Bridging the Gap: A Systematic Review of Primary Health Care Access in Remote Indigenous Communities of Australia.

introductionDespite significant government investment over the past two decades, considerable disparity between the health outcomes of Aboriginal and Torres Strait Islander Australians and non-Indigenous Australians remains. People residing in remote Indigenous communities face the greatest disadvantage. Understanding the factors that hinder or facilitate timely healthcare access for this cohort is essential to help close this gap.

methodsA preregistered systematic review (PROSPERO ID: CRD42024574570) of empirical, peer-reviewed qualitative, quantitative, mixed-methods, and expert opinion research was conducted to investigate the factors influencing primary healthcare access and strategies to improve access for Aboriginal and Torres Strait Islander Australians living in remote Indigenous communities. Databases searched included PubMED, PROQUEST, CINAHL, Informit, and PsycINFO.

resultsEighteen studies met the inclusion criteria. Traditional appraisal tools indicated that the studies were of excellent quality; however, the Aboriginal and Torres Strait Islander Quality Appraisal Tool revealed that only 20% of the studies were conducted in response to community-identified needs. Most studies sought the views of healthcare workers, while only five directly consulted with community members. Social determinants and culturally inappropriate models of care were found to influence healthcare access, with suggested strategies to improve access tending to address the latter.

conclusionEngaging with the perspectives of Indigenous Australians residing in remote Indigenous communities is crucial for understanding their unique needs and delivering tailored, person-centred care. Developing and implementing governance structures, models of care, and health promotion initiatives that align with the cultural beliefs of local community members holds promise for enhancing access to primary healthcare services.