Assessment 2: Research Proposal on Indigenous Australian Health

This research proposal investigates the prevalence of rheumatic fever within the Indigenous Australian population, focusing on the Northern Territory. It outlines the research questions, aims, and methodology, including literature review, theoretical and conceptual frameworks, sampling methods, and data collection techniques. The study aims to understand the causes of the disease, government responses, and the satisfaction of Indigenous people with healthcare services. It also explores the impact of the disease and the need for improved socio-economic conditions to enhance hygiene and health. The proposal details the research design, data analysis methods, dissemination plans, ethical considerations, and a proposed timetable for the study, with the goal of creating a positive impact on Australian society by addressing the healthcare challenges faced by the Indigenous population and contributing to a reduction in the prevalence of rheumatic fever.

Running Head: Indigenous Australian Health
Indigenous Australian Health
Assessment 2:
Research
Proposal(Rheumatic
Fever in Indigenous
Australian Population)

Indigenous Australian Health 1
Contents
Acknowledgement:....................................................................................................................2
Abstract:.....................................................................................................................................2
Scope of Research:.....................................................................................................................3
Introduction & Rationale:......................................................................................................3
Definitions & Terms of Reference:........................................................................................4
Background:...........................................................................................................................4
Research Questions & Aims:.................................................................................................5
Route to Impact:.....................................................................................................................6
Research Design& Methodology:..............................................................................................7
Literature review:...................................................................................................................7
Theoretical Framework:.......................................................................................................10
Conceptual Framework:.......................................................................................................10
Sampling Frame:..................................................................................................................11
Methods of Data Collection:................................................................................................11
Approaches to Data analysis:...............................................................................................11
Dissemination of Results:....................................................................................................11
Ethics and Delimitations & Timelines:....................................................................................12
Ethical considerations:.........................................................................................................12
Strengths and Weaknesses:..................................................................................................12
Timetable:............................................................................................................................12

Indigenous Australian Health 2
Bibliography:............................................................................................................................14
Appendix:.................................................................................................................................15

Indigenous Australian Health 3
Acknowledgement:
I hereby certify that this work is solely my own creation. It has not been adopted or copied
from any other source. I thank all my professors and colleagues who have helped me to
undertake this research study.
……………………………..
Date………………………..
Abstract:
This proposal entails the various steps to be undertaken with respect to an intended research
study on the indigenous Australian health. The topic that has been chosen for the research is
the incidences of rheumatic fever in the indigenous and aboriginal Australian population. The
research study has already undertaken a review of literatures that helped in the formulation of
the basic knowledge and ideas on the research subject. The current scenario of the research
problem has been better understood from the review of literature. It was followed by the
development of this proposal that describes the proposed methodology of the research. In
order to arrive at the results and expected outcomes, the research would consider the
collection of primary data from around 50 aboriginal people in Northern Territory, namely
the Aboriginal and Torres Strait Islanders, in the age range of 18-40 years and belonging to
both the genders. The data will be collected through the help of surveys and the results will
be analysed with the help of MS Excel software in the form of tables and graphs. The results
will lead to the interpretations and then arriving at the concluding points. Finally, the
recommendations will be offered to the sample population as to the ways in which their
health conditions might improve in future.

Indigenous Australian Health 4
Scope of Research:
Introduction & Rationale:
The research encompasses a study that has been initiated in order to understand the current
health conditions of the indigenous and aboriginal people of Australia. The indigenous people
are the natives of the country. They are the very first and primitive dwellers of the country.
They can be considered as the original inhabitants of the country. They are the actual
population of the nation. The modern urban population are mainly the settlers from outside
those have arrived from different countries around the world and colonized in Australia.
Owing to the immigration, the aboriginal population were exposed to various types of
unknown diseases which they never encountered before. The immigrants came from different
countries and they brought with them critical illnesses like smallpox, chickenpox, typhoid
and rheumatic fever. These ailments were detrimental to the natives and quickly it became an
epidemic as many of the natives fell victims to rheumatic fever. The aborigines did not lead a
very healthy lifestyle as they were economically backward and did not receive the facilities
and infrastructures like the mainstream population. The level of healthcare that they had
access to was also limited that were the main causes behind their lack of immunity and this
made them easy targets for any kind of diseases such as the rheumatic fever which is even
today one of the most potent killer diseases that have affected the aboriginal people.
This research was therefore initiated in order to understand the current state of healthcare that
these indigenous people are exposed to and also the modern prevalence of the rheumatic
fever in the population (Australian Indigenous HealthInfoNet, 2013). The aim is to gather
evidence as to the degree to which the health standards have improved and the initiatives
undertaken by the government to take care of these inhabitants and the strategies those have
been formulated to ensure that the indigenous people receive better treatment and healthcare

Indigenous Australian Health 5
services from the government clinics and also to make it easier for these aborigines to interact
with the health workers such that they can convey their issues and can interact freely with the
volunteers and other healthcare service providers of the government hospitals, special clinics
and the health camps operated by various NGOs from time to time.
Definitions & Terms of Reference:
Indigenous/ Aboriginal People – They are the original inhabitants of a country. They were
born in the country and have a long legacy of inheritance. They are the primitive dwellers of
a nation.
Immigrants- These are the people coming from different countries for colonization into a
country. These people are not the indigenous ones and their origins are external to the nation
in which they immigrate into and try to co-exist with the aborigines.
Rheumatic Fever- It is a fever that is caused due to poor nutrition, living conditions, health
and poor hygiene. It is an extremely critical disease for the indigenous people and can lead to
Rheumatic Heart Diseases if left unsatisfactorily treated since its inception in the patient
(Roberts et al., 2014).
Background:
The background of this research is the poor health conditions of health in the aboriginal
people in Australia which has made it detrimental for them as they become easy victims for
various forms of critical ailments like rheumatic fever. The aborigines are not receiving the
expected quality of healthcare though there are various policies formulated by the
government health ministry to improve the health infrastructure such that all the indigenous
people can have access to the most modern treatments and healthcare those are available to
the mainstream population in Australia. They also have inhibitions in interacting with the
non-indigenous people because they feel that they will be humiliated or abused. But, the

Indigenous Australian Health 6
government should extend their support keeping in mind these issues. The indigenous
aborigines are under social exclusion and the most of them are victims of racial and cultural
abuses.
This makes them all the more susceptible to different kinds of social problems. They fear that
the mainstream population will ignore their conditions and humiliate them. Therefore, a gap
in between the indigenous and the non-indigenous people in Australian Northern Territory
exists till today. But, the initiatives taken by the government and the various NGOs have
made the situation better as now there are interactions between the health service providers
and the community representatives for the aborigines. They mix with each other and the
health concerns are taken proper care of by the health workers. The exclusion policies of the
government have also been improved so that these indigenous people can receive all the
modern treatments in the various public hospitals and some of the special medical camps
those are set up from time to time. It is expected that these initiatives by the government and
the NGOs will help to improve the prevailing situation further and there will be better mixing
and bonding of the indigenous people with the non-indigenous section of the population. This
research seeks to identify their current state of health in terms of the prevalence of the
rheumatic fever which is one of the primary diseases which the indigenous population is
exposed to.
Research Questions & Aims:
The research questions are as follows:
Primary Research Question:
 What is the degree of prevalence of rheumatic fever in the modern population of the
indigenous people in the Northern Territory?

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Secondary Research Questions:
 What are the major causes of this disease in the indigenous population?
 How the government has reacted to control this situation?
 Are the indigenous people satisfied with the development of healthcare systems they
have access to?
 Have the situation improved in the last 5 years?
 Do the health workers and volunteers take care of the concerns of the indigenous
people?
 Do the indigenous people visit the healthcare units regularly to conduct free check-
ups as initiated by the government?
 Do the indigenous people feel abused or humiliated at the public healthcare centres?
Route to Impact:
The research intends to create an impact in the Australian society and culture by trying to
portray one of the most emerging problems in the country that is the state of healthcare of the
aboriginal people. Over the years, the immigrants have exploited and ill-treated the
indigenous or the aborigines. They have oppressed them and persecuted them. Not only this,
the immigrants are also responsible for transmitting various forms of fatal diseases which
have affected the population of the aborigines like epidemics. Rheumatic fever is one such
disease that has also been a major cause of concern for the government. Thus, the said
research will attempt to determine the present condition of the disease in the population and
identify the advances those have been made by the government to deal with the situation and
ensuring that this indigenous population receive modern treatments and healthcare facilities
which will contribute to the reduction of the prevalence of the rheumatic fever in the
population so that the mortalities leading to the disease are reduced. The research will also

Indigenous Australian Health 8
facilitate in understanding the need to improve the socio-economic conditions of these
indigenous people so that their overall level of hygiene and health improves.
Research Design& Methodology:
Literature review:
The literature review has been undertaken by collecting vital information from the various
sources available on the internet like journals, newspapers, website articles, etc. those have
facilitated the assimilation of valuable knowledge and ideas on the topic of the research. The
researched articles are discussed herein as follows.
In the opinion of Parnaby and Carapetis (2010), rheumatic fever if prolongs for a long period
of time, takes a turn towards rheumatic heart disease (RHD). This is a fatal condition and is
responsible for the death and disability of a large number of children in Australia. Since this
disease is caused and aggravated due to the unhygienic and unhealthy social conditions
leading to poor hygiene and nutrition, it is more prominent in the underprivileged stratum of
the society like the poor people and also in case of the aborigines and indigenous population.
The disease incidences are much less in the developed sections of the population where there
are improved and advanced infrastructure providing healthy and hygienic health conditions
for the population to sustain (MG and JR., 2010).
The information obtained from RHD Australia (2017), depicts that although the case of
rheumatic fever and RHD have greatly been reduced in the developed and developing
countries in the world, yet it is still prevalent in the indigenous and aboriginal population in
Australia owing to their extremely low hygiene and health conditions. The affected tribes are
mainly the Torres Strait Islanders and the Aboriginal communities. These incidents are
mainly prevalent in the Northern Territory. The study has revealed that between 2005 and

Indigenous Australian Health 9
2010 around 98% cases of rheumatic fever in the Northern Territory encompassed the
Aboriginal and Torres Strait Islander communities. The previous records and trends have
shown that the aborigines are 69 times more prone to rheumatic fever and 64 times more
prone to contract RHD. In between 2007 and 2009 around 897 deaths have occurred in the
Northern Territory from RHD (RHD Australia, 2017).
Marks (2017) observes that with the advancements in the treatment for the rheumatic heart
diseases, he believes that like many other developed nations around the world, the disease
will soon be eradicated from the Australian population. The condition of this disease is the
most fearful in the Northern Territory of Australia where the Aboriginal and Torres Strait
Islanders communities reside. But, the doctors of the modern era are confident that with the
government trying to undertake measures to develop the infrastructure and technologies
related to healthcare manifold and with a special focus on the socio-economic situation of the
aborigines and indigenous people of the country, the communities suffering from the disease
will have much better access to world class treatment and required awareness for this disease.
This will definitely lead to the eradication of the disease very soon from the country (Marks,
2017).
From the information available from Menzies School of Health Research (2017), out of all
the countries around the world, Australia has the highest incidents of Acute Rheumatic Fever
(ARF) and Rheumatic Heart Disease (RHD). The disease often assumes epic proportions in
case of the aboriginal and the indigenous people and they are almost 8 times more likely to
need hospital care and as much as 20 times as more prone to die from this critical ailment.
The major cause of this ARF is Group A Streptococcal Infection (GAS) that if untreated and
unsatisfactorily treated then will most definitely lead to Rheumatic Heart Disease (RHD) in
future. It is responsible for the most of the cardiac deaths of children and adults those are
below 40 years of age. So, it can be said that the scenario is concerning and the government

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10
must intervene to take proper strategies to prevent this disease and to offer the best possible
healthcare services for the patients with ARF and RHD (Menzies School of Health Research,
2017).
In the opinion of Steer (2015), rheumatic fever was a threat to the global population in the era
between 1940 and 1950. Perhaps no disease has received so much of exposure around the
world in terms of the epidemiology in the last century as rheumatic fever. The disease has
been eradicated from the industrially developed nations in the world. However, the disease is
till potent in restricted zones in case of the indigenous people in Australia and New Zealand.
This difference is the cause of the socio-economic factors which are prevalent in the
communities of these aboriginal people. A vaccine is reportedly in development for treating
ARF by fighting against the Streptococcus pyogenes which is the cause of the strep throat
that leads to the development of rheumatic fever and then leading to the RHD (Steer, 2015).
According to Roberts, Brown, Atkinson, Remenyi, Wheaton, Ilton and Carapetis (2015), the
rheumatic heart disease is one of the most potent among the Australian indigenous and
aboriginal people, especially the children. There are differences in the regional prevalence of
the disease which is detected through the echocardiographic screening of the indigenous
Australian children those are in the high-risk zone. Apart from the regional differences of
prevalence, the logistics of the places as well as the screening of the affected children is in
itself a challenging task in absence of the desired infrastructure and facilities. The research
revealed that the Top End of the Northern Territory is the most affected part. It necessitates
that the regional differences should be considered while understanding the benefits of the
echocardiographic screenings (Roberts et al., 2015).

Literature Review Proposal Development Primary Data Collection
Data AnalysisResults & InterpretationsConclusions
Recommendations Final submission of report
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11
Theoretical Framework:
The theoretical framework for the intended research has been underpinned from the “A
Theory for Indigenous Australian Health and Human Service Work” by Lorraine Muller.
Here the theorist discusses about the need of the healthcare service providers to be empathetic
and warm with the indigenous and aboriginal dwellers of the country (Muller, 2015). He puts
forward the need to undertake a benevolent approach while seeking to work for the welfare of
these indigenous populations so that their issues and concerns could be well understood and
their cooperation is solicited while undertaking this research study.
Conceptual Framework:
The conceptual framework for this research study consists of the various processes for the
said research to be undertaken so that it can maintain a seamless flow from the start till the
conclusion of the research with the final outcomes.
Conceptual Framework: