural Victoria
• ABS Data Standards for Statistics on Cultural and Linguistic Diversity.

Actions we will take

Four appendices have been provided for the Department of Health multicultural health action plan 2023-27:

• Key terms and definitions
• Timeline of Victoria's progress to improve multicultural health outcomes
• Victoria's multicultural legal and policy frameworks
• Victoria's targeted multicultural health programs, policies and training