Introduction
The indigenous medical system in Australia encounters significant obstacles in several areas of service. The issues related to quality and access to health care facilities are the focus of current academic research in the field. The problems of inequity in access and overall service seem to have the most impact on the health outcomes for Torres Strait Islanders and Aboriginal Australians. To identify the most influential effects inequity has on these people’s health, one should operate some valid academic data. The first article used for the analysis concentrates on the causes of inequity in access and their outcomes (Davy, Harfield, McArthur, Munn, & Brown, 2016). The authors’ validation of the problem under discussion spreads beyond the aspect of physical ability to reach a facility and grasps the factors of discrimination and racism, which become crucial barriers for indigenous peoples.
The accessibility of medical services appears to be the main issue of concern. According to Davy et al. (2016), the main deterrent was related to inadequate funding of healthcare and overpriced transportation in addition to the high cost of services the majority of indigenous individuals cannot afford. Therefore, as found by the researchers, poverty is one of the main issues on the way of indigenous Australians access healthcare. Such social health determinants as low level of income or education also has an adverse effect on the increasing rates in disease epidemics, comorbidities, and the rising of mortality rates (Davy et al., 2016). Local communities have to work together with the state authorities to ensure lower costs of health care, transportation to the medical institutions, and the development of services aimed at underprivileged indigenous people. Thus, barriers related to cultural diversity impose significant difficulties for indigenous people to obtain qualitative care, which is broadly addressed in the second analyzed article.
Main body
Indeed, Li (2017) elaborates on the topic of cultural inequity that hinders aboriginal Australians and Torres Strait Islanders’ health care coverage and leads to severe adverse outcomes. As the article shows, these populations’ life expectancy “was estimated to be 11.5 years lower than that of the non-indigenous population for males … and 9.7 years lower for females” (Li, 2017, p. 208). This high level of deaths of native Australians is related to an increase in complications in prenatal care, infants’ care, insufficient treatment of infectious disease, as well as chronic and sexually transmitted illnesses. It is vitally important to solve these problems by eliminating the root causes them.
As has already been mentioned, the main reasons for poor health care services quality for indigenous Australians are not limited to financial and geographical differences. Cultural barriers as manifested in language, staff’s nationalities, and culturally sensitive communication in the workplace are all very influential. As the study implies, the difference in the cultural background of medical workers and patients needs to be addressed appropriately to succeed in meeting people’s needs (Li, 2017). Communities have to be provided with workers who speak the language their patients understand, know their cultural background to be able to act within their acceptable framework of beliefs, and ensure equity in services’ access.
Specific interventions are needed to meet these requirements on both local and governmental levels. There exist some successfully adopted programs that have shown positive results in achieving cultural equity, as, for example, the Advance Care Planning program in Singapore (Li, 2017). For Australia, it is vital to use the international experience to develop specialized programs for staff training to fill in the health equity gaps and provide “culturally and linguistically appropriate services” (Li, 2017, p. 209). Nurse managers are responsible not only for nursing staff training but also for applying specific interventions capable of making a change and improve the indigenous peoples’ life quality.
Employment of Indigenous Staff
To make a change in the quality of health care services for Australian Aboriginal and Torres Strait Islander people, health care providers should use current research findings to develop effective interventions. The first option is to employ indigenous staff at a medical facility to make the workplace more culturally diverse. As evidence shows, health outcomes are better if the local communities work with their population’s needs separately (Davy et al., 2016). Such an implication is based on a suggestion that such services “are more likely to be free of racism and are generally more culturally appropriate than mainstream services” (Davy et al., 2016, p. 1). Therefore, specialists of the same cultural background and speaking the same language as their patients have better chances to provide qualitative care and ensure patients’ trust.
Since cultural difference has been identified as the main barrier in health care services’ accessibility, indigenous staff employment is a method of overcoming this obstacle. The study by Gibson et al. (2015) shows that most local people were more comfortable with accessing medical facilities where indigenous staff worked. Under such circumstances, the fact that a person in charge of treatment provision shares the same cultural background and language encourages patients to seek help and receive services. In fact, the findings demonstrate that even “care in a service where Indigenous clinical, reception, paramedical and/or administrative staff were employed” was more likely to be attended by aboriginal Australians and Torres Strait Islanders (Gibson et al., 2015, p. 8). Overall, such a system of hospital and primary care units staffing allowed for obtaining higher levels of positive healthcare results. Community members were more likely to admit to a hospital due to the trusting and culturally sensitive framework of doctor-patient communication. Since family members’ support was acceptable, patients showed better rates in adhering to treatment plans.
The improvement of the quality of health within a population depends not only on qualitative care but also on sufficient promoting and preventive programs. As mentioned by Peiris et al. (2012), many studies have been devoted to the inclusion of indigenous staff in all levels of health care community work. The results show that the employment of Aboriginal and Torres Strait Islander staff has positive outcomes not only for patients in care but also for a healthy lifestyle promotion (Peiris et al., 2012). When working as health promoters, aboriginal health workers ensure people’s inclusiveness in the process. They are more likely to accept and positively respond to the information concerning the crucial influential factors in maintaining a healthy lifestyle. Such a result is achieved due to the high rates of trust in the indigenous staff. The specialists manage to conduct friendly relationships with their patients and perform their professional duties.
Provision of Specialist Outreach
The second way a health care provider can facilitate the access and accessibility of medical services for indigenous peoples is the development of specialist outreach programs. The analysis of the facilities and their staffing on the background of geographical positioning shows that the distribution of services is inadequate. Most medical specialists prefer to work in big cities, thus contributing to the disproportionate allocation of services. According to Gruen, Weeramanthri, and Bailie (2002), “twenty-eight percent of the Australian population, but only 12% of specialists, live in rural and remote areas” (p. 518). This means that many people who live in remote areas of Australia are deprived of the possibility to have accessible primary care and specialist services.
As mentioned earlier in the paper, poverty becomes a significant obstacle for underprivileged native populations to use transportation from remote areas of habitation to the cities where they can see specialists. Therefore, specialist outreach is an effective solution to the problem. The study has demonstrated some significant achievements in this sphere. Gruen et al. (2002) claim that “outreach delivery … has overcome some of the barriers relating to distance, communication, and cultural inappropriateness” and has stimulated an increase in the rates of people’s consultations with the specialists (p. 519). However, it is essential to analyze the needs and specific features of the population from the remote areas to be able to supply a relevant number of specialists in appropriate fields.
Many health care organizations work on the development of a system of regular appointments with an on-site specialist. Indeed, timely access to medical services might play a crucial role in critically ill patients. In this regard, the clinical setting is of great importance (Gruent et al., 2002). Therefore, on-site specialist clinics provide a possibility to engage more patients in the process and establish high-quality treatment for people in small communities. To succeed at the organization of such a system of work, responsible authorities have to establish proper collaboration between health care providers, their community-based representatives, and patients located in remote regions of Australia. In such a manner, the indigenous population will have more trust in governmental health care programs and will rely on their help (Gruent et al., 2002).
Conclusion
However, to regulate the implementation of the analyzed interventions, the authorities have to attract sufficient funding, which appeared to be one of the most severe challenges so far. When supplied with adequate funding, the detailed plan of the programs’ application will be able to meet demand. Ultimately, this initiative will be able to improve the cultural equity, accessibility, and quality of health care services for indigenous peoples in Australia.