This Australian research group sought to identify what challenges confront Indigenous peoples attempting to access appropriate mainstream primary health care services. The researchers performed a framework synthesis of 50 published papers to examine data describing issues surrounding access to (factors relating to Indigenous peoples, their families and their communities) or accessibility of Indigenous primary health care services. Twenty-four papers reported on Indigenous Health Care Services based in Australia, 15 within the USA, 4 in Canada and New Zealand, 2 in South America and 1 in Papua New Guinea. Findings were thematically analysed using Levesque and colleague’s accessibility framework. They suggested that the broader health care system appeared to influence access to and acceptability of care. Funding was an obvious system issue: Indigenous health care services operated within constrained budgets resulting in a reduction of services for Indigenous peoples. The researchers also found that cultural and social determinants of health such as unemployment and low levels of education influenced patients’ ability to engage with health care. Many of the Indigenous health care services addressed these issues by providing transport to and from appointments, a reduction in health care costs for people on low incomes and close consultation with community members in identifying and then addressing health care needs.
