Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Enablers and Barriers to Accessing Healthcare Services for Aboriginal People in New South Wales, Australia

Version 1 : Received: 21 February 2021 / Approved: 22 February 2021 / Online: 22 February 2021 (13:22:45 CET)

A peer-reviewed article of this Preprint also exists.

Nolan-Isles, D.; Macniven, R.; Hunter, K.; Gwynn, J.; Lincoln, M.; Moir, R.; Dimitropoulos, Y.; Taylor, D.; Agius, T.; Finlayson, H.; Martin, R.; Ward, K.; Tobin, S.; Gwynne, K. Enablers and Barriers to Accessing Healthcare Services for Aboriginal People in New South Wales, Australia. Int. J. Environ. Res. Public Health 2021, 18, 3014. Nolan-Isles, D.; Macniven, R.; Hunter, K.; Gwynn, J.; Lincoln, M.; Moir, R.; Dimitropoulos, Y.; Taylor, D.; Agius, T.; Finlayson, H.; Martin, R.; Ward, K.; Tobin, S.; Gwynne, K. Enablers and Barriers to Accessing Healthcare Services for Aboriginal People in New South Wales, Australia. Int. J. Environ. Res. Public Health 2021, 18, 3014.

Journal reference: Int. J. Environ. Res. Public Health 2021, 18, 3014
DOI: 10.3390/ijerph18063014

Abstract

Background: Australia’s healthcare system is complex and fragmented which can create challenges in healthcare, particularly in rural and remote areas. Aboriginal people experience inequalities in healthcare treatment and outcomes. This study aimed to investigate barriers and enablers to accessing healthcare services for Aboriginal people living in rural and remote Australia. Methods: Semi-structured interviews were conducted with healthcare delivery staff and stakeholders recruited through snowball sampling. The communities were selected for their high proportion of Aboriginal people and geographical representation (coastal, rural, and border). Thematic analysis identified barriers and enablers. Results: Thirty-one interviews were conducted (n =5 coastal, n=13 remote, and n=13 border) and six themes identified: 1) Improved coordination of healthcare services; 2) Better communication between services and patients; 3) Trust in services and cultural safety; 4) Importance of prioritizing health services by Aboriginal people; 5) Importance of reliable, affordable and sustainable services; 6) Distance and transport availability. These themes were often present as both barriers and enablers to healthcare access for Aboriginal people. They were also present across the healthcare system and within all three communities. Conclusions: This study describes a pathway to better healthcare outcomes for Aboriginal Australians by providing insights into ways to improve access.

Keywords

Indigenous; First Nations; Health Services Accessibility; Health Services Administration; Trust; Communication; Primary Health Care; Health Policy

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