Australian Healthcare System: Indigenous Health - Essay Example

Australian Healthcare System: Indigenous Health Australian Healthcare System: Indigenous Health One of the finest healthcare systemsin the world is found in Australia; nevertheless, it has several problematic areas linked to health inequity and disparities in accessing health services(Kebede-Francis,2011) .Some of the causative factors to such inequalities comprise age, gender, culture and ethnicity, educational background, disability and socioeconomic status(Cerasa,2011).For instance, several studies confirm that Indigenous Australians get lower standards of healthcare when compared to the rest of the Australian population (Shepherd, Li & Zubrick,2012).Regardless of the fact that the Australian government has been endeavoring to tackle this issue and has commissioned multidisciplinary teams to regions dwelt by the Aborigines ,disparities in health still persist because of economic, social, geographical, biological and cultural influences .The objective of this paper is presentation of a critical analysis of the present Australian Indigenous health care system, its past background and pressing issues that require immediate address (Kronenfeld,2009). Indigenous Healthcare System The phrase Indigenous Australians means numerous Aboriginal together with Torres Strait Islander groups representing no less than 2.4 percent of Australia’s total population (Turale & Miller,2008).Significant gaps are present between the well-being and health of Indigenous Australians and the non-Indigenous ones (Department t of Health,2014;Australian Institute of Health and Welfare,2010;Department of Human Services,2014; Turale & Miller,2008 & Australian Government,2014).Thus, for example and as will be elaborated at length in following segments of this paper, by 2008,Indigeneous Australians’ life expectancy was on average lower than that of their non-Indigenous counterparts (Cerasa,2011).Furthermore, infant mortality amongst Indigenous populations is much high in comparison to the entire Australian population (Cerasa,2011).The absurdity in this case is that Australia has been ranked among countries with the lowest infant mortality by the Organisation for Economic Cooperation and Development(OECD) whereas the truth is that the number is particularly high for Indigenous Australians (Ceras,2011,& OECD,2014). Even though the Australian government seems to be trying hard to tackle these inequalities, Indigenous Australians’ healthcare programs are extremely splintered having no individually cohesive system set up to enhance Indigenous healthcare proactively (Willis, et al, 2012). At present ,the Office for Aboriginal and Torres Strait Islander Health(OATSIH) under the Department of Health and Aging, supervises the Indigenous Australians’ healthcare (Department of Health,2014).The OATSIH was especially set up so as to offer much attention to the health requirements of Aboriginal and Torres Strait Islander populations in conventional health programs in addition to administering financing for the “Aboriginal and Torres Strait Islander Community managed health (Department of Health,2014).Thus, the OATSIH has a continuing strategy for enhancing Indigenous Australians’ to all-inclusive fundamental healthcare services (Department of Health,2014).So as to accomplish this, the OATSIH aims to offer harmonized clinical care, health promotion and population health activities so as to enable prevention of illness, early intervention as well as efficient management of disease (Department of Health ,2014).The modus operandi of OATSIH is on the basis of existing evidence that improved access to all-inclusive basic health care can impact positively the health status on a continuous basis. OATSIH’s strategy is on the basis of working together with the controlled health sector of Indigenous Australians (Guzys & Petrie, 2013). The OATSIH, in light of this has a 3-pronged technique to accomplish its objectives and goals. The first is enhancement of access to, in addition to responsiveness of, healthcare system of Australia. Secondly, the OATSIH aims to guarantee that there is equivalent activity by Aboriginal and Torres Strait Islander detailed health and thirdly is enhancement of collaboration between Australian healthcare sector and governments so as to enhance service delivery together with health outcomes of the envisioned population (Department of Health, 2014). Such endeavours by OATSIH will not produce anticipated results if not aided by appropriate policies. The National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes, popularly known as Closing the Gap is the core policy that strengthens the OATSIH strategy (Department of Social Services, 2014).On December 2008,Closing the Gap was signed ,effectively providing a sum of 1.57 dollars from 2009 to 2013 so as to tackle the challenge of Indigenous community’s chronic disease (Department of Social Services,2014).Currently, Closing the Gap concentrates on risk factors, enhancement of management of chronic disease and follow-up, together with growing Indigenous health’s workforce capacity (Department of Social Services,2014). Smoking, efficient basic healthcare services, enhanced harmonization of patients’ passage via the health system, transiting healthily to adulthood are the 5 areas of priority of Closing the Gap (Australian Government Department of Social Services, 2014). The Commonwealth has been addressing the first 3 priority areas together with territories and countries endeavoring to tackle all the 5 aspects. Administration of the Indigenous Chronic Disease Package under the Department of Health and Ageing as a provision of the National Partnership Agreement (Kebede-Francis, 2011). In the meantime, the Indigenous Chronic Disease Package is an umbrella approach that aims to thwart as well as enhance chronic diseases management amongst Indigenous Australians. It is mandated to narrow the “life expectancy gap within a generation” (Department of Social Services,2014).Thus the main aims of the Package comprise of first addressing the basic risk factors for chronic ailments, secondly enhance chronic disease and follow-up care management for the target population and thirdly increase the potential of basic care workforce for the intention of offering superior healthcare to Indigenous Australians suffering from chronic diseases (Department of Social Services,2014).The Package consists of numerous programs that include Break the Chain aimed at promoting cessation of smoking, secondly Health Heroes that is planned to promote Indigenous Australians to get employment in the healthcare sector ,thirdly Local Community Campaigns designed in collaboration with communities so as to “encourage people to Get Active, Eat Good Tucker, Live Longer!;”,fourthly is Petrol Sniffing Prevention Program whose objective is prevention of substance abuse as well as sniffing petrol in the targeted population; fifthly is Regional Tackling Indigenous smoking and Promoting Healthy Lifestyles Program, which makes use of both local and regional approaches that aim to decrease smoking amongst Indigenous Australians as well as promotion of healthy lifestyles (Department of Social Services,2014). The other considerable stand alone program, administered by Medicare is the Indigenous Access Program (IAP) .This Program is specifically designed for Aboriginal and Torres Strait Islander Australians for them to get better Medicare services (Department of Human Services,2014).The IAP has employed Medicare Liaison Officers amongst other developments for Indigenous Access, in addition to creating an access hotline for Indigenous Australians. Other services that may provided by Medicare via the IAP comprise; the Australian Organ Donor Register, the Pharmaceutical Benefits Scheme, the Australian Childhood Immunisation Register in addition to other services. Historical Contexts Over time researchers have time after time claimed that Indigenous Australians health issues have their origins from colonial experiences (Nelson, 2009 & Sherwood, 2013).Before the influx and settlement of people from different continents (especially Europe) ,Australia’s population consisted of Indigenous groups. Just like other regions in the world that have been occupied by settlers, the indigenous populations were displaced from their original regions and consequently moved to most remote parts of the country. With the passage of time, the native groups were unable to effectively preserve their domains since several of them were peaceful and those who attempted to resist and fight lacked weaponry to chase away their intruders. Consequently, these native groups have always existed at society’s margins and it’s only in recent times that the government has begun giving them attention because ignoring them is no longer working (Fleming & Parker, 2012). In fact, it is crucial to understand that the methodical removal of native Australians from their original domains, the annihilation of native families by way of “policies” and withholding decades’ worth of wages have had and will go on having a lasting effect on the well-being and health of Indigenous people (Nelson, 2009, pp.97-102).Such repressive incidents have led to the loss of significant careers for several Indigenous Australians (Nelson, 2009, pp.97-102).Thus, decades and at times centuries of repression have resulted in several of these people losing occupations as well as capacity to be integrated into normal culture. Their living in remote and far flung regions has made sure that these groups lack a say on various policies implemented by the government. By virtue of their isolation, these groups have only Australia as a name and are at society’s periphery receiving only a tiny majority of what is gotten by the majority. While Australia was being colonized, native people were removed from their original homes. As a result, they were forced to settle in far flung regions typified by exceptionally poor conditions as well as lack of clean and accessible potable water .Lack of potable water implied that these individuals had to search for water in other regions or make best use of whatever they had. Dirty water, naturally may result in several ailment. In addition, severe weather conditions implied that these natives experienced hunger since they were unable to raise livestock or crops. On the other hand, mainstream society cared less about their predicament since they were far away from them and hailed from a culture different from theirs (Willis, et al, 2012). Loss of the hunting and gathering lifestyle was one of the consequences of this displacement since their fertile land had been taken away. The following Figure 1aptly illustrates the past contexts of health inequalities presently being experienced by Indigenous Australians The chart below illustrates how the negative effects of colonization to the groups that initially settled in Australia (Raphael, 2012). Figure: Illustrating the Historical contexts of Health Inequalities Amongst Indigenous Australians (Raphael, 2012). As illustrated above, Indigenous Australians underwent marginalization since the white society excluded them in addition to discriminating against them and were completely cut off from mainstream society .Various tangible programs that would have addressed the poor social situations of the indigenous people have been wanting in the past, and though some there was implementation of some actions; they were not sufficient in nature and therefore their effects were short-lived. Because of this, Indigenous groups have continued to suffer from underprivileged health outcomes (Raphael, 2012). Even though the Australian government has been relentlessly looking for approaches to tackle the health inequalities experienced by Indigenous Australians, key impediments continue standing are a stumbling block such that no matter how strategies and policies appear to be well-planned they fail to produce anticipated results (Shepherd, et al,2012).These key obstacles comprise of the isolation of the regions where Indigenous Australians live, as well as cultural factors influencing beliefs and attitudes of these populations regarding healthcare and health (Australian Center for Health Research, 2011).It can also e argued that these Indigenous people fail to welcome the cultural variations of mainstream society because of the fact that they have been neglected for too way long. In addition, they fail to trust people outside their culture since they have been severally betrayed in the past. It must also be stressed that living in far flung regions implies that Indigenous Australians go on relying on traditional medical providers, several of whom have no tertiary or formal qualifications or even training (Cerasa, 2011). Thus, Indigenous people choose to consult these local practitioners since the idea of travelling long distances to overpopulated regions in search of medical attention is purely such a daunting task as well as costly for individuals with no steady means of doing so (Raphael,2012). Furthermore, residing in far flung regions implies more freight costs, limited storage facilities and badly grown produce. Indigenous Australians therefore have had restricted access to various kinds of nutritious foods. In recent times, accessibility of facilities distributing maternal services to remote as well as rural Australia has reduced further (AIHW,2014).Just about 130 maternity clinics situated in far flung regions in Australia shut down from 1995-2006 ,mainly because of shortage of labor and concerns regarding quality of healthcare and safety (Cerasa,2011). Indigenous Australians’ marginalization bears a twin burden because it implies that they fail to develop properly. It is essential to recognize that the Australian government had deployed a national Strategic Framework for aboriginal and Torres Strait Islander Health in the 1980s ,however this was never implemented wholly due to the aforementioned obstacles (NACCHO,2014).Numerous individuals are hopeful that the present programs for Indigenous Australians would be more successful. Nevertheless, they appear to be extremely fragmented such that it would be hard to evaluate them for efficiency. Present Major Issues Reviewing Indigenous Australians’ healthcare system, it is obvious that health inequality is one of the core issues at hand; however, since it happens on several levels, it appears hard to tackle. This complicated issue cannot be tackled without addressing other features of Indigenous living. Health inequality, in other words, does not regard health alone, but is also a consequence of several crisscrossing factors (Kronenfeld, 2009). Life expectancy is an example of a conspicuous inequality. Thus, life expectancy amongst Indigenous males is 67 years in comparison to 79 years for non-Indigenous males (Cerasa, 2011).Indigenous life expectancy for women is 73 years in comparison to 83 years for non-indigenous women. Comparing the two genders, there is at least a ten year difference for each of the genders. Although the infant mortality level had reduced in Australia from 8.7 deaths to 4.7 deaths per 1,000 births in 1987, the infant mortality rates on the other hand for Indigenous Australians was in 2003 at 10.3 per 1,000 births and in 2007 was at 4.2 per 1,000 births (Cerasa, 2011).A key contributory factor to this relates to the closing down of health centres because of financial constraints and medical supplies transportation difficulties to these far-flung regions. In the meantime, health inequalities also result due to gaps in health delivery. Most of Indigenous infant deaths come about due to birth trauma, disorders associated with the growth of fetus and difficulties from pregnancy, labour and delivery (Australian Institute of Health and Welfare (AIHW), 2014).Furthermore, sudden infant death syndrome (SIDS) is two times high amongst indigenous children in comparison to non-indigenous children 9AIHW, 2014).In fact SIDS was in 2006 the cause of death for 10.9 percent of all deaths for Aboriginal and Torres Strait Islander infants. Numbers such as these indicate that irrespective of ongoing endeavors to develop and enhance health care delivery amongst every member of Australian Society, it is obvious that indigenous groups are highly marginalized ( Cerasa ,2011;Shepherd,et al,2012). Nonetheless, there are specific regions, such as Queensland and New South Wales where the survival rates of Indigenous infants has improved (AIHW,2014),even though this tendency is not constant. Distinctive possibilities exists that women experience birthing difficulties and are not offered proper and prompt postnatal and prenatal care thus resulting to deaths of infants (Cerasa, 2011).There is also likelihood that cultural values like having local medicine individuals helping in birthing in unhygienic conditions leads to Indigenous deaths of infants (Cesara, 2011).Thus, lack of trust in modern medicine may merely not be due to cultural but also inadequate education. Indigenous groups fail to wholly understand modern medicine and therefore would choose to consult as well as hold fast to what they have been brought up with for their entire lives. Lack of constant interaction with the modern world has separated Indigenous people from progress (Australian Center for Health Research, 2011). For Indigenous adults, meanwhile, most early deaths are caused by nutritional, metabolic and endocrine diseases, especially type 2 diabetes (Turale & Miller, 2008).These ailments have a significant severe impact on quality of life because patients are not offered proper treatment and medication. Whereas PBS and Medicare assist in offering these medications, the distance of far flung villages implies that only a few are capable of such help. In addition, there are also extreme cases of substance abuse and alcoholism amongst Indigenous Australians (Turale & Miller, 2006). The inequality in indigenous health is also firmly entrenched in social reasons in addition to the ones already mentioned. According to Jenny Macklin-Indigenous Affairs Minister, using money on indigenous health may not be the all-inclusive solution to the issue (Dart, 2008).Thus, the government has been actively been financing different health programs and services for Indigenous groups; nevertheless, this has not been effective enough to reduce the gap. Thus, for instance, constructing clinics so as to avail health services easily, will tackle only one feature of aboriginal life but on the other hand, enhance the predicament of the people. It is imperative that Indigenous Australians be empowered in such a manner that they are independent of government’s handouts as well as social welfare programs (Duckett & Willcox, 2011). This implies that apart from availing and delivering health services, the government must ensure aborigines experience development in all other areas of their lives in order for them to have enhanced lifestyles that comprise of managing their health properly. The key problem as already mentioned is social in its nature, for example in the manner in which the aborigines are underprivileged in regard to education, housing as well as participation in the country’s economic affairs (Duckett & Willcox, 2011).Since the aborigines lack adequate and proper housing, aborigines live in completely different conditions compared to those of mainstream population. This implies that such living conditions may increase their vulnerability to unhygienic environments that may breed illness or disease. Some individuals are not able to afford better and safe housing due to their lack of capacity to do so. This raises the education issue and how aborigines have managed to go to school and acquire degrees. Were it norm for this groups to acquire a college degree, then their respective incomes would also rise since they can positively play a role in economic development by getting better careers implying better lifestyles and access to housing (Duckett & Willcox, 2011). Conclusion One critical aspect of the Australian Healthcare system regards Indigenous Australians. Regardless of the fact that Australia’s mainstream population is enjoying one of the best healthcare services in the world; her Indigenous population is not .Thus, the government has been attempting to tackle health inequalities affecting Indigenous Australians, nevertheless, key obstacles hinder such developments, blocking the way, comprising the remoteness of the regions where Indigenous people live, in addition to cultural beliefs and values relating to health management and health care. There are also issues with education, economic participation and education that imply several aborigines are worse off when in comparison to the rest of the groups. There are numerous policies and programs at this point that seek to tackle health inequalities that affect Indigenous Australians. A critical concern here is that programs and policies seem to be extremely fragmented making it hard to evaluate their efficiency. References Australian Center for Health Research.(2011) Health Care in Australia:Prescriptions for Improvement. New York: ACHR. Aihw.gov.au. (2014). Indigenous Australians (AIHW). [Online] Retrieved from: http://www.aihw.gov.au/indigenous-australians/ [Accessed: 11April 2015]. Allan, S. (2010). Health System Reform. Clinical Governance, 15 (1), pp. 46–49. Australias Health 2010: The twelfth biennial health report of the Australian Institute of Health and Welfare. (2010). [e-book] Canberra: Australian Institute of Health and Welfare. 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