Academic Journal

Enablers and barriers to primary health care access for Indigenous adolescents: a systematic review and meta-aggregation of studies across Australia, Canada, New Zealand, and USA

Bibliographic Details
Title: Enablers and barriers to primary health care access for Indigenous adolescents: a systematic review and meta-aggregation of studies across Australia, Canada, New Zealand, and USA
Authors: Stephen Harfield, Tara Purcell, Eliza Schioldann, James Ward, Odette Pearson, Peter Azzopardi
Source: BMC Health Services Research, Vol 24, Iss 1, Pp 1-29 (2024)
Subject Terms: Primary health care, Indigenous peoples, Adolescents, Australia, New Zealand, Canada, Public aspects of medicine, RA1-1270
Publisher Information: BMC, 2024.
Publication Year: 2024
Collection: LCC:Public aspects of medicine
Description: Abstract Background Indigenous adolescents access primary health care services at lower rates, despite their greater health needs and experience of disadvantage. This systematic review identifies the enablers and barriers to primary health care access for Indigenous adolescents to inform service and policy improvements. Methods We systematically searched databases for publications reporting enablers or barriers to primary health care access for Indigenous adolescents from the perspective of adolescents, their parents and health care providers, and included studies focused on Indigenous adolescents aged 10–24 years from Australia, Canada, New Zealand, and United States of America. Results were analyzed against the WHO Global standards for quality health-care services for adolescents. An additional ninth standard was added which focused on cultural safety. Results A total of 41 studies were included. More barriers were identified than enablers, and against the WHO Global standards most enablers and barriers related to supply factors – providers’ competencies, appropriate package of services, and cultural safety. Providers who built trust, respect, and relationships; appropriate package of service; and culturally safe environments and care were enablers to care reported by adolescents, and health care providers and parents. Embarrassment, shame, or fear; a lack of culturally appropriate services; and privacy and confidentiality were common barriers identified by both adolescent and health care providers and parents. Cultural safety was identified as a key issue among Indigenous adolescents. Enablers and barriers related to cultural safety included culturally appropriate services, culturally safe environment and care, traditional and cultural practices, cultural protocols, Indigenous health care providers, cultural training for health care providers, and colonization, intergenerational trauma, and racism. Nine recommendations were identified which aim to address the enablers and barriers associated with primary health care access for Indigenous adolescents. Conclusion This review provides important evidence to inform how services, organizations and governments can create accessible primary health care services that specifically meet the needs of Indigenous adolescents. We identify nine recommendations for improving the accessibility of primary health care services for Indigenous adolescents.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1472-6963
Relation: https://doaj.org/toc/1472-6963
DOI: 10.1186/s12913-024-10796-5
Access URL: https://doaj.org/article/44ab01a8a1c3404f8e52312261c782cd
Accession Number: edsdoj.44ab01a8a1c3404f8e52312261c782cd
ISSN: 14726963
DOI: 10.1186/s12913-024-10796-5
Database: Directory of Open Access Journals