title: Perspectives of Indigenous people in the Pilbara about the delivery of healthcare services.
abstract: OBJECTIVE
  To identify Indigenous people's views about gaps and practical solutions for the delivery of healthcare services in the Pilbara.
  
  
  METHODS
  A structured guide was used to interview three Indigenous language groups from the Pilbara region of Western Australia. The responses were analysed with the use of content analysis. In the first stage, codes were developed by assigning names to small sections of the interview transcripts. Next, the most salient incisive codes were identified and developed into themes that captured the most important issues.
  
  
  RESULTS
  Many respondents said that there were insufficient health professionals near country, which was compounded by a lack of adequate transport to reach healthcare services. Moreover, respondents commonly indicated that they would be unable to secure adequate accommodation for themselves and any carer when needing to leave country to undergo medical care. The importance of secondary healthcare interventions was highlighted, particularly health promotion initiatives that improved diet and exercise levels and reduced substance abuse. Assuming responsibility for one's own health was seen as integral to improving the overall health of communities. The respondents saw role models as the most important influence in leading people to take responsibility for improving their own health.
  
  
  CONCLUSIONS
  This study provides Indigenous perspectives about gaps and solutions in healthcare service delivery in the Pilbara region of Western Australia. Although initiatives have commenced to address the shortfall in health professionals and inadequate transport to healthcare, there are still gaps in service provision. Mobile health services were strongly supported as an integral measure to address these gaps. WHAT IS KNOWN ABOUT THIS TOPIC? About two out of every three Indigenous adults in the Pilbara experience a chronic health condition. Moreover, compared with non-Indigenous people in the region, Indigenous people experience a significantly higher mortality rate for numerous chronic health conditions. Although some information is available about the provision of health services for Indigenous people in the Pilbara, little is known about Indigenous people's perspectives about its adequacy or how it should be delivered. WHAT DOES THIS PAPER ADD? This study details three local language groups' views about the gaps and solutions to delivery of healthcare for Indigenous people in the Pilbara. It highlights the need for secondary healthcare interventions given difficulties around providing adequate primary care in remote settings. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Health promotion initiatives need to be prioritised to improve the health of Australian Indigenous people in the Pilbara and the initiatives should be delivered with the involvement of the local communities. Innovative solutions are required to improve the continuity of healthcare in the Pilbara, including increased use of mobile services.
authors.affiliation: School of Health Professions, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia. Email:
authors.forename: Bruce F
authors.initials: BF
authors.lastname: Walker
authors.affiliation: School of Health Professions, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia. Email:
authors.forename: Norman J
authors.initials: NJ
authors.lastname: Stomski
authors.affiliation: Murdoch University, 90 South Street, Murdoch, WA 6150, Australia. Email: .
authors.forename: Anne
authors.initials: A
authors.lastname: Price
authors.affiliation: Murdoch University, 90 South Street, Murdoch, WA 6150, Australia. Email: .
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Jackson-Barrett
mesh_terms: D003695:Delivery of Health Care; D007722:Health Knowledge, Attitudes, Practice; D006303:Health Services, Indigenous / Q000600:supply & distribution*; D006801:Humans; D036301:Qualitative Research; D014904:Western Australia / Q000208:ethnology; D000095283:Australian Aboriginal and Torres Strait Islander Peoples