These key messages were reinforced with energy and hope at the 2008 General Practice and Primary Health Care (GP & PHC) Research Conference, Health for All? Presenters, including more Indigenous researchers than in previous years, described a range of research initiatives being taken to 'close the gap' in health between Indigenous and non-Indigenous Australians.

Key findings

Evaluating local projects to improve Indigenous health

Health services for Indigenous people must be accessible, both geographically and socio-culturally.

It's not about hard to reach populations but hard to reach services.^A

Infant mortality

Indigenous women access antenatal care later than non-Indigenous women and are more likely to die during pregnancy. Identifying culturally appropriate approaches will increase Indigenous women's use of health services and lead to improved health for them and their families.
A Tamworth project found that Indigenous women prefer an Indigenous health worker during their pregnancy, but this is not so important after the birth.^B Continuity of care is very important. The women prefer talking about their health to using written or computer health materials.

Bringing dialysis to the people

Ten years ago analysis showed that Indigenous people in the Northern Territory lived for half as long after dialysis as non-Indigenous people. The Aboriginal and Community Controlled Health Service in Broome is closing the gap in life expectancy between Indigenous and non-Indigenous Australians who are receiving dialysis.^C However, the demand exceeds the resources' ability to meet it and about 30% of Kimberley people still received treatment in Perth in 2007.

The Western Desert Nganampa Walytja Palyantjaku Tjutaku (or the Western Desert Dialysis Mob) provides even more remote service, enabling seriously ill patients receiving long-term dialysis treatment in 'the purple house' in Alice Springs to visit their homes and families in the remote Western Desert of NT and receive dialysis while they are there.^D

Substance abuse outflanked

When I walked to work … I'd trip over cans and see kids with paint over their lips looking like they just weren't there … now … I don't see those kids anymore.

In Palmerston Indigenous Village two complementary projects reduced youth substance abuse and improved community pride. In one, local retailers learnt how to minimise inappropriate purchases and substance abuse.^E In the other, the community took responsibility to provide breakfast and lunch-boxes to schoolchildren by adapting the Australian Government's School Nutrition Program.⁴

These projects demonstrate the power of local, culturally appropriate service models. They fit with Prime Minister Rudd's statement of the need to close the gap "with sufficient flexibility not to insist on a one-size-fits-all approach for each of the hundreds of remote and regional Indigenous communities across the country".¹

Population data

Different Indigenous groups have different health needs. Population data can overturn assumptions about particular groups and result in policies and health services more likely to improve health outcomes for key groups.

Infant and maternal health - the Gudaga 'healthy baby' project

Over a third of mothers of Indigenous children in this project's cohort are not themselves Indigenous, are younger than other mothers and less likely to be married or to have finished school. They may be in greater need of support in managing their babies' health.^F