PUBH6013: Qualitative Research on Healthcare Access Disparities

This report presents a qualitative research study examining the factors contributing to inequitable healthcare access for Aboriginal and Torres Strait Islander communities in Australia. Using phenomenological interviews with four respondents, the study identifies key themes such as geographic inaccessibility, cultural and traditional beliefs, discrimination within healthcare facilities, language barriers, and the high cost of healthcare. The research highlights how these factors create disparities in healthcare access and quality, leading to poorer health outcomes for indigenous populations. The findings emphasize the need for culturally sensitive healthcare plans, improved language services, reduced healthcare costs, increased information and support, and a customer-centered approach to care. The reflection section discusses the research process, including challenges and opportunities for improvement, and the significance of the study in understanding and addressing healthcare inequalities within Australia. The report also highlights the importance of community health workers and culturally sensitive healthcare approaches to bridge the gap in health services.

Running head: QUALITATIVE RESEARCH METHODS FOR PUBLIC HEALTH 1
QUALITATIVE RESEARCH METHODS FOR PUBLIC HEALTH
Name of Student
Institution Affiliation

QUALITATIVE RESEARCH METHODS FOR PUBLIC HEALTH 2
QUALITATIVE RESEARCH METHODS FOR PUBLIC HEALTH
Introduction
This paper discusses the interviews carried out with interviewees who are
members of the Aboriginal and Torrents community. The interviews were carried out
with the aim of establishing the factors that contribute to inequitable access to
healthcare for Aboriginal and Torres-Strait Islanders people. The research is carried
out using qualitative research method to identify the barriers to access to quality
healthcare among the indigenous communities. Phenomenological research method
was used to collect data for this study. Phenomenology design is a research method,
which describes how a human being experienced a certain phenomenon. The method
ignores all perception and attitudes and focuses on the individual experiences of a
person who has experienced a scenario or a situation firsthand (Massey,
Miller,Saggers, Durrheim, Speare, Taylor, & Kelly, 2011). The interviews were
conducted with four respondents who are from the indigenous communities. The data
from the interviews is transcribed, immersed and then coded. Data analysis is done
using the cyclic method to allow the researcher to refine questions and to pursue any
important inquiries that may emerge. The report also contains a reflection on the
experiences of interviewing the respondents as well as analyzing data. The challenges
and the learning points are identified.
Results and discussion
The interview was carried out with members of the indigenous people of
Australia. The interview has helped in identifying various themes that are crucial in
determining the factors that lead to inequitable healthcare provision among the
indigenous communities. One of the themes identified from the study is that of

QUALITATIVE RESEARCH METHODS FOR PUBLIC HEALTH 3
accessibility of healthcare facility due to location. Two of the four respondents
indicated that they faced a challenge in accessing healthcare because,they lived too far
from the nearest health clinic.Majority of the respondents indicated that they lived in
places where accessing primary healthcare is a problem. The major reason identified
by the respondents is that there is a challenge of transportation. The research shows
that most of the roads are inaccessible and hence residents have to walk long distances
in order to access medical care (Massey, Miller,Saggers, Durrheim, Speare, Taylor &
Kelly, 2011). The respondents also indicated that the distance to the nearest medical
facility was an hindrance to them accessing quality health services. Most hospitals are
located near urban centers and this discourages the people who live in remote areas
from travelling to seek health services(O’Donoghue, Percival, Laycock, McCalman,
Tsey, Armit & Bailie, 2014). This greatly impacts provision of quality healthcare
services.
From the interviews conducted with the Aboriginals and Torres Islanders, it is
clear that cultural belief and traditions have impacted on their access to healthcare
services (Ware,2013). Respondent B indicated that he has cultural beliefs which have
impacted on his health. He indicated that he had strong belief in the healing ability of
traditional hebrs and did not see the need to visit the hospital. He reveals how he got
discouraged from seeking health services by an health worker he insisted that he
avoids using the bush medicine (Shahid,Finn, Bessarab & Thompson, 2009). From
that moment, he decided not to go back to the hospital and this has really affected him
since the wound has not healed to date. Respondent C also indicates that he is a very
spiritual person and he is reluctant to seek health services since he beliefs that he
needs spiritual intervention in order to be healed. These cultural beliefs and traditions
among the indigenous people have resulted into inequality in health services. The

QUALITATIVE RESEARCH METHODS FOR PUBLIC HEALTH 4
beliefs have led to many people being scared from visiting healthcare facilities where
they can receive quality treatment. In order to overcome this challenge, it is important
to create a special healthcare plan which is integrated with the culture and traditions
of the indigenous people (Marmot, 2011). The healthcare plan will accommodate the
cultural beliefs in order to encourage more people to visit healthcare facilities.
Creation of awareness though community health workers will also be crucial in
overcoming this challenge
Another common theme identified in this research is that the indigenous
people face discrimination when they visit healthcare facilities. Under this theme,
there is racial discrimination as well as discrimination due to social status and income
levels (Hayman, White & Spurling, 2009). Respondents indicated that they faced
instances of discrimination when seeking medical services. One of the respondents
indicated that they faced racial discrimination from fellow patient. The respondent felt
dejected and aggrieved and this resulted to them shying away from visiting the
hospital in future.From the research, it also possible to understand that the indigenous
people have faced discrimination from the healthcare workers. The discrimination
was mainly due to inability to communicate perfectly. The indigenous people have
also faced discrimination due to the negative perceptions and attitudes that the rest of
the people have towards them (Markwick, Ansari, Sullivan, Parsons & McNeil,
2014). This has played been a major barrier in accessing healthcare services. The
respondents have indicated that due to discrimination when seeking medical care, they
have been forced to use alternative means of healthcare. Discrimination has greatly
resulted to isolation of the indigenous community because they feel that they don’t get
the respect that they deserve (Peiris,Patel, Cass, Howard,Tchan, Brady & Brown,
2009).

QUALITATIVE RESEARCH METHODS FOR PUBLIC HEALTH 5
Language has also been identified as one of the major barriers to equitable
heathcare services. Majority of the Aboriginals and Torres Islanders people face
language barrier problems, because a good number of them are incapable of
communicating in English (Freeman, Edwards, Baum,Lawless,Jolley, Javanparast &
Francis,2014).Therefore, it means that they either need an interpreter or they should
be treated by an healthcare who can speak and understand their language.
Respondents B indicates that he was not able to get quality healthcare services
because the nurse who attended to him was not familiar with the local language.
There was no translator at the facility and the nurses who are from the indigenous
community were all busy or on leave. The patient therefore had to leave without
receiving medical attention and this was a very bad experience for him. Nurses or
healthcare workers who work among the aboriginals and Torres Islanders therefore
need to be offered adequate training on the local language as well as any cultural
factors that may affect health.
Cost of healthcare is another common theme in this study. Majority of the
respondents indicated that their levels of income are very low because most of them
do menial jobs which are not well paying (White, Wong, Sureshkumur & Singh,
2010).Therefore, poverty has greatly resulted to inequality in provision of quality
health services. Most of the people from the indigenous communities either are
unemployed or earn very little income. This has made it difficult for these people to
access healthcare because, the cost of healthcare is very high. Despite health for
indigenous people being subsidized by the federal government, most people still
cannot afford to pay for health services. Most the indigenous lack a comprehensive
medical cover and hence they have to spend huge amounts of money when they visit
hospitals(Baba, Brolan & Hill,2014). This has been made worse by many cases of

QUALITATIVE RESEARCH METHODS FOR PUBLIC HEALTH 6
chronic disease which are costly to treat. Respodent A discusses how he has not been
able to attend most of his chemotherapy sections because he cannot afford to pay and
his medical cover has run out. Respondent A has also had to manage pain using bush
medicine because he is unable to afford most of the drugs, which have been
recommended by the doctor. Respondent C also indicates that with a reduction in cost
of healthcare services, he is ready to visit health facilities more often in order to get
quality healthcare services. The other costs such as transport cost have also been a
barrier, which has discouraged the indigenous communities from visiting healthcare
facilities (McBain‐Rigg & Veitch, 2011). In order to bridge the inequality gap, it is
therefore critical to lower the cost of health services further in order to make it
affordable to many. Access can also be improved by creating employment
opportunities for the indigenous people in order to improve their income levels and
make healthcare more affordable and accessible (Hayman, 2010).
Lack of information and support is another common theme identified in the
study. Majority of the Aboriginal and Torres Islanders have a poor educational
background. Most of the respondents therefore lack common knowledge about
disease prevention as well as self care (Davidson, Abbott,Davison & DiGiacomo,
2010). This has resulted to many people avoiding to visit health facilities. The
indigenous communities lack knowledge about managing illnesses such as diabetes,
blood pressure or kidney diseases. Most of them therefore suffer once they are
diagnosed with these diseases and they are not able to get personalized care that they
need. Most of the people are abandoned by family and close friends and are left alone
to suffer without care (White, Wong,Sureshkumur & Singh, 2010).Furthermore, most
of them do not even understand how they can take care of themselves in order to
manage the disease. Respondent A indicates that he was not able to get any support

QUALITATIVE RESEARCH METHODS FOR PUBLIC HEALTH 7
from an health worker after he was diagnosed with kidney disease. He was also not
able to get any advice or information, which could have helped him to manage his
health in a better way. He was not able to get patient focused care and this contributed
to poor health outcomes. Access to health information has also been a major challenge
for the indigenous communities. This is because most of the people from these
communities do not have access to mobile phones and internet services which are
crucial in disseminating information in this era (Aspin, Brown, Jowsey, Yen &
Leeder, 2012). In order to achieve equity in access to healthcare services, the health
providers have to focus more on customer-centered approach to care. This will help to
ensure that the patient are involved in decision making on their health and that they
have enough knowledge and information which could help in improving health
outcomes (Povey, Mills,Dingwall, Lowell, Singer, Rotumah & Nagel, 2016). Health
workers also need to focus on educating the local people about their health so that
they can feel more involved and get encouraged to visit healthcare centers to seek
medical attention.
Reflection
While carrying out the interview, I gave the respondents enough time to explain
the issues being evaluated. This helped in minimizing bias and in getting more in-
depth details about the respondents to experience while accessing medical care. The
interview was carried out in using the language of choice of the respondents. This
ensures that they can communicate correctly and freely since they use the language
they understand best to describe their experiences. During the data analysis process, I
would have wished for more time since the time provided was not sufficient to
evaluate all the factors that the residents thought barred them from receiving quality
healthcare services.

QUALITATIVE RESEARCH METHODS FOR PUBLIC HEALTH 8
What I could have done differently during the interviews is that I could have
increased the sample size to improve the quality of the data. This would have offered
more participants with diverse experiences in accessing care to give their views on the
accessibility of health services in Australia.
Through this experience, I was able to understand the huge disparity in access to
healthcare between the indigenous people and other communities living in Australia. I
was able to learn the tribulations that the Aboriginals go through while trying to
access medical services. Additionally, through this study, I was able to learn and
understand the measures that should be taken to encourage the Aboriginals and Torres
Islanders to visit health facilities and hence improve their health outcomes.
Conclusion
The aim of this study is to identify the barriers to inequitable healthcare access
for Aboriginal Australians as well as Torres Islanders. Interviews are conducted from
a sample size of four respondents. Discrimination was one of the most common
themes identified in the research. Most respondents indicated that they felt
discriminated in various ways once they visited healthcare facilities to seek treatment.
Cultural factors were also identified as one of the significant factor, which prevented
the indigenous communities from seeking medical care. The other factors leading to
inequity in healthcare access is poor means of transport. Respondents revealed that
there are no affordable or convenient means of transport to health facilities since most
live in very remote areas, which have poor road network. Cost of healthcare and lack
of information and support is another barrier to equitable access to healthcare.

QUALITATIVE RESEARCH METHODS FOR PUBLIC HEALTH 9
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