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Evaluation of unequal Aboriginal Health access in Australia

ABSTRACT

There is a presence of huge variations in the quality of public health care that is provided to native residents of any nation. These differences are on account of a wide number of economic and sociological factors that have an impact on the overall health care system. In this regard there has been a reporting of various quality issues in the usage of health care services that is provided to the users. There has been an under usage of service in some nations while others have been overusing it. Moreover, most of the nations have faced an unequal distribution of health and related services. This can be said as some members of community have got a proper access to health while others are unable to receive even the basic kind of health system.

This problem is more prone in developed nations like Australia. The issues are being observed with aboriginal population of Australia who are not getting proper access to health care facilities. The native population of Australia have been displaced as well as exploited since the English settlement developed its roots in the sub-continent. This setting up happened two centuries ago but the Aboriginals are still made to bear the brunt of higher health risk and reduced treatment opportunities. A very little or no progress has been made in the overall health status of Aboriginal and Torres Strait Islander populations of Australia. There has been a policy norm for the same but a serious lack is being observed in its overall implementation. This clearly shows a lack of commitment towards implementing the existing policies.

The purpose of present doctoral research under study is to determine how aboriginal populations in Australia can receive a better access towards health facilities. These are required so as to bridge the prevailing level of gaps towards proper access to health care. Hence, the report starts with formulation of research aims and objectives followed by research questions. Then there has been a discussion of overall background of the topic under study. This is followed by discussion of significance which further continues with research methods, adherence to ethical issues and preparing of time line.

RESEARCH OBJECTIVES

The primary objective of the present research endeavor is to determine how best to improve health access and health outcomes for aboriginal populations in Australia. In order to do so, there has been formulation of many secondary research objectives, which are as follows;

To identify the predominant causes of the inequality in health access and outcomes for aboriginal populations in Australia.

To promote solutions for improving access and outcomes experienced by aboriginal populations within the context of Australian public health.

To create actionable recommendations that will help to bridge these gaps.

RESEARCH QUESTION

The research questions in any study helps in providing valuable answers to issues. The questions are considered as that part of study around which entire topic is made to revolve. There has been a formulation of many overarching research questions on the basis of identified aims and objectives for the research study. These are as follows;

What are the causes behind inequality in health access for aboriginal populations in Australia?What solutions can be used to improve access and outcomes experienced by aboriginal populations in terms of Australian public health?

BACKGROUND

The quality of public healthcare is typically diverse as there is a wide array of economic and sociological factors that directly implicate that there is a tendency towards some form of inequality in every national healthcare system (Mohajer and Earnest, 2009). The reasons are often associated with ethnic disparity, socio-economic hierarchy and geographical disadvantage. A social phenomenon called marginalization is also present that tends to place a specific demographic population at a lesser opportunity to access proper care (Weerasinghe, 2012). In Australia, this is a condition which is well known to impact the Aboriginal populations’ native to the continent. The inhabitants have been displaced and exploited since the initiation of English settlement over two centuries ago. The result is that today, Aboriginals suffer higher health risk than other Australians and have a far lesser access to proper treatment opportunities (Dunne, Geppert and Courneya, 2013). This prevailing issue will drive the focus of my studies as I proceed toward my doctorate in public health.  As I am working in the public healthcare sphere, it will be incumbent upon me to better understand and respond Australia’s longstanding issues of social and racial inequality. 

The disparity between Aboriginal and Australian populations in terms of health is both severe and tells of the longstanding inequality to which this former group has been subjected, even in present times (Acton, 2012).  Marmot’s (2005) article underscores the currency of this issue and the potentially devastating outcome of such marginalization. Marmot contends that “health inequalities within countries is 20-year gap in life expectancy between Australian Aboriginal and Torres Strait Islander peoples—life expectancy is 56•3 years for men and 62•8 years for women—and the Australian average. The men in this population would look unhealthy in India (male life expectancy 60•1 years) whereas Australian life expectancy is among the highest in the world, marginally behind Iceland, Sweden, and Japan.”  (Marmot, 1100)

This is a troubling gap which denotes that living conditions have resulted in two separate experiences in the same nation.  And unfortunately, this condition has remained even though Australian policy has begun to adopt a path of change (Carson, Dunbar and Chenhall, 2007). There has been a longstanding failure of the federal healthcare system as it has failed to recognize the needs of indigenous populations throughout Australia. Though policy steps have been made towards resolving the serious imbalance between indigenous and English-speaking populations in Australia, but the obstruction to successful actualization of such policy demonstrates the long-term impact of marginalization (Blas and Kurup, 2010). 

SIGNIFICANCE

The potential significance of the study is to bring improvement in the overall access to health provided to native aboriginal population of Australia. This is followed by further development of strategies to improve the overall access of health care. The study will definitely play a key role to improve the overall health status of Australian aboriginal population (Down and et.al., 2010). It will provide for a valuable set of guidelines so as to improve the overall health status of native aboriginal population. These can be utilized by the government agencies and health department present in Australia so as to bring a change in health. The research study is this significant for many individuals. It may provide valuable input to;

The academicians and research scholars who are repairing a PhD thesis on the related topic. The research will assist in helping them develop a deep understanding towards the health care system of Australia.

To thinkers for which the present research will provide a novel sight towards development of ideas and techniques.

RESEARCH METHODS

The methodology that will be employed to address the research objective is qualitative in nature. This is essential as the research study is aimed at aimed at improving both the access and outcomes experienced by aboriginal populations within the context of Australian public health. The qualitative methods will this help in promoting a number of solutions so as to bridge these troublesome gaps. The primary instrument for data-collection will be a survey which will be designed keeping in mind the primary research question which will be tested through a pilot experiment (Kothari, 2004).

The survey will employ a Likert Scale structure and will ask respondents to circle a response indicating one’s level of agreement with a provided statement.  Each statement will concern some aspect of health access as it relates to the aboriginal experience.  The survey will be composed of 20 statements and each response will add a score to a total index.  This index will be employed to draw conclusions regarding the aboriginal perspective on issues of health access. Respondents will be drawn from the local aboriginal population by courting voluntary, private and anonymous participation in the experiment. The sample size will be determined as the research endeavor proceeds and a combination of needs and resources becomes more apparent (Kuada, 2012). Researchers will take steps to assure the protection of privacy and to maintain findings only for the purposes of research as stated here. This includes protection of the identity of all respondents. 

Incentives for participation

To aid in the facilitation of respondents to take part in the research study, the need is to offer incentives for participation so that they get ready to complete the question sets and related measures of evaluation (Daniel and Sam, 2011). There can be offering of monetary incentives. Non monetary incentives given to aboriginals of Australia are making them into a lucky draw so that they can win gift vouchers from department store. Hence, they can be requested for taking part in survey sessions and fill the questionnaires and evaluation measures.

Research Setting

The research setting would be the local region of Australia and will depend substantially on outreach efforts through use of selected public and government sponsored agencies as well as with the help of public health outlets and aboriginal advocacy groups.

Sample size

Respondents will be drawn from the local aboriginal population by courting voluntary, private and anonymous participation in the experiment. The sample size selected for the present study happens to be 50 local aboriginal populations that have been residing in Australia.  There will be usage of random selection method so as to select the aboriginal population. Specific sample selection measure used is cluster sampling method (Hay, 2010). Here, the participants will be selected randomly within identified suburbs where aboriginal Australians have been residing.

Exclusion criteria

The concept of exclusion criteria is basically utilized to find out whether an individual should participate in a research study or should be excluded completely from the systematic review (Daniel and Sam, 2011). The criteria help in suitable identification of participants which can be included in present research. The exclusion criteria set for the current research study based on studying the access to health care system by aboriginal population of Australia is
Less than 18 years of age
Do not belong to aboriginal population of Australia. 

Intervention instrumentation

There will be a utilization of existing instrument that have been pilot tested prior to their implementation in the research study.

Questionnaire (Self-report measures)

There will be an administration of a self-administered questionnaire to all respondent so as to investigate the very aim of topic which happens to be determining how best to improve health access and health outcomes for aboriginal populations in Australia. The questionnaire will be based on judging satisfaction level of aboriginal populations in Australia towards the existing health care services. They will mainly focus on judging the aboriginal experience in terms of proper access to health care.

There will be a use of Likert Scale structure so as to tell respondents to circle a response which would indicate there level of agreement with a provided statement. There will also be a few questions related to finding out the set of issues being faced by population in terms of overall access to health care (Lewis, Pun, and Lalla, 2004). The respondents will also be questioned towards providing a set of recommendations so that there suggestions can be used to bring improvement in health care.

Data analysis

The present research study deals with the use of qualitative methods. Hence, the data analysis will also be done a qualitative manner by making use of thematic analysis technique (Dey, 2002). Here, there will be formulation of themes based on aims and objective to be covered in the research report.

ETHICAL ISSUES

The term ethics is defined as applying the basic ethical principles towards topic involving scientific research (Brannen and Moss, 2012). Utmost care will be taken to perform present study on aboriginal population of Australia in an ethical manner. A special care has been taken to follow the legal norms and related laws. The principles are as follows;

Respect – The aspect of confidentiality of the aboriginal population to be included as participants will be maintained throughout the study. This will also be in terms of documentation and non disclosure of any details to outside authorities. If done, then there will be a provision of scientific reason for the same (Azorin, 2012). Consent of all the participants will also be taken in written and oral terms. They will also be given a freedom to leave the study in the middle.   

Justice - This area of any research study entails for providing equal selection to the participants. The respondents would not be coerced to be a part of study. Care was also taken to undertake the study in a just manner without any kind of manipulation in terms of views given by respondents (Alam, 2005).

It has also been made sure to avoid any act of carelessness and negligence while conducting research on Aboriginal population of Australia. A careful as well as critical examination of the works done by researcher has been carried out. A good record of research activities has been kept. These have been related to collection of data by conducting of survey sessions.

The aspect of privacy with respect to research participants have been maintained throughout. As the research has been obtained form the information undertaken from respondent’s hence special care has been taken to maintain the aspect of respondent anonymity (Kothari, 2004).

FACILITIES AND RESOURCES    

The funding of the PhD report will be given by the University. It will also provide all the facilities and resources which are required for completion of this study. The following areas are taken care of throughout the entire duration of report.

The costs involved in completion of research study would be budgeted accordingly.
Access to campus facilities after the working hours will be provided.
There will also a provision of the necessary library support.

Other than this, there has been a usage of many resources to adhere with the principle of study. In present scenario there has been a requirement of interviewers, research assistant, for proper collection of data (Hay, 2010). To collect the survey responses there is a need for a proper internet connection, computers, laptops, stationary items etc. A draft depicting ethical code of conduct as well as consent form has also been a major requirement of present study. This is required so as to adhere with persisting ethical guidelines linked to research.

DATA STORAGE

The data that has been collected from respondent by use of survey questionnaire sessions will be collected in audio tapes and prepared summary notes. These would further be stored in the locked research room of University campus. The access to the data will only be in hands of researcher, research assistants and the concerned supervisors. The data that has been stored electronically will be protected with help of password which is to be accessed only by researchers and the concerned supervisor. There will also be retention of original data for five years after the publication date.

TIMELINE

Gantt chart is a tool of bar chart that helps in explaining a project schedule. It explains the star and finish dates of the terminal components and summary components of a project. Terminal and summary components comprise the work breakdown structure of the project. Gantt charts also define the dependency relationship between activities (Brannen and Moss, 2012). This instrument is commonly used in project management and is the most effective and useful method of showing activities displayed against time. Left side of the chart reflects the list of activities and on the top is suitable time scale.

Each of the activity is represented by a bar, the position and length of the bar shows the start date, duration and end date of the activity. It helps in representing a visual presentation of a project schedule (Azorin, 2012). These are useful in planning how long a project should take and helps in deciding the sequence of events. It sequences the activities by laying them out in the order in which the works need to be completed. In this respect, there has been a preparation of timeline in form of a Gantt chart. This has been formulated so as to get an overview about research activities undertaken by scholar and the time given for each.

REFERENCES

  • Acton, A. Q. (2012). Issues in Healthcare Management, Economics and Education, ScholarlyEditions.
  • Alam, I. (2005). Fieldwork and data collection in qualitative marketing research. Qualitative Market Research: An International Journal, 8(1),  pp.97 – 112.
  • Azorin, J.F.M. (2012). Mixed Methods Research in Strategic Management: Impact and Applications. Organizational Research Methods, 15(1), pp. 33-56.
  • Blas, E and Kurup, S. A. (2010). Equity, Social Determinants and Public Health Programmes, World Health Organization.
  • Brannen, J., and Moss, G. (2012). Critical Issues in Designing Mixed Methods Policy Research. American Behavioral Scientist, 56(6), Pp. 789- 801.
  • Carson, B. Dunbar, T and Chenhall, R. (2007). Social Determinants of Indigenous Health, Allen & Unwin.
  • Daniel, S. P. and Sam, G. A. (2011). Research Methodology, Gyan Publishing House.
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