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Aboriginal Health Research Paper

Abstract Background There are many challenges associated with health care among indigenous communities in remote and rural areas in Australia. Aim This paper overviews three challenges faced by indigenous people while getting health care in remote and rural communities in Australia. It describes present approaches to solve these alarming health issues and evaluates the approaches. Results The Cultural beliefs of indigenous people, lack of nurses from indigenous communities and poor assess to transportation are the leading causes behind poor health care.

Various approaches are being implemented to provide better health care for remote indigenous people and are showing some positive results. The results suggest the approaches are being implemented well, but the progress in the health of indigenous people is slow. Introduction There is an enormous gap between Aboriginal and nonAboriginal Australians which is approximately 12 years (Australian Institute of Health and Welfare, 2014). But this gap is more in rural and especially in remote areas 17 years compared to urban communities (Reeve et al, 2015).

Therefore, health care challenges for aboriginal people in rural and remote areas are significant across the Australia. This assignment aims to discuss the three major health care challenges for aboriginal people in rural and remote Australia and evaluate the present approaches to these challenges. Due to the word limit, only three major issues will be discussed. If these problems are addressed properly it can make a huge difference to reduce the life expectancy gap among aboriginal and non-indigenous people.

Indigenous people are defined as “inhabiting or existing in a land from the earliest times or from before the arrival of colonists” (Oxford Dictionary, n. d. ). Three major challenges associated with health care for Aboriginal people, namely, cultural beliefs, lack of nurses from indigenous communities and difficulties in accessing transport will be discussed. In addition, three current approaches to overcome those challenges, being, Aboriginal Community Controlled Health Services (ACCHSs), recruiting and retaining more indigenous nurses and the Telehealth scheme will also be discussed and evaluated.

Cultural beliefs of indigenous people regarding health Indigenous people of Australia have a holistic and complex concept of health. “Health is spiritual, emotional, psychological, and physical and is deeply connected to the land of their ancestors, and to their past, present and future simultaneously” (Baba, Brolan, & Hill 2014). However, modern health services are only associated with physical health and absence of disease. Hence, Aboriginal people prefer bush medicine and traditional healers than modern health care services as they recognize it more culturally appropriate.

Lack of trust and respect; and poor cross-cultural communications also pull them back towards traditional medicine. The example of this is an indigenous people consider the deaths of newborns and older people as a normal cause. However, unanticipated, untimely and sudden deaths are regarded as some superficial or sorcery influences. Sorcery is the chief component of death and illness (Maher 1999). Hence, some Aboriginals believe that illness can only be removed by sorcerers. Therefore, they do not want to get western medicine.

This may be one of the reasons which lead negative health outcomes in indigenous people. Among the many approaches to this issue, one of the most useful approaches is Aboriginal Community Controlled Health Services. In Sydney, the first Aboriginal Community Controlled Health Services (ACCHSs) was set up in 1971. Aboriginal Community Controlled Health Services are defined as “primary health care services initiated and managed by local Aboriginal communities to deliver holistic and culturally appropriate care to people within their community” (Dwyer, Wilson, & Silburn, 2004).

The purpose behind developing ACCHS was to provide comprehensive primary health care to the first people of Australia. Therefore, this is a holistic approach which focuses on social, emotional and physical well-being while treating indigenous people. It is oldest and widely used approach as it dealt in all states and territories of Australia with 152 centers (mostly located in rural and remote areas) since 1971. ACCHS are trying to provide efficient patient-centered health care. It is a broader and effective in scope compared to mainstream general practice as it encompasses early intervention, prevention and comprehensive care.

It means manage the health risk through diagnosis and provide support to citizens, families and groups to be responsible for their personal health (Panaretto, Wenitong, Button, & Ring, 2014; Dwyer, Wilson, & Silburn, 2004). In addition, it involves community, cultural safety, cultural respect, social determinants and health promotion in health program. ACCHS are planned to deliver the cultural understanding of health care by culturally well-trained and indigenous staff to ensure that patients feel comfortable while taking health care. It is a highly regarded approach.

According to Medicare Australia data, more than 50% of indigenous people use ACCHS services compared to GP services. ACCHS are the major performers in recognition of risk elements and maintaining the health documents (Panaretto, Wenitong, Button, & Ring 2014). Abovestated data illustrates the obligation to providing evidenced based care by medical teams. The existing provision of PHC facilities given through ACCHS is inadequate for Indigenous Australians to meet their current requirements. ACCHS need more health workforce to address the dispersed population in very remote areas and required more funding.

Overall, this program is highly successful in rural and remote areas. It is contributing to closing the life expectancy gap among indigenous and non-indigenous people. ACCHS is helpful for health professionals to understand about Indigenous people’s concept of health care. Lack of Aboriginal nurses in remote areas In addition to cultural belief, another significant challenge associated with health care among indigenous people is lack of Aboriginal nurses. Nurses plays foremost role in providing health care provision.

Therefore, increasing the numbers of Indigenous people working in health sector will significantly improve health outcomes for Indigenous people (AIHW], 2012). Indigenous nurses have better appreciation of issues regarding their culture and in what way these influence on providing culturally appropriate health care. Current data shows that indigenous people make up 2. 5 percent of total population, while only 0. 8 percent work force is represented by indigenous nurses. (Australian Institute of Health and Welfare (AIHW], as cited in Best & Stuart, 2012).

Various approaches have been implemented in order to increase participation of indigenous people in nursing by recruiting and retaining more number of indigenous. The Indigenous Nurse Education Working Group (INEWG) was also founded in 2000, in order to increase the retention and recruitment of Aboriginal students in nursing. Australian Government provide funds for programmes which provides scholarship designed especially for indigenous people. The Government have offered specific scholarships for Aboriginal nursing students in remote areas.

Taking as an example, 7. % of Commonwealth Undergraduate Rural and Remote Nursing Scholarships (CURRNS) are separated for Indigenous nursing students. Acco tment of the Prime Minister and Cabinet (2014), the positive outcomes have been seen after execution of such programmes. Moreover, the data from Higher Education Student Statistic of 2012 expected 2,037 enrolments for courses related with health were for indigenous students, and 353 finished course related with health. Following this, enrolments for course relating to health in 2012 for Indigenous undergraduate students were maximum for nursing where 943 enrolled and 115 completed the course.

In 2012, the rate of success for Indigenous university students studying healthrelated courses was 77% compared with 92% for nonIndigenous students. However, Best and Stuart (2014) stated that there has been slow progress in building number of indigenous nurses. Despite of many strategies implemented in an attempt to achieve such a goal, there appears to have been only minimal improvement in this area within nursing (West, Usher & Foster, 2014). Difficulties in accessing transport Furthermore, difficulties in accessing transportation is considered as one of the major health care barriers for regional indigenous people.

Transport has been regarded as a major factor in determining access to healthcare, particularly for remote indigenous communities (Kelly et al. , 2014). Rosier (2011) reported that remote Aboriginal people have considerably low rates of accessing public transportation (5%) and vehicle ownership (7%) which interferes with Aboriginal people’s ability to access primary health care services. According to Pink (2008), approximately 70% of remote Aboriginal people have no public transportation in their regions and 15% of these people cannot reach hospitals when they need to have hospital care.

This has led remote Aboriginal people to travel to city hospitals for health care and has brought detrimental effects such as travelling a long distance in pain and financial concerns to organise travelling (Kelly et al. , 2014). The Telehealth scheme has been broadly implemented in regional areas of Australia from the year 1984 as a way of overcoming the problem of accessing to transport for rural indigenous people’s health care service (Australian Wound Management Association, 2013). This approach aims to reduce the need to travel to access health services and needless admissions to hospitals.

The Telehealth service is designed to provide health care services and transmit health information over a distance including telephone calls, transferring images, data and information instead of moving medical specialists and educators. Video-conferencing is a typical way to use Telehealth which can ameliorate the remote Aboriginal patients’ problems of low accessibility to health care services (The Department of Health, 2015). The Telehealth scheme has reduced the need for patients to travel and increased cost-effectiveness for travelling and accommodation (Reven et al. 2013).

The Department of Health (2015) reported that over 90% of Aboriginal people who are currently using Telehealth have higher satisfaction levels in this initiative because of not having to travel for a long distance to the hospitals. Additionally, approximately $800,000 in travelling costs and accommodation is expected to be saved among remote Aboriginal communities in Northern Territory per year. Despite of the advantages of the Telehealth initiative, it brings some detrimental aspects to the remote Aboriginal health care.

Bywood (2013) claimed that a large amount of government budget would be needed to support Telehealth operations such as equipment maintenance and repair, internet connectivity and staff training. As a result, the budget concern of the Telehealth scheme could negatively impact on the Telehealth sustainability. Another point is that operating Telehealth for regional indigenous communities is hampered by some technical infrastructure. The internet connection in regional Australia, in particular, is an ongoing issue of Telehealth maintenance.

Moffatt (2011) stated that the broadband access is only available for only 27% of regional Aboriginal people compared to those who are living in urban areas (46%). Carey (2015) also pointed out that internet access for remote indigenous communities is essential to ensure Telehealth delivery. However, this issue could be solved as the NBN (National Broadband Network) scheme is broadly available now in remote Aboriginal communities. Additionally, the Australian government expects NBN service would enable more and more Aboriginal communities to access to the Telehealth service (Australian Telehealth Society, 2011).

Overall, although there are some of limitations of the Telehealth scheme, it seems to be a practical solution to solve transport challenges for remote Aboriginal health care. Conclusion To conclude, it is apparent that the three challenges: sticking to traditional norms and values, lack of Aboriginal nurses in remote areas and transport have brought detrimental effects on remote Aboriginal people’s health care. To overcome these problems, a number of effective schemes such as ACCHS, the government’s framework and Telehealth have been implementing nationwide over recent years.

Such efforts seem to offer the potential to significantly improve the rural indigenous health care. However, it could be questioned whether the initiatives are sustainable or not due to the lack of funding support from the government. Indeed, the government should continuously play a crucial role in allocating more budget for operating the schemes for regional Aboriginal communities’ health. Were the government to be more concerned about the remote Aboriginal health care, the problems associated with this would be doubtless alleviated.

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