Perspectives of Indigenous people in the Pilbara about the delivery of healthcare servicesBruce F. Walker A C , Norman J. Stomski A , Anne Price B and Elizabeth Jackson-Barrett B
A School of Health Professions, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia. Email: firstname.lastname@example.org
C Corresponding author. Email: email@example.com
Australian Health Review 38(1) 93-98 https://doi.org/10.1071/AH13074
Submitted: 15 April 2013 Accepted: 7 August 2013 Published: 6 December 2013
Aim To identify Indigenous people’s views about gaps and practical solutions for the delivery of healthcare services in the Pilbara.
Methods A structured guide was used to interview three Indigenous language groups from the Pilbara region of Western Australia. The responses were analysed with the use of content analysis. In the first stage, codes were developed by assigning names to small sections of the interview transcripts. Next, the most salient incisive codes were identified and developed into themes that captured the most important issues.
Results Many respondents said that there were insufficient health professionals near country, which was compounded by a lack of adequate transport to reach healthcare services. Moreover, respondents commonly indicated that they would be unable to secure adequate accommodation for themselves and any carer when needing to leave country to undergo medical care. The importance of secondary healthcare interventions was highlighted, particularly health promotion initiatives that improved diet and exercise levels and reduced substance abuse. Assuming responsibility for one’s own health was seen as integral to improving the overall health of communities. The respondents saw role models as the most important influence in leading people to take responsibility for improving their own health.
Conclusion This study provides Indigenous perspectives about gaps and solutions in healthcare service delivery in the Pilbara region of Western Australia. Although initiatives have commenced to address the shortfall in health professionals and inadequate transport to healthcare, there are still gaps in service provision. Mobile health services were strongly supported as an integral measure to address these gaps.
What is known about this topic? About two out of every three Indigenous adults in the Pilbara experience a chronic health condition. Moreover, compared with non-Indigenous people in the region, Indigenous people experience a significantly higher mortality rate for numerous chronic health conditions. Although some information is available about the provision of health services for Indigenous people in the Pilbara, little is known about Indigenous people’s perspectives about its adequacy or how it should be delivered.
What does this paper add? This study details three local language groups’ views about the gaps and solutions to delivery of healthcare for Indigenous people in the Pilbara. It highlights the need for secondary healthcare interventions given difficulties around providing adequate primary care in remote settings.
What are the implications for practitioners? Health promotion initiatives need to be prioritised to improve the health of Australian Indigenous people in the Pilbara and the initiatives should be delivered with the involvement of the local communities. Innovative solutions are required to improve the continuity of healthcare in the Pilbara, including increased use of mobile services.
References Australian Bureau of Statistics. Census. 2011.
 Marmot M. Social determinants of health inequalities. Lancet 2005; 365 1099–104.
| 15781105PubMed |
 Thomson N, MacRae A, Burns J, Catto M, Debuyst O, Krom I, et al. Overview of Australian Indigenous health status. Available at http://www.healthinfonet.ecu.edu.au/health-facts/overviews [verified 23 March 2012]
 Australian Bureau of Statistics, Australian Institute of Health and Welfare. The health and welfare of Australia’s Aboriginal and Torres Strait Islander Peoples. Available at http://www.abs.gov.au/ausstats/abs@.nsf/mf/4704.0 [verified 15 May 2012]
 WACHS Planning Team. Pilbara health profile. Perth: Department of Health, Northern and Remote Country Health Service. 2012.
 Aboriginal Health Council of Western Australia. Improving the health and wellbeing of Aboriginal peoples in Western Australia Annual Report 2007–2008. Perth: Department of Health, Government of Western Australia. 2008.
 Department of Health and Aging. Aboriginal and Torres Strait Islander health performance framework. Canberra: Commonwealth of Australia. 2011.
 Australian Indigenous HealthInfoNet. Summary of developments in Indigenous health promotion. Available at http://www.healthinfonet.ecu.edu.au/health-systems/health-promotion/rev [verified 4 April 2012]
 Murphy E, Dingwall R, Greatbatch D, Parker S, Watson P. Qualitative research methods in health technology assessment: a review of the literature. Health Technol Assess 1998; 2 1–276.
 ABC News. Chronically ill patients living in tents. Available at http://www.abc.net.au/news/2011-08-15/shocking-conditions-of-patients-in-wa-pilbara-pm/2840302 [verified 12 February 2012]
 WA Country Health Service. Scheme overview. Available at http://www.wacountry.health.wa.gov.au/index.php?id=628 [verified 14 February 2012]
 RP Data. Rental review - first quarter 2011. Available at http://www.rpdata.net.au/news/pdfs/quarterly_rental_review_mar_11.pdf [verified 25 February 2012]
 Australian Medical Association. 2010-11 AMA Indigenous health report card - Best practice in primary health care for Aboriginal Peoples and Torres Strait Islanders. Available at http://ama.com.au/aboriginal-reportcard2010-11 [verified 17 March 2012]
 Burns J, Thomson N. Summary of overweight and obesity among Indigenous peoples. Available at http://www.healthinfonet.ecu.edu.au/health-risks/overweight-obesity/reviews/our-review [verified 4 April 2012]
 Council of Australian Governments. National strategy for remote food security in Indigenous communities. Canberra: Commonwealth of Australia; 2009.
 Rowley K. Improving nutrition in an Aboriginal community - Looma Healthy Lifestyle. Food Chain 2000; 4 4–8.
 Egger G, Fisher G, Piers S, Bedford K, Morseau G, Sabasio S, et al Abdominal obesity reduction in Indigenous men. Int J Obes Relat Metab Disord 1999; 23 564–9.
| Abdominal obesity reduction in Indigenous men.CrossRef | 1:STN:280:DyaK1MzjslSgtw%3D%3D&md5=e7fb3972a756090ebaeb5e985bea5ffeCAS | 10411228PubMed |
 Barnett L, Kendall E. Culturally appropriate methods for enhancing the participation of Aboriginal Australians in health promoting programs. Health Promot J Austr 2011; 22 27–32.
| 21717834PubMed |