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  • Subject Name : Indigenous Australian Cultures

Perspectives on Public Policy

Table of contents

Introduction.

Background.

Determinants of health.

Principles for a policy response.

Strategies and recommendations.

Conclusion.

References.

Introduction to COVID-19

The ongoing pandemic of disease COVID-19 caused by the SARS-Cov-2 has resulted in a multimodal impact on the health of people (Cousins, 2020). With multiple lockdowns in the countries, the physical movement of the individuals has been restrained. This has severely impacted the healthcare access to patients who were suffering from chronic illnesses (Tanne et al., 2020). A significant impact of this can be observed on the individuals belonging to the Aboriginal Torre Strait Islander community (Zaman et al., 2020). Health inequity has been a major challenge for the Australian healthcare system. The ongoing pandemic has further limited the access to the healthcare services by the indigenous people of Australia (Cousins, 2020). This paper will identify the need for improved and advanced healthcare policies in the times of pandemic to assist the aboriginals with the access to healthcare services for the management of the health conditions. This paper will also identify the determinants of the health impacting the lives of the indigenous population of Australia, determine the principles of the policy response, and provide actionable strategies and recommendations for the healthcare system improvement in the present scenario with an evidence-based approach.

Background of Public Policy

Drastic lockdown measures have been imposed by the Australian government at the territory, state, and national levels to limit the spread of the virus in the community. As a consequence, there has been a restriction on the mobility and the access to healthcare services by the people in the remote locations. There exists a significant gap in the healthcare access between the population that belongs to the Aboriginal Torre Strait Islander community and the mainlanders. The cause of this prevalent gap is varied but is largely associated with the existing stigmas, prejudices, and communication barriers. The health inequity and the disparity in the access to healthcare are prominent in Australia reflected by the disease incident rates, rate of mortality, and the large gap in the life expectancy of the population (Godding,2014). The mortality rate of the individuals belonging to the lower social-economic status has also been 1.5 times higher than the people living in the major cities (AIHW, 2016). The death rates of the indigenous population in Australia is almost twice than that of the mainlanders. Further, there is a gap of almost 10 years in the life expectancy of the mainlanders and the people belonging to the Aboriginal Torre Strait Islander community (AIHW, 2016).

Even when the government has launched several healthcare schemes targeted for the improvement of the healthcare access to the Aboriginal Torres Strait Islander community to close the gap, the current situation of lockdown has rendered these programs and schemes ineffective (Cousins, 2020). The people belonging to the Aboriginal Torre Strait Islander community, living in the remote locations have not been able to the gather resources and avail the healthcare services due to the nationwide shut down due to pandemic and focus of the entire healthcare system for the management of COVID-19 cases. Therefore, this has resulted in poor management of chronic illnesses in the community with limited knowledge and access (Markham & Smith, 2020). With most of the community services and public healthcare diverged and focused on the ongoing COVID-19, management and treatment, the bridge to access to healthcare services in the remote locations by the Aboriginal Torre Strait Islander community has been compromised (Tanne et al., 2020). Therefore, comprehensive policies are required in association with the guidelines that have been issued by the Government of Australia for the prevention of COVID-19 spread in the remote locations and aboriginal community (Government of Australia, 2020)

Determinants of Health

The World Health Organization (2018) has defined the social determinants of health as” the conditions in which people are born, grow, live, work and age”. These factors are inclusive of the employment conditions, social exclusion, education, social and cultural factors, access to healthcare, economic stability, etc. In the focused case of the access to healthcare facilities to the Aboriginal Torres Strait and Islander community of Australia, economic stability, education, social community, and the access to healthcare are the key determinants that impact the healthcare of the community in the ongoing pandemic (Tanne, 2020). The Aboriginal Torres Strait and Islander community of Australia have been severely impacted by the stigma and the prejudice that affects the access to the healthcare services by the community (Zaman et al., 2020). Therefore, community programs and wider reach is essential to increase the participation of the community and to promote health and beneficence in the community practice. However, the lockdown and the social distancing mandated for curbing COVID-19 has directly impacted the reach (Cousins, 2020). The lack of economic stability and the poor reach of the healthcare in the remote communities has also resulted in hindering the healthcare access to the Aboriginal Torres Strait and Islander community of Australia (Markham & Smith, 2020).

Principles for A Policy Response

The primary principles that govern the access COVID-19 response include the following (Bewster et al., 2020):

  1. Fair and equitable access to healthcare services
  2. Shared economic sacrifice
  3. Enhancing social relationships 
  4. Protection of the democracy, rights, and liberties of the individuals. 
  5. Building a sustainable future

Lack of adequate healthcare access is associated with the principles 1,3,4, and 5 of the COVID-19 response. The indigenous population residing away from the hospitals and care centres making the healthcare inaccessible must be given an opportunity to access the healthcare services for the management of their health conditions. The social relationships between the indigenous community and the non-indigenous community should be enhanced to improve the access and quality of the care services availed. Healthcare has been identified as the fundamental right of every individual. Hence, access to quality care services for the community must be ensured even in the times of pandemic. The improved healthcare and access to community services will help in the development of a sustainable future after the pandemic is over for Australia as the care needs of the population other than COVID-19 will not be neglected. 

Strategies and Recommendations on Perspectives on Public Policy

The suitable strategies to improve the healthcare access for the Aboriginal Torres Strait and Islander population include:

  1. Promotion of telemedicine: Telemedicine and Tele-health services can serve as a boon in the times of pandemic. The telehealthcare services can reach the remote and rural locations for care and provide assistance to the patients when the physical consultations are not possible. This can help in the prognosis as well as the management of the existing healthcare conditions in the community (Hyland et al., 2018). 
  2. Promotion of community action: It is important to analyze that a collaborative approach is essential to ensure the beneficence of the community as a whole. The individuals belonging to the Aboriginal Torres Strait and Islander community must participate with a will to improve their health and promote wellness by adopting a healthy lifestyle and ensure the required precautions for the maintenance of the existing health conditions and prevention from COVID-19 (Farley et al., 2020).
  3. Policymaking: The government must devise and apply the policies to improve healthcare access and national, state, and territorial levels to ensure the wellbeing of the community (Farley et al., 2020).
  4. Community education: The community must be educated by various means about the use of telehealth services, for the precautions and the management of the existing healthcare conditions, and overall wellbeing (Haines et al., 2020). 

To accomplish the following strategies. The following recommendations have been suggested:

  1. Improvement of the telecommunications network (Hollander & Carr, 2020)
  2. Funding for the care programs and telemedical services (Hollander & Carr, 2020)
  3. Training the healthcare staff for the management of the health conditions of individuals belonging to the indigenous population by promoting cultural safety and competent care (Farley et al., 2020).
  4. Promoting patient education and participatory approach for the management of the health conditions (Haines et al., 2020). 
  5. Provide psychological assistance and support along with physical healthcare (Haines et al., 2020). 

Conclusion on Perspectives on Public Policy

The presented document identifies a major lacuna in the public health in the times of COVID-19 pandemic. The equitable access to the healthcare services is a fundamental right and has been severely affected by the COVID-19 pandemic for the Aboriginal Torres Strait and Islander community in Australia. There is an existing gap in the equitable healthcare access in Australia that has been worsened due to the strict lockdowns restricting the movement of people and affecting the reach and accessibility to the healthcare services. This report summarizes the need of a policy to improve the healthcare access by the implementation of strategies like telemedicine, community action, and policymaking for Aboriginal Torres Strait and Islander community for an overall improvement of the healthcare system and beneficence of the community.

References for Perspectives on Public Policy

AIHW (2016). Australia’s Health 2016. Retrieved from: https://www.aihw.gov.au/reports/australias-health/australias-health2016/contents/chapter-5-health-of-population-groups

Brewster, D. J., Chrimes, N. C., Do, T. B., Fraser, K., Groombridge, C. J., Higgs, A., ... & Nickson, C. P. (2020). Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID-19 adult patient group. Medical Journal of Australia,16, 25

Cousins, S. (2020). Indigenous Australians Avert an Outbreak—for Now. Retrieved from: https://foreignpolicy.com/2020/05/19/indigenous-australians-avert-coronavirus-outbreak-for-now-aboriginal/

Farley, J. H., Hines, J., Lee, N. K., Brooks, S. E., Nair, N., Brown, C. L., ... & Chapman-Davis, E. (2020). Promoting health equity in the era of COVID-19. Gynecologic Oncology. 16, 25

Godding, R. (2014). The persistent challenge of inequality in Australia's health. The Medical Journal of Australia, 201(8), 432.

Government of Australia (2020). Coronavirus (COVID-19) advice for Aboriginal and Torres Strait Islander peoples and remote communities Retrieved from: https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/advice-for-people-at-risk-of-coronavirus-covid-19/coronavirus-covid-19-advice-for-aboriginal-and-torres-strait-islander-peoples-and-remote-communities

Government of Western Australia (2020). Coronavirus (COVID-19) for Aboriginal people. Retrieved from: https://healthywa.wa.gov.au/Articles/A_E/Coronavirus/Coronavirus-information-for-Aboriginal-people

Haines, A., de Barros, E. F., Berlin, A., Heymann, D. L., & Harris, M. J. (2020). National UK programme of community health workers for COVID-19 response. The Lancet, 395(10231), 1173-1175.

Hollander, J. E., & Carr, B. G. (2020). Virtually perfect? Telemedicine for COVID-19. New England Journal of Medicine, 382(18), 1679-1681.

Hyland, P., Raymond, E. G., & Chong, E. (2018). A direct‐to‐patient telemedicine abortion service in Australia: Retrospective analysis of the first 18 months. Australian and New Zealand Journal of Obstetrics and Gynaecology, 58(3), 335-340.

Markham, F., & Smith, D. (2020). Indigenous Australians and the COVID 19 crisis: Perspectives on public policy. 201(8), 432.

Tanne, J. H., Hayasaki, E., Zastrow, M., Pulla, P., Smith, P., & Rada, A. G. (2020). Covid-19: how doctors and healthcare systems are tackling coronavirus worldwide. Biomedical Journal, 368.

Weiss-Randall, D. (2014). A community health approach to asthma in the schools. Kappa Delta Pi Record, 50(4), 164-169.

World Health Organization (2018). Social determinants of health. Retrieved from: https://www.who.int/social_determinants/sdh_definition/en/

Zaman, S., MacIsaac, A. I., Jennings, G. L., Schlaich, M., Inglis, S. C., Arnold, R., ... & Duffy, S. J. (2020). Cardiovascular disease and COVID-19: Australian/New Zealand consensus statement. Medical Journal of Australia, 1,216

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