Perspectives of Indigenous people in the Pilbara about the delivery of healthcare services

Abstract

Aim. To identify Indigenous people's views about gaps and practical solutions for the delivery of healthcare services in the Pilbara.Methods. A structured guide was used to interview three Indigenous language groups from the Pilbara region of Western Australia. The responses were analysed with the use of content 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.Results. Many respondents said that there were insufficient health professionals near country, which was compounded by a lack of adequate transport to reach healthcare services. Moreover, respondents commonly indicated that they would be unable to secure adequate accommodation for themselves and any carer when needing to leave country to undergo medical care. The importance of secondary healthcare interventions was highlighted, particularly health promotion initiatives that improved diet and exercise levels and reduced substance abuse. Assuming responsibility for one's own health was seen as integral to improving the overall health of communities. The respondents saw role models as the most important influence in leading people to take responsibility for improving their own health.Conclusion. This study provides Indigenous perspectives about gaps and solutions in healthcare service delivery in the Pilbara region of Western Australia. Although initiatives have commenced to address the shortfall in health professionals and inadequate transport to healthcare, there are still gaps in service provision. Mobile health services were strongly supported as an integral measure to address these gaps.What is known about this topic? About two out of every three Indigenous adults in the Pilbara experience a chronic health condition. Moreover, compared with non-Indigenous people in the region, Indigenous people experience a significantly higher mortality rate for numerous chronic health conditions. Although some information is available about the provision of health services for Indigenous people in the Pilbara, little is known about Indigenous people's perspectives about its adequacy or how it should be delivered. What does this paper add? This study details three local language groups' views about the gaps and solutions to delivery of healthcare for Indigenous people in the Pilbara. It highlights the need for secondary healthcare interventions given difficulties around providing adequate primary care in remote settings. What are the implications for practitioners? Health promotion initiatives need to be prioritised to improve the health of Australian Indigenous people in the Pilbara and the initiatives should be delivered with the involvement of the local communities. Innovative solutions are required to improve the continuity of healthcare in the Pilbara, including increased use of mobile services.

How telehealth facilitates the provision of culturally appropriate healthcare for Indigenous Australians

“…2,13,16 Provision of healthcare in a service that is trusted and inclusive, without the need for travel and with the support of family can improve engagement with the health system. [17][18][19] To date, outreach delivery of specialist services has addressed some of the barriers to healthcare access such as distance, cost and communication and resulted in improvements in healthcare access in remote communities. 20 Similar to telehealth, outreach services delivered in an ACCHS may provide a culturally appropriate alternative to travel to mainstream health services.…”

“…2,13,16 Provision of healthcare in a service that is trusted and inclusive, without the need for travel and with the support of family can improve engagement with the health system. 17–19…”

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“…Several studies have noted barriers in meeting the health and hygiene needs of the indigenous community members. Various social and physical barriers, including the non‐function of health and hardware items, low levels of knowledge about and attitudes toward hygiene behavior, and the insufficiency of health professionals have been shown to aggravate health and hygiene in the community (Balilla, Mchenry, Mchenry, Parkinson, & Banal, 2014; McDonald, Bailie, Grace, & Brewster, 2009; Walker, Stomski, Price, Ed, & Jackson‐Barrett, 2014). The findings of these studies also indicate that additional housing, sanitary facilities, and health promotion education are considered essential to health improvement of the community.…”

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“…However, they also experience negative influences on well-being, mental illness, and suicide at higher rates than their non-Indigenous counterparts [2,3]. Help-seeking is impeded by stigma, shame, differences in language and culture, geographical isolation, and cost [4][5][6][7]. Mental health services that integrate Aboriginal and Torres Strait Islander people's holistic health worldviews are recommended [8] but remain limited [4].…”