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
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We know language is always changing, and we recognise that words are powerful and can have different meaning for different people.
We define key terms below and acknowledge that people have different definitions. Language continues to evolve.
We recognise the limitations of terminology to adequately describe the breadth of experiences of people from multicultural communities. We recognise, respect and support the right of all people to identify using the language they choose.
Term Definition Aboriginal people and communities While the terms ‘Koorie’ or ‘Koori’ are commonly used to describe Aboriginal communities of southeast Australia, the term ‘Aboriginal people’ is used in this plan to include all Aboriginal and Torres Strait Islander peoples living in Victoria. Cultural competency The Plan uses the term ‘cultural competency’ for multicultural communities.
Cultural competency involves a set of congruent behaviours, attitudes and policies that come together in a system, agency or among professionals. It enables that system, agency or those professionals to work effectively in cross-cultural situations.49 Cultural competence offers a framework through which to improve service delivery to people from culturally and linguistically diverse backgrounds. This framework enables people to assess and make improvements to every aspect of an organisation, from management and governance structures to service delivery and staff development. It helps ensure all people receive safe, high-quality and culturally appropriate health care.50
To become more culturally competent, a system needs to:
- value diversity
- have the capacity for cultural self-assessment
- be conscious of the dynamics that occur when cultures interact
- institutionalise cultural knowledge
- adapt service delivery so it reflects an understanding of the diversity between and within cultures.51
Culturally and linguistically diverse communities The term ‘culturally and linguistically diverse’ with the associated acronym ‘CALD’, is currently used by Australian governments, the public and private sector and in research and academic institutions to describe populations other than the Anglo-Celtic majority. There is increasing academic and community debate about the usefulness of the term ‘CALD’. For example, the Federation for Ethnic Communities Councils of Australia52 now use the term ‘culturally, ethnically and linguistically diverse backgrounds’ to recognise race/ethnicity.
In line with the Victorian Government’s Better practice guide for multicultural ,53 this plan uses the term ‘multicultural communities’.
Cultural safety Aboriginal and Torres Strait Islander cultural safety is defined as an environment that is safe for Aboriginal and Torres Strait Islander peoples, where there is no assault, challenge or denial of their identity and experience.54
In a health service context, it includes several elements to consider:
- individual staff knowledge and respect for self (reflection on knowledge, bias, learning journey)
- knowledge and respect for Aboriginal people and culture
- organisational reflection, a commitment to organisational review and system redesign to eliminate racism and discrimination.
Intersectionality or intersectional approaches Intersectionality offers a way of understanding and interrogating interactions between people and systems. An intersectional approach examines and addresses the interconnected nature of attributes of a person or group of people that create overlapping and interdependent systems of disadvantage or discrimination. Intersectionality places emphasis on systems and structures and how they respond to people and their identities. Migrant The term ‘migrant’ is used to describe a person who has entered Australia through a variety of pathways, including through humanitarian, family and skilled migration pathways, with the purpose of establishing a permanent or semi-permanent residence in Australia.
In comparison with refugees and people seeking asylum, ‘migrants’ choose to move to Australia, mainly to improve their lives, and can usually return home safely.
Multicultural communities The plan uses the term ‘multicultural communities’ to describe the vast number of diverse cultural, racial and ethnic groups who live in Victoria. We chose this word because it is succinct and broadly inclusive and recognises the different lived experiences of:
- migrants from new and emerging communities who have recently arrived in Victoria
- people from refugee backgrounds and people seeking asylum
- people who speak languages other than English or who speak English with an accent
- people who follow a broad range of religious and spiritual practices.
Multicultural community organisations ‘Multicultural community organisations’ refers to targeted services that offer specialised support for multicultural communities, ranging from local community-led multicultural organisations, settlement services and multicultural, refugee and asylum seeker health services through to peak agencies such as the Ethnic Communities Council of Victoria. Multifaith communities The term ‘multifaith communities’ is used to encompass the vast number of diverse faith groups in Victoria. Faith refers to a group that share their own religion and traditions. New and emerging communities The term ‘new and emerging’55 identifies communities of migrants and refugees that have recently arrived in Australia and may need extra support during settlement. The main identifiers of a new and emerging community are:
- a lack of established family networks, support systems, community structures and resources
- unfamiliarity with universal services and challenges in accessing services
- limited English language proficiency, high numbers of refugees, low levels of formal education, financial vulnerabilities and difficulty in finding long-term and sustainable employment.
People of colour The term ‘people of colour’ is used for the purposes of taking affirmative action to improve inclusion for under-represented ethnic groups that may face discrimination and disadvantage. It recognises that some people experience greater levels of systemic racism and inequity than others. People/person who speak(s) a language other than English at home The terms ‘people who speak a language other than English at home’ and ‘person who speaks a language other than English at home’ are the preferred terms, while the terms ‘LOTE’ (language other than English)’ and ‘NESB’ (‘non-English-speaking background’) are no longer in regular use. These terms are only used when data collection requires this specific information and should always be spelt out in full. People from refugee backgrounds ‘People from refugee backgrounds’ is used throughout this document to refer to people who have arrived through the Humanitarian Programme, people seeking asylum and people who come from refugee backgrounds who arrive on another visa type, including family migration and skilled migration. Person/people seeking asylum The terms ‘person seeking asylum’ or ‘people seeking asylum’ are used to describe people who have entered Australia by plane usually under a valid visa or by boat usually without a visa and subsequently sought protection to stay in Australia based on refugee claims. They are known as people seeking asylum while their refugee status is being determined. People seeking asylum live in the community on bridging visas, in community detention or in immigration detention facilities in Australia or offshore.
Note that the department uses ‘person seeking asylum’ not ‘asylum seeker’ to use person-first language that puts the person before the description of their experience.
Race Society forms ideas of race based on geographic, historical, political, economic, social and cultural factors and physical traits, even though we cannot use them to classify groups of people. Racism and discrimination ‘Racism and discrimination’ in this document includes all forms of discrimination on the basis of ethnicity, cultural background, language, country of origin and faith. Refugee A ‘refugee’ is a person granted an Australian visa because they have experienced persecution or a similar human rights violation in their country of origin or they have a well-founded fear of persecution in their country of origin for reasons of race, religion, nationality, membership of a particular social group or political opinion. Temporary migrant Temporary migrants come to Australia for a temporary stay for a range of purposes such as tourism, study, skilled work, working holidays or other specialist activities. This group includes international students, working visa holders, skilled migrants and women on provisional spouse visas.
Temporary migrants’ level of health access and entitlements is more limited because they are ineligible for Medicare, Commonwealth income support and Low Income Health Care Cards, making affordability a significant issue.
Undocumented migrants ‘Undocumented migrants’ are people on lapsed or cancelled visas. This group can include people who have been trafficked and other groups experiencing significant vulnerability and risk of exploitation. 49Cross TL, Bazron BJ, Dennis KW, et al. 1989, Towards a culturally competent system of care, Vol. 1, Georgetown University Child Development Centre, Washington DC.
50 Centre for Culture, Ethnicity and Health 2012, A framework for cultural , Centre for Culture, Ethnicity and Health, North Richmond.
51 National Health and Medical Research Council 2005, Cultural competency in health: a guide for policy, partnership and , Australian Government, Canberra.
52 Federation of Ethnic Communities’ Councils of Australia 2020, IF WE DON’T COUNT IT… IT DOESN’T COUNT! Towards consistent national data collection and reporting on cultural, ethnic and linguistic , Federation of Ethnic Communities’ Councils of Australia, Deakin.
53 Victorian Government 2023, Better practice guide for multicultural , Victorian Government, Melbourne.
54 Williams R 2008 ‘Cultural safety: what does it mean for our work ’, Australian and New Zealand Journal of Public Health, 23(2): 213–214.
55 Federation of Ethnic Communities’ Councils of Australia 2019, New and emerging communities in Australia: enhancing capacity for , Federation of Ethnic Communities’ Councils of Australia, Deakin.
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Year Initiative Improvement activity 2001 Racial and Religious Tolerance Act 2001 Legislation introduced or revised 2001 Hospital immigrant clinics in Melbourne established in 2001 Targeted multicultural health programs 2004 Multicultural Act 2004 Legislation introduced or revised 2004 Multicultural Health and Support Service established in 2004 Targeted multicultural health programs 2005 Refugee Health Program established in 2005 Targeted multicultural health programs 2005 First Victorian refugee health and wellbeing action plan 2005-08 Department of Health (DH) / Department of Health and Human Services (DHHS) policies and guidelines 2006 Charter of Human Rights and Responsibilities Act 2006 Legislation introduced or revised 2006 Victorian Government commitment for all departments to develop and report progress on Cultural Diversity Plans Legislation introduced or revised 2007 Victorian Refugee Health Network established in 2007 Targeted multicultural health programs 2008 Refugee Health Fellows Program established in 2008 Targeted multicultural health programs 2008 Second Victorian refugee health and wellbeing action plan 2008-2010 DH / DHHS policies and guidelines 2009 Cultural responsiveness framework for Victorian health services 2009 DH / DHHS policies and guidelines 2010 Equal Opportunity Act 2010 Legislation introduced or revised 2011 Multicultural Act 2011 Legislation introduced or revised 2011 Guide to asylum seeker access to health and community services in Victoria 2011 DH / DHHS policies and guidelines 2011 Guide to access to Victorian public health services by people living in community detention 2011 DH / DHHS policies and guidelines 2011 Refugee status report on children and young people 2011 Victorian Government policies and reports with a multicultural policy focus 2013 Refugee Health State Budget initiative (2013–ongoing) Targeted multicultural health programs 2014 Health Translations established in 2014 Targeted multicultural health programs 2014 Third Victorian refugee and asylum seeker health action plan 2014–2018 DH / DHHS policies and guidelines 2014 Victorian Auditor General’s Office (VAGO) Audit on Access to services for migrants, refugees and asylum seekers 2014 Victorian Government policies and reports with a multicultural policy focus 2015 Community health guidelines for refugee health 2015 DH / DHHS policies and guidelines 2016 Delivering for diversity – Department of Health and Human Services (DHHS) cultural diversity plan 2016–2019 DH / DHHS policies and guidelines 2016 African Ministerial Working Group (2016–18) Population focused community advisory structures 2016 Ambulance fee waiver for people seeking asylum 2016 DH / DHHS policies and guidelines 2016 Syrian and Iraqi Health and Wellbeing State Budget initiative (2016–21) Targeted multicultural health programs 2017 Victorian. And proud of it: Victoria’s Multicultural Policy Statement 2017 Victorian Government policies and reports with a multicultural focus 2017 DHHS Language services policy and guidelines 2017 DH / DHHS policies and guidelines 2017 Premier's Asylum Seeker Support package (2017–18) Targeted multicultural health programs 2018 DHHS Designing for Diversity resources 2018 DH / DHHS policies and guidelines 2018 Victorian African communities action plan 2018–28 Victorian Government policies and reports with a multicultural focus 2018 Family Safety Victoria Diverse Communities Intersectionality Working Group established in 2018 Population focused community advisory structures 2019 Family Safety Victoria inclusion and equity statement 2019, Blueprint and intersectionality capacity building resources Victorian Government policies and reports with a multicultural focus 2019 Community health guidelines for refugee health (revised in 2019) DH / DHHS policies and guidelines 2019 Support for Asylum Seekers State Budget initiative (2019–24) Targeted multicultural health programs 2020 Hospital access policy for people seeking asylum (revised in 2020) DH / DHHS policies and guidelines 2020 Targeted COVID-19 response programs for multicultural communities – testing, vaccines and targeted programs (2020-24) Targeted multicultural health programs 2021 Mental Health Uplift Response Package (2021–24) Targeted multicultural health programs 2021 CALD Communities Taskforce 2020–22) Population focused community advisory structures 2021 Anti-Racism Taskforce (2021–now) Population focused community advisory structures 2021 CALD Health Advisory Group (2021–now) Population focused community advisory structures 2021 Health Translations upgrade in 2021 Targeted multicultural health programs 2021 Afghan evacuee health response (2021–22) Targeted multicultural health programs 2021 Diverse Communities’ Mental Health and Wellbeing grants program (2021–25) Targeted multicultural health programs 2022 Victorian African Communities Committee (2022–now) Population focused community advisory structures 2022 Diverse Communities’ Mental Health and Wellbeing Working Group (2022–now) Population focused community advisory structures 2022 Refugee Health Program Boost State Budget initiative (2022–24) Targeted multicultural health programs 2022 Free medical services for displaced Ukrainian nationals 2022 Targeted multicultural health programs 2022 Summary Offences Amendment Nazi Symbol Prohibition Act 2022 Legislation introduced or revised 2023 Department of Health multicultural health action plan 2023-2027 DH / DHHS policies and guidelines 2024 Diverse Communities’ Mental Health and Wellbeing Framework (to be released 2024) DH / DHHS policies and guidelines 2024 Victorian Anti-Racism Strategy (to be released 2024) Victorian Government policies and reports with a multicultural focus -
Framework Description International declarations and conventions United Nations declarations and conventions that Australia is a signatory to:
- Universal Declaration of Human Rights (1948)
- Convention on the Elimination of All Forms of Racial (1965)
- International Covenant on Economic, Social and Cultural (1966).
National legislation The Racial Discrimination Act 1975 states that it is unlawful to discrimination against people on the basis of race, colour, descent or national or ethnic origin.
The Australian Human Rights Commission Act 1986 gives effect to Australia’s obligations international conventions and declarations.
Victorian legislation The Multicultural Victoria Act 2011 provides the whole-of-government framework that recognises and values cultural, racial, religious and linguistic diversity of people living in Victoria. The Act requires all Victorian Government departments to develop and implement cultural diversity plans.
The Equal Opportunity Act 2010 states that all Victorian departments and service providers have a positive duty under this Act to take reasonable and proportionate measures to identify and eliminate discrimination.
The Victorian Charter of Human Rights and Responsibilities Act 2006 sets out the basic rights of people living in Victoria to live with freedom, respect, equality and dignity. It requires public authorities to act compatibly with the Charter.
The Racial and Religious Tolerance Act 2001 prohibits behaviours that incite or encourage hatred, serious contempt, revulsion or severe ridicule against another person or group of people because of their race and/or religion.
Victorian Government multicultural policy Victorian. And proud of it: Victoria’s multicultural policy statement 2017 sets out the government’s vision and commitment to multiculturalism.
The Victorian African communities action plan 2018–28 outlines actions to build inclusive communities, improve outcomes and create sustainable opportunities for people with African heritage living in Victoria.
Departmental cultural diversity plans Cultural diversity plans created by other Victorian Government departments to promote cultural diversity both internally and when delivering policies, services and programs to the Victorian community. Cultural diversity plans sit alongside other departmental actions plans for disability, Aboriginal reconciliation, gender equality and LGBTIQA+ equality. Individual departmental policies, plans and strategies The plan has been developed alongside as number of new departmental policies and strategies to improve access, equity, participation, health, wellbeing, mental health and health literacy with a focus on planning for and responding to the needs of multicultural communities. -
Ongoing targeted multicultural health programs in Victoria
Language services include interpreting and translations in hospitals, maternal and child health services, community health, dental services, the Home and Community Care Program and other health services.
The Centre for Culture, Ethnicity and provides cultural consultancy services, resource development and professional development and training in cultural competency, health literacy and language services. The centre manages the Health online portal for health professionals and communities seeking multilingual health resources and delivers the Multicultural Health and Support Service, which provides community and workforce education and support about sexual health, HIV/AIDS and blood-borne viruses.
The Family and Reproductive Rights Education supports women and girls who have undergone female genital mutilation/cutting. It promotes attitudinal change in communities and works to strengthen prevention. The program is funded in a range of agencies and adopts a community development approach.
The Multicultural Centre for Women’s works to improve health and wellbeing outcomes for multicultural women through research, leadership, education and advocacy.
The statewide Refugee Health Program provides early health assessment, referrals and health promotion and increases primary care capacity in refugee health.
The Refugee Health Fellows provides support to primary and specialist health service providers through direct specialist clinical services, telehealth support, education, capacity building, secondary consultation and outreach.
Hospital and outreach immigrant and refugee health clinics across Victoria are hubs for research, policy development, education and training. Examples include Royal Children’s Hospital Immigrant Health and Royal Melbourne Hospital’s Refugee Assessment .
The Victorian Refugee Health engages and coordinates refugee health and settlement organisations and advises government on the needs of refugee communities.
The Victorian Foundation for Survivors of Torture (Foundation ) provides specialised counselling services and related supports to adults and children who have experienced torture, persecution or war-related trauma before their arrival in Australia.
The statewide Victorian Transcultural Mental builds the capacity of mental health services to work with multicultural communities and is administered by St Vincent’s Hospital Melbourne.
The Home and Community Care Program for Younger People supports younger people with moderate, severe or profound disabilities and their unpaid carers. Currently, 32 ethno-specific organisations are funded to support multicultural young people with disability.
Note that the department also funds a range of short-term programs and projects, from translations projects, community grants and co-design projects, through to pilot projects that engage multicultural communities. Many of these are detailed in the actions of the plan.
Multicultural health policies in Victoria
The department’s Language services policy and translations guidelines support the department and its funded services to respond to the needs of linguistically diverse people. The policy and guidelines identify when language services should be offered to clients and carers based on legislative requirements and best practice service delivery. Funded organisations and services should develop local language services policies and procedures consistent with this policy.
The Refugee and asylum seeker health services: guidelines for the community health program provides guidance to community health services engaged in the support and care of refugees and people seeking asylum.
The department’s Guide to asylum seeker access to health and community services in Victoria outlines policies that support access for people seeking asylum including hospital, ambulance, community health, dental and immunisation services.
Designing for Diversity resources provide a framework and tools for embedding responsiveness to diversity at the outset of any policy reform or service design process.
Multicultural health sector training and professional development in Victoria
The Centre for Culture, Ethnicity and has fact sheets, training and resources on cultural competency, as well as professional development and resources for multicultural communities and services through the Multicultural Health Support Service.
The Water Well provides free, interactive health education sessions on a broad range of topics, delivered in partnership with the Brotherhood of St Laurence, Spectrum Migrant Resource Centre, Foundation House and the Australian Medical Association Victoria.
Foundation runs learning and professional development workshops. Themes for workshops include an introduction to the Refugee Experience, Incidental Counselling skills, Community Detention sessions and on-request professional development.
The Victorian Refugee Health has online training and a national resource on promoting refugee health and a related desktop guide.
Victorian Transcultural Mental delivers group learning discussions, workshops, seminars and online learning for clinicians and workers in mental health services.
The Refugee Health Fellows offers education, secondary consult, support and referral information to primary care providers.
The Centre for Multicultural delivers cross-cultural professional development and training programs that focus on working with migrant and refugee young people.
The Multicultural Centre for Women’s offers training in intersectionality, leadership and understanding culture, race and gender.
Reviewed 16 April 2024