Department of Health

Key messages

  • Designing for Diversity is the department’s framework for embedding responsiveness to diversity at the outset of any policy reform or service design process.
  • This framework comprises an approach and suite of resources to highlight diversity considerations and identify gaps in the design process where diversity may not have been adequately addressed.
  • The resources are intended for departmental policy and service designers. However, other staff or agencies may wish to use the resources to inform their own policies or services.

Diversity responsiveness

Designing for Diversity is an initiative to embed responsiveness to diversity at the outset of any policy reform or service design process. The department recognises that diversity responsive design is critical to ensuring positive and equitable health and wellbeing outcomes for all Victorians.

Being responsive to diversity requires that services are both universally accommodating as well as tailored to particular population groups. As part of this approach, we have specifically considered people from lesbian, gay, bisexual, transgender, intersex, queer/questioning, asexual (LGBTIQA+) communities, Aboriginal people, people from culturally and linguistically diverse and faith communities, refugees and asylum seekers, people with a disability, and gender.

Designing for Diversity also prompts consideration of how the policy or service will impact people across the life-course, particularly young and older Victorians, as well as people living in regional areas or areas of disadvantage. Age and place can significantly impact on health and wellbeing, especially when combined with other aspects of diversity that may further amplify barriers to accessing appropriate services and lead to inequitable health and wellbeing outcomes.

Benefits of planning for diversity

Together, people from diverse communities make up a large proportion of our population. The department values this diversity as a strength of the Victorian population.

Ensuring that policies and services reflect the broad diversity within the Victorian population will add considerable value to existing and emerging approaches to improving population health, wellbeing and safety.

Designing for Diversity contributes to all five of the department’s outcome areas, in which all Victorians:

  • are healthy and well
  • are safe and secure
  • have the capabilities to participate
  • are connected to culture and community
  • can access person-centred and sustainable health and human services

The initiative is also a key strategy in fulfilling the department’s commitment to person-centred services and care, supporting local solutions and advancing quality, safety and innovation in health and human services.

Risks of not addressing diversity

Failure to consider diversity in policy and service design leads to enormous risks to the department, community organisations, and Victorians, including:

  • increasing barriers to services
  • lack of appropriate, equitable and safe services
  • increasing the risk of preventable adverse events
  • decreasing positive health and wellbeing outcomes
  • contributing to a decreased sense of belonging.

Failure to consider diversity can also contribute to a lack of social cohesion in our community.

Diversity within diversity

While each community will require different considerations in terms of policy and service design, it is important to recognise that communities are not homogenous and that services must ultimately be designed to be responsive to the unique needs of individuals.

This includes acknowledging that responding to a person’s needs requires an understanding of a broad range of personal differences, including religion, ethnicity, gender, sex, sexual orientation, age, culture, language and communication requirements or disability. It also involves acknowledging contextual differences such as visa status, socio-economic status, and geographic location. Many of these characteristics are common across a number of communities but may impact individuals in different ways.

Further, Designing for Diversity also recognises that where systems fail to respond to the wide varieties within diverse communities, overlapping forms of discrimination, vulnerability and disadvantage can result. This can further exacerbate barriers to engagement and services, leading to poor health and wellbeing outcomes.

The needs of all Victorians will be met by designing for diversity.

Resources

These resources and tools are intended to provide guidance around embedding diversity considerations across all aspects of policy and service design. Program areas may wish to adapt them to their particular area of reform and incorporate them into existing policies and frameworks.

Note that these resources are currently in the process of being tested and piloted with areas of reform in the department and with community stakeholders, which may lead to further updates.

For more information on this approach or how to adapt these resources to your area of service design or reform please contact the Diversity team.

  • The following statement of principles is designed to stand alone as a foundation for the Designing for Diversity approach as well as be integrated with principles described in other relevant policies, including those relating to specific diverse communities or program areas.

    Access and equity

    Service design should respond to the needs of different communities as well as individual needs and preferences. It should ensure everyone has equal access and opportunity to utilise services and feel safe doing so, taking into account such things as financial, communication, geographic, social, cultural and physical barriers, as well as the ways these barriers can combine to further inhibit individuals’ use of services.

    Related Concepts: Safety, Flexibility, Rights, Tailored care

    Inclusiveness

    Services should be non-discriminatory and welcoming of all people, with the diversity of the community reflected in their workforce and decision-making bodies. People and communities with diverse lived experiences should be actively included and encouraged to participate in governance structures and processes that concern and impact them as clients.

    Related Concepts: Non-discriminatory, Cooperative, Partnerships, Representation, Client/community focused, Respect & trust

    Responsiveness

    Services should understand and respond to the diverse and intersecting needs of all individuals and communities and not be rigid or tailored to a single population group. Service providers should be accountable and periodically review the effectiveness of their services for diverse communities, while also demonstrating awareness and openness to the experiences and preferences of individual clients in service design and delivery, including how these may change over time.

    Related Concepts: Accountable, Quality, Evidence-based, Flexible

    Empowerment and self-determination

    Diverse communities should be empowered to own, direct and make decisions about the design of services and programs that impact them. Service design should act to avoid the exclusion and disempowerment of communities in organisational structures. Services should build broader sustainable capacity in diverse communities to assist individuals and groups to have their rights promoted and upheld, and participate in society on their own terms. Service design should recognise the value of the lived experiences of clients and enable them to make decisions about how they engage with services.

    As outlined in the Aboriginal health, wellbeing and safety strategic plan 2017-2027,the department recognises that Aboriginal self-determination and leadership is absolutely essential to achieving positive health, wellbeing and safety outcomes for people from Aboriginal communities. Described by the National Community Controlled Health Organisation as ‘the ability of Aboriginal people to determine their own political, economic, social and cultural development as an essential approach to overcoming Indigenous disadvantage,’ the department also recognises that it is the role of community, not government, to define what self-determination means to and for Aboriginal Victorians’.

    Related Concepts: Rights based, Participative, Strengths-based

  • The purpose of the key elements is to detail the specific elements of service reform/design and service planning in which diversity considerations should be applied. It also provides specific ideas on and examples of how these principles can be embedded in design solutions.

    The document consists of two parts:

    • Reform and design processes
    • Aspects of service planning

    It is equally important that the proposed service reform or design output itself and the processes contributing to it are responsive to diversity issues and embody the four diversity principles. For example, it is essential that services are accessible to people with a disability, but equally that governance meetings for the relevant reform initiative are also accessible.

    Part 1 and 2 of the document are broken down into three sections:

    Reform and design processes/Aspect of service planning: refers to components of reform processes (part 1) or service planning (part 2) where diversity should be considered.

    Key elements: describes specific actions that should be taken and/or processes that should exist to ensure the reform meets the needs of all. This section is intended to highlight the specific, actionable ways in which diversity should be considered.

    Examples: describes what the key elements can look like in practice, with reference to particular communities. It is not prescriptive as each reform area will differ.

    Part 1 – Reform and design processes

    No.

    Reform process

    Key elements

    Examples of good practice

    1.1

    Governance of reform

    Membership of governing bodies (e.g. reference groups/taskforces) is reflective of the diversity of the community

    Support structures exist to counter potential barriers to participation for particular groups or individuals

    Governance structures and meetings are accessible and operate responsively to issues of cultural safety

    Members are sought from peak bodies representing diverse population groups, along with regional representatives, for the governing board of a reform initiative

    Reform body membership meets goal of at least 50% female membership

    Clear guidelines exist for discussions in governance meetings, including an Acknowledgement of Country at the outset of each meeting; referring to people using their preferred descriptors and pronouns

    Governance meetings are held in an accessible venue; information is included in different formats, including Easy English; an AUSLAN interpreter is available for Deaf people to participate

    1.2

    Population/

    client needs analysis

    Demographic data on diverse communities is used to support reform design

    Analysis of population needs is conducted in consultation with members of relevant communities in a culturally competent and accessible way

    Existing evidence and analysis of issue impact for different groups is sought and utilised in establishing client needs

    Data of greater granularity is sought from local area programs and community specific data sets

    Analysis for family violence services uses a defined minimum data set, including country of birth, language spoken, year of arrival, ATSI status, disability, gender and sexual identity (where relevant to obtain)

    A survey uses best practice on questions about gender and sexual identity (when relevant to obtain) to ensure accurate information about demographics

    1.3

    Stakeholder engagement & co-design

    Consultation processes are inclusive and accessible

    Stakeholders are actively involved in reform design and decision-making processes

    Updates are provided to stakeholders on a regular basis with a formal pathway for feedback and contributions using a ‘two-way’ approach to knowledge sharing

    Communications seeking consultation and feedback are available in multiple languages/dialects and accessible formats, and reviewed for cultural appropriateness as part of the translation process

    Non-written methods of engagement are held to avoid excluding people with low literacy

    Community forums are conducted in regional areas and areas of disadvantage

    Aboriginal stakeholders have control and ownership over decisions made regarding their community relating to child protection reform

    A regular update is emailed to LGBTI community organisations who were consulted in the reform process for youth support services informing them of progress and seeking feedback

    Consultations for youth support services are held with the Maori community in a meeting format appropriate to that community

    1.4

    Defining goals and outcomes

    Specific outcomes for diverse communities are identified in relation to their particular needs at the outset of the reform design process

    Recommendations from community groups about relevant measures of success for their populations are prioritised in setting goals

    Feeling connected to culture, country and community is included as a specific measure of success for Aboriginal Victorians based on input from community organisations

    Self-determination is a priority for Aboriginal organisations within the reform area and drives any changes

    Resilience for LGBTI clients is a stated goal due to the effects on LGBTI people of the ongoing debate on marriage equality

    Following consultation, improving inclusion for people with a disability is a key priority in out of home care reform

    Part 2 – Service planning

    No.

    Aspect of service design

    Key elements

    Examples of good practice

    2.1

    Funding models

    From the outset funding models and allocations are responsive to the specific needs of different population groups and communities

    Funding allocation to Aboriginal Community Controlled Organisations support self-determined responses to Aboriginal health, wellbeing and safety

    Funding is allocated for staff training on diversity competence, including Aboriginal cultural safety

    Consideration is given to the weighting of prices to recognise the additional time that may be required to provide responsive services

    Funding considers culture an integral part of service delivery

    Funding is allocated to enable access to all parts of service for people with a disability, such as adjusting unit prices to allow for embedding of language services

    2.2

    Monitoring, review and evaluation systems (including data)

    Data collection processes have the capacity to identify demographic factors relating to diversity

    Monitoring systems include accessible pathways for feedback about services

    Reporting systems include specific reports about outcomes for diverse communities

    Communities have access to data about themselves and are actively informed of this

    Data is available in accessible formats

    Questions feeding into client databases use minimum data set including country of birth, language spoken, year of arrival, ATSI status, disability, gender and sexual identity

    Reports include gender-specific information on outcomes and evaluate reasons for any differences

    A questionnaire is produced in multiple languages and accessible format

    Data and reports regarding child protection outcomes are regularly circulated to culturally and linguistically diverse community organisations

    Aboriginal communities lead the design of evaluation questions and outcomes relevant to Aboriginal health, wellbeing and safety

    2.3

    Safety, risk management

    Policies and procedures account for different risk factors for particular groups and individuals

    Physical facilities mitigate risk factors experience by different population groups

    All aspects of service design and delivery incorporate the notion of cultural safety

    Training is implemented to improve workforce capacity to implement the above

    Communication with families of LGBTI clients avoids disclosing their identity without their consent

    Evacuation procedures for people with a disability are clearly planned and communicated to all staff and affected clients

    All discussions and documents refer to a person by their preferred identity and any related descriptors – for example, calling someone Aboriginal rather than indigenous according to their preference

    Research about Aboriginal health adheres to National Medical Research Council ethics guidelines for Aboriginal and Torres Strait Islander peoples

    2.4

    Consumer participation

    People have input into decisions about their care or services

    A formal system exists for identifying client preferences

    People are given options for treatment or services in line with their preferences

    A client with limited English is provided interpreting services to fully understand their options

    A transgender person is referred to a case manager; a clear record exists of their preferences, e.g. pronouns, and desired outcomes as a client

    A Maori person is given service options incorporating their cultural beliefs and practices; the organisation has a pathway to contact or provide referrals to Aboriginal community organisations if this is desired

    Clients are asked if they have a preference for the gender of their case manager

    2.5

    Governance structures

    Membership of ongoing governing and advisory bodies is reflective of community members and community needs

    Support structures exist to counter potential barriers to participation for particular groups or individuals

    Governance structures and meetings are responsive to issues of cultural safety

    Community organisations for diverse cultural groups are contacted to seek representatives for governing board of the reform of an aged care service

    Interpreter is available to allow a hearing-impaired person to participate in governance meetings

    Governance body has at least 50% female membership

    Clear guidelines exist for discussions in governance meetings including referring to people using their preferred descriptors and pronouns.

    All governance meetings include an Acknowledgement of Country at the outset

    2.6

    Service elements:

    Intake and assessment

    Case management

    Referrals

    Peer support

    All aspects of case management consider clients as individuals rather than being ‘typical’ of a particular population group

    Client preferences are considered at all points of service delivery

    Clear guidelines exist for practices regarding differences between various communities

    A Muslim person who identifies as being from an LGBTI community is given the option of referral to a different support network, rather than a community faith leader who may not be supportive of their identity

    An Aboriginal client is given the option of being referred to an ACCHO

    All staff of a sexual health service are aware of how to respectfully discuss issues relating to sexual preference with people identifying as men who have sex with men

    2.7

    Workforce recruitment and development

    Recruitment processes aim for a workforce representing the diversity of the community

    Training is provided for staff on competence in relevant areas

    Diversity competence is a part of staff performance requirements

    Adherence to best practice and continuous improvement to practice is a system priority diversity accreditations such as the Rainbow Tick

    Hiring processes are accessible, advertised through community organisations and culturally appropriate

    Flexible workforce arrangements are in place to avoid discriminating against people with caring responsibilities.

    Aboriginal cultural awareness training is available to all staff

    Procedures exist to eliminate bias in recruiting, e.g. removing names from job applications. Policies ensure an equal gender representation in the workforce

    Staff receive training on how to communicate effectively with all people, including those with limited English, an intellectual disability or people with complex communication needs.

    2.8

    Infrastructure – including physical facilities & IT

    Facilities are universally accessible

    Facilities demonstrate awareness and acceptance of diverse client groups

    Services operate on the principle of place-based care

    Electronic resources are available in accessible formats for people with a vision impairment

    Aboriginal artwork is displayed in an organisation with servicing Aboriginal client groups

    Rainbow stickers are visible to indicate an organisation is LGBTI-inclusive

    A service with a high proportion of refugee clients located centrally opens an outpost in the Dandenong area, where many people from a refugee background reside

    An access consultant is engaged to ensure that services employ principles of universal age-friendly design and are accessible for older people using mobility aids and people with a disability, including a ramp and electric doors

    Buildings include prayer/faith rooms with washing facilities available

  • The Rapid Review tool is part of the Designing for Diversity suite of resources. Its application should be underpinned by consideration of the core principles of access and equity, inclusiveness, responsiveness, and empowerment and self-determination. The questions in the tool align closely with the aspects of service reform and design as outlined in the Key Elements document, which also provides examples that clearly illustrate ways in which diversity can and should be considered in planning processes.

    Application of the tool

    This tool is designed to guide an assessment of how a new or existing policy or service design considers issues relating to diversity. It can be:

    • applied at a whole of initiative level or in relation to a particular component
    • applied in a planning or review context
    • applied at a number of stages of the overall initiative
    • amenable to either a desktop analysis or facilitated discussion (e.g, in a steering committee or reference group)
    • completed by project leaders on their own, or with the assistance of the department’s Diversity team to guide the process.

    Note that the tool is not designed to assess outcomes or to address the needs or concerns of diverse population/client groups. The aim is to capture how and where the design and implementation process has considered diversity issues.

    Answering the questions

    For each of the following questions, please select from: ‘not at all’, ‘partially’, or ‘comprehensively’ before explaining how diversity has been considered. Each question should be considered in relation to achieving equity between (and within) the multiple and diverse communities in the Victorian population. Questions also seek to elicit how particular population groups have been considered – for example, Aboriginal people, people from culturally and linguistically diverse communities, refugees and asylum-seekers, people from LGBTI communities, people with a disability, women, older and younger cohorts, and people living in regional areas and areas of disadvantage.

    It is recommended that relevant documentation relating to how each item has been addressed be noted to allow for further development.

  • This document is currently under review and is unavailable to download.

  • Designing for Diversity: Key documents summary provides a list of key national and state resources in relation to culturally and linguistically diverse communities, gender, Aboriginal communities, disability, and people from LGBTI communities.

Reviewed 07 December 2023

Health.vic

Contact details

International, interstate and mobile callers: +61 3 9096 9000

Diversity team Department of Health

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