Perspectives of Indigenous people in the Pilbara about the delivery of healthcare services (original) (raw)
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Australian health review: a publication of the Australian Hospital Association
Purpose. To explore health professionals' views about Australian Indigenous people's health and the delivery of healthcare to them in the Pilbara region of Western Australia. Methods. An open-ended questionnaire was used to gather information from health professionals located across diverse regions in the Pilbara. The responses were analysed with the use of thematic analysis. In the first stage, codes were developed by assigning names to small sections of the interview transcripts. Next, the most salient incisive codes were identified and developed into themes that captured the most important issues. Findings. Twenty-eight health professionals indicated that the most important health issues were chronic diseases, substance abuse and ear disease. These health issues were often attributed to a cycle of poor health perpetuated throughout generations. Educational initiatives were thought to be integral to intervening in this cycle. Of particular importance in improving the effec...
Strategies to Improve Indigenous Access for Urban and Regional Populations to Health Services
Heart, Lung and Circulation, 2010
Lack of appropriate health service provision for Aboriginal and Torres Strait people still remains and important social determinant of ill health. Historically, health services have been absent or inappropriate. Cultural factors, financial factors and distance from health services have been important barriers limiting Indigenous access to mainstream health services. The Inala Indigenous Health Service, a mainstream health service has been able to improve Indigenous access from 12 Aboriginal and Torres Strait Islander patients in 1995 to 4000 patients in 2009, and approximately 1200 doctor consultations each month. Community consultation and participation were the main ingredients to improving indigenous access to the service. With improved access the Inala Indigenous Health Service has been able to analyse 413 Adult Health Checks aged 15-54 years. The Adult Health Checks provide an opportunity to evaluate health status, identifying chronic disease risk factors and for implementing preventive care.
Reorientating health services in remote North Queensland to better address Indigenous health
Australia may be a wide brown land but it is also one of the most highly urbanised countries in the world, with 70% of the inhabitants clustered in the major metropolitan centres along the coastal strip. 1 The remainder of the population is spread across a diverse range of regional (13.5%), rural (13.5%) and remote (3%) locations. 2,3 The health status of Australians living in rural and remote areas is measurably poorer than that of their urban counterparts and declines along a continuum as one moves away from the capital cities. 4,5 Health issues relate to living conditions, social isolation, cultural diversity and distance from health services. 6,7 However, the single largest contributor to this differential is the very poor health status of Indigenous persons. The proportion of Indigenous residents increases as locations become more remote, from 1% of metropolitan to 20% of rural populations. 4,8
Care for chronic conditions for indigenous Australians: Key informants' perspectives on policy
Health policy, 2009
Background: The WHO's 2002 global report, Innovative Care for Chronic Conditions proposes a comprehensive framework for health systems to meet the challenges posed by chronic conditions. This paper uses the policy environment component of the WHO framework as a lens through which to examine key informants' perspectives on the management and prevention of chronic conditions in rural and remote Aboriginal communities in Australia. Methods: Twenty one semi-structured telephone interviews were conducted with a purposive sample of stakeholders, including senior commonwealth, state/territory and regional public servants and health service staff. All of the interviews were audio recorded, from which written summaries were produced. These summaries were then content analysed to build a composite picture of this area. Findings: The results indicate substantial success in developing national and sub-national strategies and refining funding and reporting arrangements. But much work remains to be done in strengthening partnerships, developing and retaining the workforce, and further shifting the focus from acute to chronic conditions. Conclusions: This paper provides a snapshot of the main policy issues, as identified by key informants, facing chronic disease management in rural and remote Indigenous communities in Australia. It has the potential to contribute to new national policy directions in Indigenous health.
JMIR Research Protocols
Background: Primary, specialist, and allied health services can assist in providing equitable access in rural and remote areas, where higher proportions of Aboriginal and Torres Strait Islander people (Aboriginal Australians) reside, to overcome the high rates of chronic diseases experienced by this population group. Little is currently known about the location and frequency of services and the extent to which providers believe delivery is occurring in a sustained and coordinated manner. Objective: The objective of this study will be to determine the availability, accessibility, and level of coordination of a range of community-based health care services to Aboriginal people and identify potential barriers in accessing health care services from the perspectives of the health service providers. Methods: This mixed-methods study will take place in 3 deidentified communities in New South Wales selected for their high population of Aboriginal people and geographical representation of location type (coastal, rural, and border). The study is designed and will be conducted in collaboration with the communities, Aboriginal Community Controlled Health Services (ACCHSs), and other local health services. Data collection will involve face-to-face and telephone interviews with participants who are health and community professionals and stakeholders. Participants will be recruited through snowball sampling and will answer structured, quantitative questions about the availability and accessibility of primary health care, specialist medical and allied health services and qualitative questions about accessing services. Quantitative data analysis will determine the frequency and accessibility of specific services across each community. Thematic and content analysis will identify issues relating to availability, accessibility, and coordination arising from the qualitative data. We will then combine the quantitative and qualitative data using a health ecosystems approach.
International Journal of Environmental Research and Public Health
Background: Australia’s healthcare system is complex and fragmented which can create challenges in healthcare, particularly in rural and remote areas. Aboriginal people experience inequalities in healthcare treatment and outcomes. This study aimed to investigate barriers and enablers to accessing healthcare services for Aboriginal people living in regional and remote Australia. Methods: Semi-structured interviews were conducted with healthcare delivery staff and stakeholders recruited through snowball sampling. Three communities were selected for their high proportion of Aboriginal people and diverse regional and remote locations. Thematic analysis identified barriers and enablers. Results: Thirty-one interviews were conducted in the three communities (n = 5 coastal, n = 13 remote, and n = 13 border) and six themes identified: (1) Improved coordination of healthcare services; (2) Better communication between services and patients; (3) Trust in services and cultural safety; (4) Impor...
2011
This thesis presents an illustration of the access barriers to health care as experienced by Aboriginal and Torres Strait Islander peoples in Mount Isa, Queensland, Australia. This examination is conducted via fieldwork observations and the narratives of Aboriginal and Torres Strait Islander peoples in Mount Isa, as well as the stories of the health professionals that care for them. In particular, this thesis attempts to unpack the term 'cultural barriers' as used in health and medical literature in discussions of access. Stories are placed within the context of Australian rural health issues and considerations of global issues affecting rural, minority and Indigenous populations. The research represents a distinct blend of anthropology and health services research principles and practices. This perspective is developed utilising principles from the 'Mindful Bodies' approach within Critical Medical Anthropology, which seeks an understanding of human health issues via...
BMC Health Services Research
Background: For Indigenous Australians, health transcends the absence of disease, and includes the health and wellbeing of their community and Country: their whole physical, cultural and spiritual environment. Stronger relationships with Country and greater involvement in cultural practices enhance the wellbeing of Indigenous Australians, and those in more remote regions have greater access to their Country and higher levels of wellbeing. However this does not translate into improvements in clinical indicators, and Indigenous Australians in more remote regions suffer higher levels of morbidity and mortality than Indigenous people in non-remote areas, and other Australians. The Interplay research project aimed to explore how Indigenous Australians in remote regions experience high levels of wellbeing despite poor health statistics, and how services could more effectively enhance both health and wellbeing. Methods: Indigenous Australians in remote regions, together with researchers and government representatives developed a wellbeing framework, comprising government and community priorities: education, employment and health, and community, culture and empowerment respectively. To explore these priorities Indigenous community researchers recruited participants from diverse Indigenous organizations, including Indigenous land management, art, business development, education, employment, health and municipal services. Fourteen focus groups and seven interviews, involving 75 Indigenous and ten non-Indigenous service providers and users were conducted. These were recorded, transcribed and analyzed, using thematic analysis, based on the wellbeing framework. Results: Research participants highlighted Indigenous land management as a source of wellbeing, through strengthened identity and empowerment, access to traditional food sources, enjoyable physical activity, and escape from communities where high levels of alcohol are consumed. Participants described how collaboration and partnerships between services, and recognition of Indigenous languages could enhance wellbeing, while competition between services undermines wellbeing. Indigenous land management programs work across different sectors and promote collaboration between services, serving as a source of comprehensive primary health care. Conclusions: Developing primary health care to reflect distinctive health needs of Indigenous Australians will enhance their health and wellbeing, which includes their communities and Country. Indigenous land management consolidates aspects of comprehensive primary health care, providing both clinical benefits and wellbeing, and can provide a focus for service collaboration.
Australian Journal of Primary Health, 2017
This study explored the views of key stakeholders on cultural appropriateness of primary health care (PHC) services for Aboriginal people. A total of 78 participants, including healthcare providers, administrative team members (n=24, ~30% of study sample) and Aboriginal community members (n=54, ∼70% of study sample) living in remote North West Queensland participated in the study. Outcome measures were assessed by administering survey questionnaires comprising qualitative questions and various subscales (e.g. provider behaviours and attitudes, communication, physical environment and facilities, and support from administrative staff). Descriptive statistics were used to present quantitative findings, whereas inductive thematic analysis was used for qualitative data. In contrast to the views of PHC providers, a significant number of Aboriginal people did not perceive that they were receiving culturally appropriate services. Although PHC providers acknowledged cultural awareness traini...
Toward health and wellbeing for indigenous Australians
Postgraduate Medical Journal, 2005
The health of indigenous Australians remains well below that of non-indigenous Australians and indigenous peoples in Canada and New Zealand. Although recent planning has initiated many outstanding, culturally appropriate programmes with indigenous involvement, health statistics only reflect marginal improvement in recent years. It is crucial that positive programmes are sustained with appropriately directed funding. An approach that includes respect for the emotional and spiritual wellbeing of Australia's indigenous peoples will assist to redress some of the disadvantage caused by dispossession of country, language, and identity. It is clear from many programmes that are in place, that primary health care delivered locally through community controlled organisations, will minimise the impact of serious illnesses that currently threaten whole families and communities. Westernised health care systems are slow to learn from indigenous peoples in Australia and other places, that maintenance of wellness, not management of illness should be the goal.