Health Services For Aboriginal People Research Articles

Accessibility of Primary, Specialist, and Allied Health Services for Aboriginal People Living in Rural and Remote Communities: Protocol for a Mixed-Methods Study.

BackgroundPrimary, 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.ObjectiveThe 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.MethodsThis 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.ResultsWe identified 28 stakeholder participants across the ACCHSs for recruitment through snowball sampling (coastal, n=4; rural, n=12; and border, n=12) for data collection. The project was funded in 2017, and enrolment was completed in 2017. Data analysis is currently under way, and the first results are expected to be submitted for publication in 2019.ConclusionsThe study will give an indication of the scope and level of coordination of primary, specialist, and allied health services in rural communities with high Aboriginal populations from the perspectives of service providers from those communities. Identification of factors affecting the availability, accessibility, and coordination of services can assist ways of developing and implementing culturally sensitive service delivery. These findings could inform recommendations for the provision of health services for Aboriginal people in rural and remote settings. The study will also contribute to the broader literature of rural and remote health service provision.International Registered Report Identifier (IRRID)DERR1-10.2196/11471

Improving the efficacy of healthcare services for Aboriginal Australians.

Objective The aim of the present systematic review was to examine the enablers for effective health service delivery for Aboriginal Australians. Methods This systematic review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Papers were included if they had data related to health services for Australian Aboriginal people and were published between 2000 and 2015. The 21 papers that met the inclusion criteria were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Seven papers were subsequently excluded due to weak methodological approaches. Results There were two findings in the present study: (1) that Aboriginal people fare worse than non-Aboriginal people when accessing usual healthcare services; and (2) there are five enablers for effective health care services for Australian Aboriginal people: cultural competence, participation rates, organisational, clinical governance and compliance, and availability of services. Conclusions Health services for Australian Aboriginal people must be tailored and implementation of the five enablers is likely to affect the effectiveness of health services for Aboriginal people. The findings of the present study have significant implications in directing the future design, funding, delivery and evaluation of health care services for Aboriginal Australians. What is known about the topic? There is significant evidence about poor health outcomes and the 10-year gap in life expectancy between Aboriginal and non-Aboriginal people, and limited evidence about improving health service efficacy. What does this paper add? This systematic review found that with usual health care delivery, Aboriginal people experience worse health outcomes. This paper identifies five strategies in the literature that improve the effectiveness of health care services intended for Aboriginal people. What are the implications for practitioners? Aboriginal people fare worse in both experience and outcomes when they access usual care services. Health services intended for Aboriginal people should be tailored using the five enablers to provide timely, culturally safe and high-quality care.

Eye health services for Aboriginal people in the western region of NSW, 2010

To assess the availability, accessibility and uptake of eye health services for Aboriginal people in western NSW in 2010. The use of document review, observational visits, key stakeholder consultation and service data reviews, including number of cataract operations performed, to determine regional service availability and use. Aboriginal people in western NSW have a lower uptake of tertiary eye health services, with cataract surgery rates of 1750 per million for Aboriginal people and 9702 per million for non-Aboriginal people. Public ophthalmology clinics increase access to tertiary services for Aboriginal people. Eye health services are not equally available and accessible for Aboriginal people in western NSW. Increasing the availability of culturally competent public ophthalmology clinics may increase access to tertiary ophthalmology services for Aboriginal people. The report of the review was published online, and outlines a list of recommendations.

The Development of an ‘Indigenous Team’ in a Mainstream Mental Health Service in South Australia

The Social Justice Report 2005 recommended that the governments of Australia commit to achieving equal health status for all Australians "within a generation". Improving the accessibility of mainstream health services for Aboriginal people is highlighted as a central requirement. This paper describes the establishment, roles and functions of the 'Indigenous team' embedded within the South Australian Rural and Remote Mental Health Service (RRMHS) as one strategy to improve access and responsiveness of mental health services to Aboriginal patients in South Australia. We report on our progress to date and possible future directions for the team.

James B Waldram, D Ann Herring, and T Kue Young, Aboriginal health in Canada: historical, cultural, and epidemiological perspectives, second edition, University of Toronto Press, 2006, pp. xii, 367, £45.00, $70.00 (hardback 978-0-8020-8792-8); £20.00, $29.95 (paperback 978-0-8020-8579-8).

James B Waldram, D Ann Herring, and T Kue Young, Aboriginal health in Canada: historical, cultural, and epidemiological perspectives, second edition, University of Toronto Press, 2006, pp. xii, 367, £45.00, 29.95 (paperback 978-0-8020-8579-8). - Volume 51 Issue 4

Grief and courage in a river town: a pilot project in the Aboriginal community of Kempsey, New South Wales

Objective: To describe a pilot project implemented in Kempsey, NSW, whereby a psychiatry registrar worked in a community-controlled Aboriginal medical service, Durri Aboriginal Corporation Medical Service, which provides mental health services for Aboriginal people. Conclusions: The Aboriginal Mental Health Workers and psychiatry registrar jointly managed a significant number of Aboriginal people, often with assistance from the local mental health service at Kempsey. The registrar gained insight into the local Aboriginal community and more culturally appropriate clinical methods, as well as some cultural factors that can influence the presentation and management of mental illnesses. The Aboriginal Mental Health Workers increased their clinical knowledge and confidence through working with the registrar.

Grief and Courage in a River Town: A Pilot Project in the Aboriginal Community of Kempsey, New South Wales

To describe a pilot project implemented in Kempsey, NSW, whereby a psychiatry registrar worked in a community-controlled Aboriginal medical service, Durri Aboriginal Corporation Medical Service, which provides mental health services for Aboriginal people. The Aboriginal Mental Health Workers and psychiatry registrar jointly managed a significant number of Aboriginal people, often with assistance from the local mental health service at Kempsey. The registrar gained insight into the local Aboriginal community and more culturally appropriate clinical methods, as well as some cultural factors that can influence the presentation and management of mental illnesses. The Aboriginal Mental Health Workers increased their clinical knowledge and confidence through working with the registrar.

Better medication management for Indigenous Australians: findings from the field

This paper reports findings from interviews and focus groups conducted within a multi-dimensional action research project concerning medication management among Indigenous Australians. Participants were Aboriginal people with mental health problems, carers and family members, and health and social service workers from different regions in South Australia. A meta-analysis of findings from each regional project component was conducted, and major themes conceptualised and developed into a coherent summary. The findings revealed problems of a magnitude not previously realised - mental health problems (including alcohol and drug problems) and medication management among Aboriginal people clearly are major issues requiring immediate and sustained attention if the health and welfare of the Australian Indigenous population are to be improved. Findings concerned eight major areas: social and emotional wellbeing issues; stressors on Aboriginal health services and providers; training for the Aboriginal health workforce; mainstream health services for Aboriginal people; trust and confidentiality within Aboriginal health services; English language literacy and numeracy skills of Aboriginal clients; remote living arrangements for many Aboriginal people; problems with alcohol use; and institutionalised and individual racism in the community at large.

Health issues for aboriginal youth: social and cultural factors associated with resilience.

Research into Aboriginal health has tended to focus on the morbidity of babies and young children, or on the chronic illnesses of adults. Adolescent Aborigines are rarely the target of health research. While health services for Aboriginal people, even in remote areas, have improved enormously over the last few years with the provision of Aboriginal-controlled organizations, health services alone do not prevent the major causes of morbidity. In any case, young people, particularly adolescent boys, are poor users of these facilities. The major causes of adolescent Aboriginal morbidity and mortality are preventable: they have to do with ways of living, with the social, cultural and physical environments which surround adolescents. The paper draws on anthropological fieldwork which pays close attention to these issues. The paper examines the concept of 'adolescence' among Aboriginal groups, and explores the reasons for the resilience of some populations to a particular health problem, that of petrol sniffing among the young.