Accessing primary health care (PHC) by Indigenous peoples worldwide was my research project. The global population of Indigenous peoples is among the most marginalized people in any society and experiences barriers to accessing PHC. There has been little reduction in access barriers despite the World Health Report on PHC, and the final report by the Commission on Social Determinants of Health released in 2008 by the World Health Organization advocating for health equity.
I conducted a literature review through a systematic approach in July 2021 with the aim of examining the barriers, and to better understand the generating factors. The scope of the research was not restricted to a few countries but rather used a global lens to better inform Global Health Policy on PHC access.
Systematic literature reviews have been conducted on the topic but with different study aims, objectives and methodologies. In my study, I searched for MEDLINE, EMBASE, Global Health, Scopus, and Web of Science databases. The literature retrieved was screened for relevance, critically appraised, and the data thematically analyzed, and synthesized. Access barriers examined included racism and discrimination, cultural insensitivity, negative healthcare past experiences, shortages of healthcare workers, language difficulties, unaffordable healthcare costs, influences of Indigenous/traditional medicines, and transport difficulties. Thematic analysis revealed that 5 dimensions of access to PHC; acceptability, affordability, approachability, appropriateness, and availability were impacted. Colonialism and its legacies of violence and structural power imbalances were some of the generating factors, especially in high-income countries (HICs).

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