Factors that impact access to ongoing health care for First Nation children with a chronic condition

Julieann Coombes · Kate Hunter · Tamara Mackean · Andrew J. A. Holland · Elizabeth Sullivan · Rebecca Ivers

39 citations0/0 files storedBMC Health Services Research

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Indigenous Health, Education, and Rights Child and Adolescent Health Cultural Competency in Health Care

Abstract

BACKGROUND: Access to multidisciplinary health care services for First Nation children with a chronic condition is critical for the child's health and well-being, but disparities and inequality in health care systems have been almost impossible to eradicate for First Nation people globally. The objective of this review is to identify the factors that impact access and ongoing care for First Nation children globally with a chronic condition. METHODS: An extensive systematic search was conducted of nine electronic databases to identify primary studies that explored factors affecting access to ongoing services for First Nation children with a chronic disease or injury. Due to the heterogeneity of included studies the Mixed Method Appraisal Tool (MMAT) was used to assess study quality. RESULTS: A total of six studies from Australia, New Zealand and Canada were identified and included in this review. Four studies applied qualitative approaches using in-depth semi structured interviews, focus groups and community fora. Two of the six studies used quantitative approaches. Facilitators included the utilisation of First Nation liaison workers or First Nation Health workers. Key barriers that emerged included lack of culturally appropriate health care, distance, language and cultural barriers, racism, the lack of incorporation of First Nation workers in services, financial difficulties and transport issues. CONCLUSION: There are few studies that have identified positive factors that facilitate access to health care for First Nation children. There is an urgent need to develop programs and processes to facilitate access to appropriate health care that are inclusive of the cultural needs of First Nation children.

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References

2009Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement 2009Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.2009Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement 20248 Decolonizing Methodologies: Research and Indigenous Peoples 2005Systematically reviewing qualitative and quantitative evidence to inform management and policy-making in the health field 2011Testing the reliability and efficiency of the pilot Mixed Methods Appraisal Tool (MMAT) for systematic mixed studies review 2016Indigenous and tribal peoples' health (The Lancet–Lowitja Institute Global Collaboration): a population study 2004Understanding health and illness: research at the interface between science and indigenous knowledge

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