Indigenous populations health case analysis
Aboriginal case study examples
Conclusion While the eight characteristics were clearly distinguishable within the review, the interdependence between each characteristic was also evident. Evidence suggests that access to primary health care can be improved when services are tailored to the needs of, or owned and managed by Indigenous communities themselves [ 5 , 6 ]. The original scoping review research team, led by an Aboriginal Research Fellow was also involved in this new framework synthesis. Both user and health care service characteristics are incorporated within the five stage linear framework. Study selection The selection of studies was performed by four of the authors [SH, CD, AM, ZM] over two stages — title and abstract review; and full text review, against the inclusion criteria. Findings Summary and context history of service The Central Australian Aboriginal Congress was formed at a public meeting in Alice Springs a remote township of approximately 28, people in June , which was attended by over Aboriginal people from across Central Australia. Any disagreements were discussed and resolved by authors. Their success is partly due to the fact that they often provide comprehensive programs that incorporate treatment and management, prevention and health promotion, as well as addressing the social determinants of health. Primary health care was defined as: socially appropriate, universally accessible, scientifically sound first level care provided by health services and systems with a suitably trained workforce comprised of multi-disciplinary teams supported by integrated referral systems in a way that: gives priority to those most in need and addresses health inequalities; maximises community and individual self-reliance, participation and control; and involves collaboration and partnership with other sectors to promote public health. However, findings suggest two additional improvements, at least in relation to access to health care services for Indigenous peoples.
Background Ensuring access to primary health care is widely accepted as key to improving health outcomes [ 1 ]. Corresponding author.
Indigenous populations health case analysis
For example Haggerty et al. Electronic supplementary material The online version of this article One of the primary reasons is that Indigenous PHC services are often controlled by their local communities [ 7 , 13 , 14 , 17 ] and therefore are underpinned by the values and principles of the communities they serve [ 18 ]. Results Culture was the most prominent characteristic underpinning all of the other seven characteristics which were identified — accessible health services, community participation, continuous quality improvement, culturally appropriate and skilled workforce, flexible approach to care, holistic health care, and self-determination and empowerment. Medicare includes preventive medicine within a biomedical framework , but little that could be classified as promotive services. In Australia, the first Aboriginal PHC service was established in [ 9 ] and there are now over Aboriginal Community Controlled Health services across the country [ 10 ]. Comprehensive primary health care includes health promotion, illness prevention, treatment and care of the sick, community development, and advocacy and rehabilitation. The project started two years after the controversial Northern Territory Emergency Response began in the Northern Territory.
General practitioners are free to charge a higher fee than Medicare will reimburse, in which case the patient pays out of pocket for any fee gap. Medicare includes preventive medicine within a biomedical frameworkbut little that could be classified as promotive services.
Search strategy An initial search of PubMed was conducted to identify text words contained in the title and abstract as well as any index terms that could be used as alternate search terms.
While all of the authors were experienced in synthesising data, we believe our findings were strengthened by the involvement of Indigenous researchers who guided the interpretation of data.
Concept Concepts of interests included characteristics values, principles, components and suggested practical applications of models of service delivery implemented within an Indigenous primary health service.
Quantitative measures of socioeconomic status with indicators of disadvantage have also been included [ 1415 ].
Similar gaps in life expectancy exist in New Zealand [ 4 ], Canada [ 5 ] and the United States [ 6 ]. Early research defined access in terms of how well available services are able to meet the health needs of the populations they serve [ 17 ], or alternatively how well patients are able to access health care given their particular capacity to seek and obtain care [ 1819 ].
Why are aboriginal community controlled health services important?
For example Haggerty et al. Results Culture was the most prominent characteristic underpinning all of the other seven characteristics which were identified — accessible health services, community participation, continuous quality improvement, culturally appropriate and skilled workforce, flexible approach to care, holistic health care, and self-determination and empowerment. This article has been cited by other articles in PMC. Quantitative measures of socioeconomic status with indicators of disadvantage have also been included [ 14 , 15 ]. Clearly these quantitative perspectives ignore many of the access issues relevant to Indigenous peoples such as the ability of the service to accommodate the social and cultural needs of Indigenous peoples, the provision of health care by Indigenous staff in an Indigenous friendly space and considering the important role that communities and families often play within the care process [ 16 ]. Not all researchers agree with this dichotomy. Step four, Health Care Utilisation, encompasses the cost to patients accessing services Ability to Pay and the expenses incurred in running a health care service Affordability. For each service, a case study of intersectoral action on a social determinant of health. While we found that the South Australian services moved away from implementation of the comprehensive PHC vision, we found that Congress maintained a comprehensive view of health as a human right, potentially providing a strong basis for UHC. Sixty-two studies met the inclusion criteria. However, in reality, the South Australian services were mostly small in scale and residual available only to those unable to afford private services ; they provided timely care only to those individuals and families who qualified as disadvantaged, and their care generally centered only on physical chronic diseases.
Three of the South Australian sites anonymized as Services, A, C, and E were longstanding services which arose from a national Community Health Program in that established community health centers led by community boards and that provided comprehensive social health services; medical services, meanwhile, were largely provided in parallel by private general practitioners.
These findings were used to develop a new Indigenous PHC Service Delivery Model, which clearly demonstrates some of the unique characteristics of Indigenous specific models. Findings were reviewed by members of the Leadership Group on two separate occasions during the synthesis process in order to provide an Aboriginal and Torres Strait Islander perspective on their validity.
For example Haggerty et al.
Workshops at each service with community members, including three workshops at Congress with a total of 13 community members.
based on 54 review