Abstract
Background
This investigation was undertaken to define the factors determining the optimal and
most productive relationship among indigenous communities, surgeons, and providers
of surgical services.
Methods
A systematic literature review was conducted to identify studies reporting on the
experience of indigenous communities with surgeons, medical practitioners, and the
providers of surgical and other health services. The databases searched were MEDLINE,
EMBASE, PubMed, Web of Science, and Google Scholar, including all literature available
until the search date of April 3, 2019. The reference lists of all included articles
and related review articles were searched manually to identify further relevant studies.
An inductive approach was used to identify common themes.
Results
Thirty-three publications discussed the experiences of New Zealand Māori (n = 2), Aboriginal and Torres Strait Islanders (n = 20), North American First Nation (n = 10), and Indigenous Latin Americans (n = 1). Across all indigenous peoples, 6 themes emerged: accessible health services,
community participation and community governance, continuous quality improvement,
a culturally appropriate and clinically skilled workforce, a flexible approach to
care, and holistic healthcare.
Conclusion
To provide medical and surgical services in indigenous communities successfully requires
a diverse range of skills and core technical and academic competencies. Many skills
lie within the definition of professionalism and advocacy as well as the ability to
undertake and operationalize community consultation and empowerment. If surgical services
serving Indigenous communities are to be successful in addressing health disparity,
specific training in these skills will need to be developed and made available.
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References
- Engaging Māori in biobanking and genetic research: Legal, ethical, and policy challenges.International Indigenous Policy Journal. 2015; 6: 1-19
- Healthcare in remote Australian indigenous communities.Lancet. 2003; 362: 36-37
- Addressing the duality of access to healthcare for indigenous communities: Racism and geographical barriers to safe care.Healthcare Papers. 2018; 17: 6-10
- The World Bank.https://www.worldbank.org/en/country/pacificislands/overviewDate accessed: April 27, 2019
- Beyond the biomedical paradigm: The formation and development of indigenous community-controlled health organizations in Australia.In J Health Services. 2015; 45: 471-494
- Principles for the development of Aboriginal health interventions: Culturally appropriate methods through systemic empathy.Ethnicity and Health. 2015; 20: 437-452
- Multicultural social policy and community participation in health: New opportunities and challenges for indigenous people.Int J Health Planning and Management. 2012; 27: e18-e40
- A guide for health professionals working with Aboriginal peoples. Cross cultural understanding.Journal SOGC. 2001; 100: 1-15
- State of the world’s indigenous peoples.United Nations, 2009https://www.un.org/development/desa/indigenouspeoples/publications/state-of-the-worlds-indigenous-peoples.htmlDate accessed: April 27, 2019
- A guide for health professionals working with Aboriginal peoples. Health issues affecting Aboriginal peoples.Journal SOGC. 2001; 100: 54-68
- Community-identified recommendations to enhance cancer survivorship for Aboriginal and Torres Strait islander people.Aust J Primary Health. 2018; 24: 233-240
- The Lancet Commission on Global Surgery.https://www.lancetglobalsurgery.org/Date accessed: April 27, 2019
- United Nations.https://www.un.org/development/desa/indigenouspeoples/mandated-areas1/health.htmlDate accessed: April 27, 2019
- Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement.PLoS Med. 2009; 6e1000097
- Centre for Evidence-Based Medicine.https://www.cebm.net/2016/05/ocebm-levels-of-evidence/Date accessed: April 27, 2019
- Building on primary care reforms and indigenous self-determination in the northwest territories: Physician accountability and performance in context.Healthcare Papers. 2018; 17: 70-76
- Process redesign of a surgical pathway improves access to cataract surgery for Aboriginal and Torres Strait Islander people in South East Queensland.Aust J Primary Health. 2018; 24: 135-140
- Australian cancer services: A survey of providers efforts to meet the needs of indigenous patients.ANZ J Public Health. 2018; 42: 547-552
- National survey of indigenous primary healthcare capacity and delivery models in Canada: The transformation of indigenous PrimAry HEAlthcare delivery (FORGE AHEAD) community profile survey.BMC Health Services Research. 2018; 18: 1-13
- Residency programs grapple with new indigenous cultural safety training requirement.CMAJ. 2018; 25: E778-E779
- Are primary healthcare services culturally appropriate for Aboriginal people? Findings from a remote community.ANZ J Public Health. 2017; 23: 236-242
- Is remote health different to rural health.Rural and Remote Health. 2017; 17: 1-8
- Long-term trends in supply and sustainability of the health workforce in remote Aboriginal communities in the Norther Territory of Australia.BMC Health Serv Res. 2017; 17: 1-10
- Enhancing health care equity with indigenous populations: Evidence-based strategies from an ethnographic study.BMC Health Ser Res. 2016; 16: 1-17
- Establishing and delivering pulmonary rehabilitation in rural and remote settings: The opinions, attitudes and concerns of health care professionals.Aust J Rural Health. 2016; 24: 106-114
- Aboriginal health care and bioethics: A reflection on the teaching of the seven grandfathers.Am J Bioethics. 2016; 16: 38-43
- Whakawhanaungatanga: The importance of culturally meaningful connections to improve uptake of pulmonary rehabilitation by Māori with COPD: A qualitative study.Int J COPD. 2016; 11: 489-501
- Regional health workforce planning through action research: Lessons for commissioning health services from a case study in far North Queensland.Aust J Primary Health. 2016; 22: 63-68
- Developing the future indigenous health workforce: The feasibility and impact of a student-led placement programme in remote indigenous communities.Aust J Rural Health. 2016; 24: 306-311
- The fly-in fly-out and drive-in drive-out model of health care service for rural and remote Australia: Benefits and disadvantages.Rural and Remote Health. 2015; 15: 1-7
- Adoption, implementation and prioritization of specialist outreach policy in Australia: A national perspective.Bull World Health Organ. 2014; 92: 512-519
- Indigenous perspectives on the desired attributes of medical graduates practicing in remote communities: A northwest Queensland pilot study.Aust J Rural Health. 2013; 21: 90-96
- Health ownership in American indigenous communities.Rural and Remote Health. 2013; 13: 1-8
- Processes and outcomes for a successful engagement between a medical school and a remote indigenous community in North Queensland, Australia.Rural and Remote Health. 2013; 13: 1-10
- Indigenous hospital experiences: A New Zealand case study.J Clinical Nursing. 2012; 21: 2316-2326
- Providing specialist services in Australia across barriers of distance and culture.World J Surg. 2009; 33: 1562-1567
- Overseas-trained doctors in indigenous rural health services: Negotiating professional relationships across cultural domains.ANZ J Public Health. 2008; 32: 512-518
- Specialist outreach to isolated and disadvantaged communities: A population-based study.Lancet. 2006; 368: 130-138
- Specialist clinics in remote Australian Aboriginal communities: Where rock art meet rocket science.J Health Serv Res Policy. 2004; 9: S56-S62
- A guide for health professional working with Aboriginal peoples: Executive summary.J SOGC. 2000; 100: 1-6
- What indigenous Australian clients value about primary health care: A systematic review of the qualitative evidence.ANZ J Public Health. 2017; 41: 417-423
- Characteristics of indigenous primary health care service delivery models: A systematic scoping review.Global Health. 2018; 14: 1-18
- Doctors' horror: Kids with maggots in scalps and pre-schoolers with rotting teeth.https://www.nzherald.co.nz/spotlight/news/article.cfm?c_id=1504095&objectid=12093358Date accessed: April 27, 2019
- About NAVVHO. 2016.https://www.naccho.org.au/about/Date accessed: April 27, 2019
- Improving access to health care among New Zealand’s Maori population.Am J Public Health. 2006; 96: 612-617
- Ten years of health transfer first nation and Inuit control.
- Agency overview.https://www.ihs.gov/aboutihs/overview/Date accessed: April 27, 2019
- Epidemic of stab injuries: An Alice Springs dilemma.ANZ J Surg. 2007; 7: 621-625
- Are American surgical residents prepared for humanitarian deployment?: A comparative analysis of resident and humanitarian case logs.World J Surg. 2018; 42: 32-39
- Cultural safety in nursing: The New Zealand experience.Int J Qual Health Care. 1996; 8: 491-497
- Otago Medical School.https://www.otago.ac.nz/medical-school/undergraduate/medicine/msod/Date accessed: April 27, 2019
- Royal Australasian College of Surgeons.https://www.surgeons.org/becoming-a-surgeon/surgical-education-training/competencies/Date accessed: April 27, 2019
- The Royal College of Surgeons of England.https://www.rcseng.ac.uk/careers-in-surgery/trainees/foundation-and-core-trainees/competencies/Date accessed: April 27, 2019
- American College of Surgeons.https://www.facs.org/education/program/fsc/coreDate accessed: April 27, 2019
- Priorities for professionalism: What do surgeons think.Med J Aust. 2015; 202: 433-438
Article info
Publication history
Published online: October 22, 2019
Accepted:
August 17,
2019
Footnotes
The results of this review were presented, in part, at the Annual Scientific Meeting of the Royal Australasian College of Surgeons, May 9, 2019, Bangkok, Thailand.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
