ATSI Health: Primary Health Services, Disparities, and Factors Influencing Delivery | Overview and Analysis

In this document we will discuss about ATSI Health and below are the summary points of this document:- The text discusses the health status profile of Aboriginal and Torres Strait Islander (ATSI) communities. It highlights the disparities in health care delivery between ATSI and non-indigenous communities. The text explores the establishment of primary health care services for ATSI communities and the factors influencing their development.

Running head: ATSI HEALTH
Primary Health Services for the ATSI Community
Introduction: Health status profile
According to Best and Fredericks (2017), the Aboriginals and Torres
Strait Islanders (ATSI) before the invasion of the white settlers, they were
of good health status regardless of some infections, like trachoma and
yaws. The warfare and abuse the Aboriginals experienced during the
colonial period deprived them their health status. Harfield et al. (2018)
claim that, the Aboriginal community is poorer than the non-indigenous
community. This is due to the long suffering during the time of
colonization. The experience of colonization left a deep mark of
inequalities in their health status such as social, physical, mental and
emotional illness (Gracey and King, 2009). Research conducted in 2012
indicated that the life expectancy gap between the ATSI people and the
non-indigenous communities was almost 10 years in Australia with the
non-indigenous communities having a higher life expectancy (Australian
Institute of Health Welfare, 2014). The same results were found in New
Zealand (Statistics New Zealand, 2013), Canada and USA (Indian health
Service, 2015). This report would focus on delivery of primary health care
for the Aboriginals, factors that have influenced the establishment of the
primary health care and their effect on the community level.
Health service delivery to indigenous people
The Aboriginals as compared to the non-indigenous communities do
not receive quality health care. The increasing health gap between these
groups was attributed to non-communicable diseases associated with 70
percent increase of the gap, cardiovascular diseases contributed to 23
percent, diabetes increased the gap by 23 percent, mental and chronic
infections contributed to 12 percent and 9 percent respectively (Markwick,
Ansari, Sullivan, Parsons & McNeil, 2014). The inability of the mainstream
to meet the health needs of the Aboriginals, according to the Australian
Institute of Health and Welfare (2014), led to the evolution of Aboriginals
primary health care. It was also claimed that the disparities and
inequalities in their health status was because the Aboriginals were being
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marginalised from the health service mainstream (Aboriginal Medical
Service Redfern, 2015). This led to the establishment of primary health
care for and managed by the ATSI people.
Health care services were established in Australia and also in
Canada as a solution to the existing health disparities. The indigenous
primary health care services improved the health care of the ATSI people
more as compared to the mainstream services because first they were
controlled by the local communities (Gardner, Dowden Togni & Bailie,
2010) who are well aware of the principles and values of the community.
The success of the primary health care for the ATSI community is also
attributed to the provision of comprehensive care programs included
treatment, prevention, health promotion and management and also
addressed the social health determinants (Bailie, Matthews, Brands &
Schierhout, 2013).
Factor influencing establishment of health services
Davy, Harfield, McArthur, Munn & Brown (2016) think that providing
access to quality primary health care is important in improving people’s
health status and especially to the indigenous population who are faced
with increased rates of chronic infections. The population of indigenous
people dying out of cardiovascular diseases (CVDs), even in the developed
nations, is more than that of the non-indigenous people. These people are
facing difficulties in accessing primary health care due to a range of
factors such as poor communication with the nurses, facing racism and
other forms of discrimination and high cost of delivering health care
(Aspin, Brown, Jowsey, Yen & Leeder, 2012). Also Hayman (2010) thinks
that to do away with some of these factors such as discrimination,
introducing health care services tailored to the exact needs of these
people and also managed by the local communities would to a much
degree improve the health service delivery. Cost of delivering health care
services could be termed as both internal and external factor determining
delivery of health services. It could be an external factor when the
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government takes the initiative and offers affordable health services to
the people.
Another external factor that influences the delivery of health
services is poor access to the health facilities. Access to health care
services entails spatial factors like distance and location (Reeve et al.
2015). In Australia, the rural index of health care access considers factors
like population-provider ratio and number of health facilities in the
locality. The government would use these information so as to establish a
health facility (Schuurman, Berube and Crooks, 2010). Khiavi, Raeissi,
Nasiripour and Tabibi (2016) claim that the government plays a crucial
role in ensuring that health services are established in the regions
required. They achieve this by coming up with national plans and policies
with a core aim to reform health services. These national plans and
policies are design and implemented to combat different health issues
and promote health. This leads to more satisfaction in the delivery of
health care services and reduces cost of health care. The implementation
of health system plan and modifying the existing systems in an important
step in establishing quality health care. This is also important in solving
new and the ever changing needs of the ATSI people. Poor relationships
between the people and the health care professionals is perceived to be
another factor influencing establishment of quality health services. Most
health professionals would explain the health procedures and medications
using complex medical jargons which these people could not understand.
Health practices and their impact on the ATSI people’s
health
Traditional healing has been pronounced among the ATSI
community. According to Best & Fredericks (2017), the traditional healers,
wise men and women in this community had the ability to look in to the
supernatural and spiritual worlds and determine the cure for different
diseases. It is believed that just like the current days, the traditional
healers used medicinal and physical treatments. It applies ancient cultural
knowledge in addressing trauma and sustaining good health. Traditional
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healing is critical to the community as it gives the people a sense of
belonging and gives cultural identity. Traditional healing according to the
Aboriginals is a way of maintaining cultural distinctiveness which in
integral in emotional, spiritual and social wellbeing and also strengthening
the community bond. It is facilitated by maintaining their language,
traditional dances, arts, stories, foods and also traditional medicines
(Harfield et al. 2018). Australians claim that the traditional healing
programs should be kept specific to a given group and region. They
should also be performed to people of that cultural group and participants
belonging to that group and region too.
The traditional healing practices are more prevalent in the remote
and rural areas of Australia. Traditional healers use their intensive
knowledge to interpret signs and symptoms of an illness then treatment
accordingly. The traditional healing knowledge is passed from one
generation to the next. According to the ATSI people, not every person
has the ability to heal. They claim the healers possess certain powers that
capture sicknesses and heal them. The WHO received some wishes by
different countries to improve their traditional medicines and help
regulate their use in the primary health care. The indigenous primary
health care is controlled by the government and governed by the local
communities so as to help deliver holistic and culturally sensitive primary
health care. However, this does not include the traditional medicines
which are important to these communities (Oliver, 2013). The concerned
authorities should find a way to incorporate the traditional medicine in the
primary health care if they are to achieve much success. This is because
the traditional medicines have a meaning to these people.
Conclusion
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This report has touched on the ever increasing gap between the
indigenous communities and the non-indigenous people, which is mainly
caused by the inability of the ATSI people to access mainstream health
care services. To solve this, the government, the Aboriginals and the
health care professionals have partnered in an attempt to deliver quality
and culturally safe health care. They have incorporated Aboriginal health
care officers at the community level, thus reducing discrimination and
racism. The Aboriginal nurses also very well understand the cultural needs
of the community and thus would stick to them.
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References
Australian Institute of Health and Welfare. (2014)Australia’s health 2014.
Available from:
https://www.aihw.gov.au/reports/australias-health/australias-health-
2014/contents/table-of-contents
Aspin, C., Brown, N., Jowsey, T., Yen, L., & Leeder, S. (2012). Strategic
approaches to enhanced health service delivery for Aboriginal and
Torres Strait Islander people with chronic illness: a qualitative study.
BMC health services research, 12(1), 143.
Bailie, R., Matthews, V., Brands, J., & Schierhout, G. (2013). A systems-
based partnership learning model for strengthening primary
healthcare. Implementation Science, 8(1), 143.
Best, O. & Fredericks, B. (2017). Yatdjuligin: Aboriginal and Torres Strait
Islander Nursing and Midwifery Care. Australia: Cambridge
University Press.
Davy, C., Harfield, S., McArthur, A., Munn, Z., & Brown, A. (2016). Access
to primary health care services for Indigenous peoples: A framework
synthesis. International journal for equity in health, 15(1), 163.
doi:10.1186/s12939-016-0450-5
Gardner, K. L., Dowden, M., Togni, S., & Bailie, R. (2010). Understanding
uptake of continuous quality improvement in Indigenous primary
health care: lessons from a multi-site case study of the Audit and
Best Practice for Chronic Disease project. Implementation Science,
5(1), 21.
Gracey, M., & King, M. (2009). Indigenous health part 1: determinants and
disease patterns. The Lancet, 374(9683), 65-75.
Hayman, N. (2010). Strategies to improve indigenous access for urban
and regional populations to health services. Heart, Lung and
Circulation, 19(5-6), 367-371.
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ATSI HEALTH
Harfield, S. G., Davy, C., McArthur, A., Munn, Z., Brown, A., & Brown, N.
(2018). Characteristics of Indigenous primary health care service
delivery models: a systematic scoping review. Globalization and
health, 14(1), 12. doi:10.1186/s12992-018-0332-2
Khiavi, F. R., Raeissi, P., Nasiripour, A. A. and Tabibi, S. J. (2016).
Identifying factors influencing the establishment of a health system
reform plan in Iran’s public hospitals. International Journal of
Medical Research & Health Sciences, Vol. 5, No. 9, pp. 190-197.
Markwick, A., Ansari, Z., Sullivan, M. Parsons, L. and McNeil, J. (2014).
Inequalities in the social determinants of health of Aboriginal and
Torres Strait Islander People: a cross-sectional population-based
study in the Australian state of Victoria. International Journal for
Equity in Health, Vol. 13, No. 91. Doi:
https://doi.org/10.1186/s12939-014-0091-5
Oliver S. J. (2013). The role of traditional medicine practice in primary
health care within Aboriginal Australia: a review of the literature.
Journal of ethnobiology and ethnomedicine, 9, 46.
doi:10.1186/1746-4269-9-46
Statistics New Zealand. (2013). New Zealand period life tables: 2010-12.
Available from:
http://www.stats.govt.nz/browse_for_stats/health/life_expectancy/NZ
LifeTables_HOTP10-12.aspx.
Schuurman, N., Berube, M., & Crooks, V. A. (2010). Measuring potential
spatial access to primary health care physicians using a modified
gravity model. The Canadian Geographer/Le Geographe Canadien,
54(1), 29-45.
Reeve, C., Humphreys, J., Wakerman, J., Carter, M., Carroll, V., & Reeve, D.
(2015). Strengthening primary health care: achieving health gains in
a remote region of Australia. Medical Journal of Australia, 202(9),
483-487.
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