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Beyond Structural Neglect: Using Evidence to Strengthen Primary Health Care Systems, Policies and Programs for
Kootsy Canuto1, Celina Gaweda1, James Smith2
1College of Medicine and Dentistry James Cook University, Cairns, Queensland, Australia.
Abstract:
Despite decades of policy focus, Aboriginal and Torres Strait Islander men still face primary health care systems that are misaligned with their cultural and social needs, leading to low use. A strong body of evidence shows engagement improves when care is culturally safe, gender-responsive and community-led, yet these are inconsistently implemented. Short-term funding and fragmented commissioning undermine continuity, workforce stability and holistic care. Reliance on pilot programs reflects risk aversion and limits reform. Redesigning commissioning to ensure long-term funding, a stable workforce, stronger governance and learning-focused evaluation is essential. Continued delay perpetuates inequity, making reform an ethical and political imperative.
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