Access to primary health care services for Indigenous peoples: A framework synthesis

International Journal for Equity in Health

Systematic Review

Alexa McArthur¹  Zachary Munn¹  Carol Davy²  Alex Brown²  Stephen Harfield² 

[1] Joanna Briggs Institute, University of Adelaide, 5000, Adelaide, SA, Australia;Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, 5000, Adelaide, SA, Australia;

关键词: Indigenous;    Aboriginal;    First Nation;    Maori;    Primary health care;    Models of service delivery;   

DOI  :  10.1186/s12939-016-0450-5

 received in 2016-07-06, accepted in 2016-09-19,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundIndigenous peoples often find it difficult to access appropriate mainstream primary health care services. Securing access to primary health care services requires more than just services that are situated within easy reach. Ensuring the accessibility of health care for Indigenous peoples who are often faced with a vast array of additional barriers including experiences of discrimination and racism, can be complex. This framework synthesis aimed to identify issues that hindered Indigenous peoples from accessing primary health care and then explore how, if at all, these were addressed by Indigenous health care services.MethodsTo be included in this framework synthesis papers must have presented findings focused on access to (factors relating to Indigenous peoples, their families and their communities) or accessibility of Indigenous primary health care services. Findings were imported into NVivo and a framework analysis undertaken whereby findings were coded to and then thematically analysed using Levesque and colleague’s accessibility framework.ResultsIssues relating to the cultural and social determinants of health such as unemployment and low levels of education influenced whether Indigenous patients, their families and communities were able to access health care. Indigenous health care services addressed these issues in a number of ways including the provision of transport to and from appointments, a reduction in health care costs for people on low incomes and close consultation with, if not the direct involvement of, community members in identifying and then addressing health care needs.ConclusionsIndigenous health care services appear to be best placed to overcome both the social and cultural determinants of health which hamper Indigenous peoples from accessing health care. Findings of this synthesis also suggest that Levesque and colleague’s accessibility framework should be broadened to include factors related to the health care system such as funding.

【 授权许可】

CC BY   
© The Author(s). 2016