Assessment Of Needs And Challenges For Providing Primary Health Care Services To The Indigenous Population In Australia

Types of Needs Assessment

The indigenous population, especially in the suburban part of Melbourne, have poorer health outcome compared to the counterpart of the metropolitan part of the country (Lloyd, 2015). The experience of being isolated from rest another counterpart of the country malfunctioned distributions of health resources, shortage of the healthcare practitioners and lack of access to the primary care setting has caused the inequality of the health status which includes social, psychological, emotional and physical and mental wellbeing (Azzopardi et al., 2015). Primary health care proved to be effective in curing the health crisis of the indigenous population. However, there are certain flaws in the primary health care setting that hinders the improvement of health status of the indigenous population. Therefore, this paper will illustrate the assessment of different needs of the population, potential challenges for need assessment and address of them, a SWOT analysis of the healthcare setting, a program for priorities in following paragraphs. 

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A need assessment is systematic processes, which address the needs or gaps between the current condition and desired condition, and it is a part of the planning process often used for the improvement of communities or individual (Patton, 2018).  Wakerman et al. (2017), Summarized six types of needs which are based on Bradshaw’s and Mager. According to Chamberlain et al., (2016), normative needs which emerges when n individual group of people failed to meet few established standard. The normative needs can be assessed based on primary sources. The need can be assessed by taking into consideration the reports of the primary health care organization and personal interviews of the individual which suggested that the lack of the access to the primary care setting due to the location and distance, the indigenous population failed to reach the standard (Raman et al., 2017). The felt need is the second need, which can be identified by asking people about the changes the indigenous population want. The expressed need is a felt need expressed through the individuals it can be assessed by interviewing a focus group about what are the actions they want in order fulfill the needs (Raman et al., 2017). The comparative needs are present when the two groups have similar characteristics but receive different types of services (Patton, 2018). It can be assessed by interviewing individuals and identifying the parameters by which the service differs.

From the assessment, the findings suggested that due to the difference in geographical area and time is the prime reason the indigenous population failed to reach the national health standard (Gibson et al., 2015). From the felt need assessment, it was found out that primary care services are not culturally competent since a majority of the health workers belonged to non-indigenous part of Australia. From the expressed assessment, it can be out that lack of culturally competent staff in primary health care services was a huge issue and actions can be taken by recruiting culturally competent staffs (Reeve et al., 2015). From the compared need assessment it was found out that since the indigenous women have less health literacy and somewhat oppressed. They do not seek help from primary care services rather take the help of traditional healers (Reeve et al., 2015). Subsequently, the mortality rate is excessively high as compared to the others. In such a case, the first priority is to close the cultural gap then closing the literacy gap for seeking help.

Findings from the Needs Assessment

The recent literature in Australia focuses on the issues of ensuring equitable access to the primary health care services to the aboriginal women. According to world health organization, regardless of significant effort to obtain the accurate data of needs of the aboriginal population,  barriers of assessing the needs still remain and need to be addressed. The first barriers to assessing the need are the cultural gap. In the majority of the cases, individuals feel offended due to the approach of the culturally competent staffs (Hole et al., 2015). Therefore, assessing the need become difficult to obtain. Another biggest barrier of need assessment is biases of the individual (Hole et al., 2015). Since a majority of the individual is a believer in traditional healing processes, they do not express their need to advance primary health care services (Raman et al., 2017). Moreover, primary data and the data obtained from the healthcare setting for understanding the standard can be biased which is difficult to reduce (Raman et al., 2017)..

The challenges can be addressed by recruiting the staffs that are culturally competent and shows respect while assessing the individuals (Raman et al., 2017).. Moreover, education can be given to each member of the community for reducing the biases of the individual. Moreover, a skilled recruiter can be recruited for obtaining accurate assessment data (Mooney &Sariago, 2015).. Moreover, closing the gap policy can be implemented for increasing cultural competence.

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The strength of the primary health care services is that there are a huge number of staffs are present for them in the healthcare sectors that provide the patient-centric care to each member of the aboriginal people. Moreover, the staffs are well skilled in providing patient-centric care to the patient (Mooney &Sariago, 2015). However, lack of the flexibility of the shift timing for the staffs in primary health care services is one of the weaknesses. Since the majority of the healthcare sectors are far away from the populations, it is the weakness of the healthcare sectors (Smith et al., 2016). Moreover, the lack of culturally competent workers is the weakness of the healthcare services. Subsequently, the aboriginal patients do not seek the help of health care services (Clark et al., 2015). Lack of knowledge and health literacy, women does not seek the help of the health workers. Due to different geographical locations  and distance , majority of the individual in the population do not seek the primary health care services (Clark et al., 2015).. Thus, the opportunity can be the recruitment of the culturally competent workers, even the workers from the aboriginal population can be opportunity for providing effective primary health care services (Clark et al., 2015). Moreover, the opportunity can be the flexible shift timing where patients can receive effective treatment. The transport can be arranged for the individual, who lived far away from the city in order to ensure the better health for the each member of the community (Clark et al., 2015). The threat can be the migration of the aboriginal community due to lack of the proper primary health care services. Moreover, threat also can be the increase of the non adherent patient in the primary health care services due to lack of culturally competent staffs and distance for going to the hospital (Patton, 2018)..

Challenges in Need Assessment

Transport: One of the key priorities of the program concerning imparting awareness of care policies pertaining to the health of the indigenous population would be the usage of sufficient transportation facilities of the concerned staff who would be escorted to the concerned primary health care setting. Arranging sufficient transport facilities is of utmost importance due to the presence of distances between the organizations providing primary health care settings and the location of the families inhabiting indigenous populations. Hence, the program should prioritize effective transport policies in order to reduce potential costs and efforts encountered due to travelling (Lloyd et al., 2015).

Social media campaigning: With the present day advent of science and technology, the emerging trends of social media and digital marketing usage have increased worldwide due to their associated convenience and advantages outlining rapid dissemination of information. Hence, one of the major priorities of the program would require the usage of extensive social media usage (Mooney & Sariago, 2015). This can be done in the form of social media pages or posts advertising extensively concerning the needs and requirements of providing appropriate primary health care facilities to indigenous populations, which will not only result in rapid transmission of information but will also reach out to a large population group, which is a necessity concerning the lack of awareness amongst healthcare providers regarding indigenous needs (Wakerman et al., 2017).

Communication and soft skill enhancement: Indigenous populations require unique communication needs due to their non-English speaking backgrounds and adherence to novel cultures. Hence the need of the hour is for healthcare professionals is to adopt communication strategies sensitive to the needs of indigenous populations, which will be one of the key program priorities of provision of primary health care services (Wakerman et al., 2017). Hence, the program should aim to implement additional discussion sessions pertaining to the teaching and adoption of culturally appropriate and culturally competent health care practices for ensuring safe health care for indigenous populations (Hole et al., 2015).

Conclusion:

Thus, it can be concluded that the indigenous population, especially in the suburban part of Melbourne, have poorer health outcome compared to the counterpart of the metropolitan part of the country. Primary health care proved to be effective in curing the health crisis of the indigenous population. However, there are certain flaws in the primary health care setting that hinders the improvement of health status of the indigenous population. Burton and Merrill (1991), summarized six types of needs which are based on Bradshaw’s and Mager. The need can be assessed by taking into consideration the reports of the primary health care organization and personal interviews of the individual which suggested that the lack of the access to the primary care setting due to the location and distance. There are strength and weakness of the services which help in designing a program for the aboriginal in order improve the primary health care services. The program includes the transport arrangement, communication, and soft skills and, social media campaign.

Solutions for Addressing Challenges

References

Azzopardi, P. S., Sawyer, S. M., Carlin, J. B., Degenhardt, L., Brown, N., Brown, A. D., & Patton, G. C. (2018). Health and wellbeing of Indigenous adolescents in Australia: a systematic synthesis of population data. The Lancet, 391(10122), 766-782.

Bailie, J., Matthews, V., Laycock, A., Schultz, R., Burgess, C. P., Peiris, D., …&Bailie, R. (2017). Improving preventive health care in Aboriginal and Torres Strait Islander primary care settings. Globalization and health, 13(1), 48.

Chamberlain, C. R., MacLean, S., Bawden, G., Kelaher, M., Munro-Harrison, E., Boyle, J., & Freeman, K. (2016). An ‘equity’domain could strengthen the utility of a framework for assessing care coordination for Australian Aboriginal families. International Journal of Care Coordination, 19(1-2), 42-46.

Clark, R. A., Fredericks, B., Buitendyk, N. J., Adams, M. J., Howie-Esquivel, J., Dracup, K. A., …& Johnson, S. (2015). Development and feasibility testing of an education program to improve knowledge and self-care among Aboriginal and Torres Strait Islander patients with heart failure. Rural and remote health, 15.

Cunningham, F. C., Ferguson-Hill, S., Matthews, V., &Bailie, R. (2016). Leveraging quality improvement through use of the Systems Assessment Tool in Indigenous primary health care services: a mixed methods study. BMC health services research, 16(1), 583.

Freeman, T., Edwards, T., Baum, F., Lawless, A., Jolley, G., Javanparast, S., & Francis, T. (2014). Cultural respect strategies in Australian Aboriginal primary health care services: beyond education and training of practitioners. Australian and New Zealand Journal of Public Health, 38(4), 355-361.

Gibson, O., Lisy, K., Davy, C., Aromataris, E., Kite, E., Lockwood, C., …& Brown, A. (2015). Enablers and barriers to the implementation of primary health care interventions for Indigenous people with chronic diseases: a systematic review. Implementation Science, 10(1), 71.

Hole, R. D., Evans, M., Berg, L. D., Bottorff, J. L., Dingwall, C., Alexis, C., …& Smith, M. L. (2015). Visibility and voice: Aboriginal people experience culturally safe and unsafe health care. Qualitative health research, 25(12), 1662-1674.

Lloyd, J. E., Delaney-Thiele, D., Abbott, P., Baldry, E., McEntyre, E., Reath, J., …& Harris, M. F. (2015). The role of primary health care services to better meet the needs of Aboriginal Australians transitioning from prison to the community. BMC family practice, 16(1), 86.

Mooney, B., & Sariago, P. (2015). 2Spirits: Providing a multi-generational, culturally competent approach to health promotion for Aboriginal and Torres Strait Islander communities. HIV Australia, 13(3), 34.

Raman, S., Ruston, S., Irwin, S., Tran, P., Hotton, P., & Thorne, S. (2017). Taking culture seriously: Can we improve the developmental health and well?being of Australian Aboriginal children in out?of?home care?. Child: care, health and development, 43(6), 899-905.

Reeve, C., Humphreys, J., Wakerman, J., Carroll, V., Carter, M., O’Brien, T., …& Smith, B. (2015). Community participation in health service reform: the development of an innovative remote Aboriginal primary health-care service. Australian Journal of Primary Health, 21(4), 409-416.

Smith, L., Blinkhorn, F., Moir, R., Brown, N., &Blinkhorn, A. (2016). User assessment of an early childhood oral health education training course for aboriginal health workers. International Journal of Health Promotion and Education, 54(4), 172-183.

Wakerman, J., Humphreys, J., Wells, R., Kuipers, P., Entwistle, P., & Jones, J. (2017). A systematic review of primary health care delivery models in rural and remote Australia 1993-2006.

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