The Medical journal of Australia
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To evaluate regional variation in the incidence of end-stage renal disease (ESRD) in Indigenous Australians, and to examine the proximity to ESRD treatment facilities of Indigenous patients. ⋯ There is marked regional variation in the incidence of ESRD among Indigenous Australians. Because of the location of treatment centres, there is inequitable access to ESRD treatment services for a significant proportion of Indigenous patients.
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Malawi opened its only medical school in April 1991, despite opposition from some who believed that the venture was a waste of precious resources. From 1986, selected Malawi students had done preclinical training in Australia, the United Kingdom and South Africa, returning to Malawi for the clinical phase of their training. ⋯ Twenty Malawi medical students attended the medical schools of the University of Adelaide and Flinders University in South Australia between 1991 and 1996. All but three of those students are now qualified doctors working in various capacities in healthcare delivery service in Malawi.
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Implementing evidence-based medicine (EBM) in primary healthcare for Indigenous people will usually involve increasing services, particularly those for chronic conditions. As shown by the example of diabetes care, there are significant organisational, educational, economic, cultural and structural barriers to implementing EBM in many Indigenous communities. ⋯ There is evidence that delivering evidence-based primary healthcare, particularly for chronic diseases, can improve health outcomes in Indigenous communities. There is a need for more investment in strategies to implement EBM and evidence-based public health in Indigenous settings.