Perception of importance of selected health indicators and objectives for indigenous peoples related to the Healthy People 2020 in Taiwan

OBJECTIVES: The major purpose of this study is to examine the perception of importance of selected health indicators for indigenous people during the process of drafting the Healthy People 2020 in Taiwan.

METHOD: There are 372 health stations, the major public primary health care units, in Taiwan, and 56 of them were located in the indigenous areas. Data were collected through an anonymous mailed questionnaire survey for the director and the head nurse of each health station. Forty-two health indicators and/or objectives were divided into three categories, namely life expectancy and mortality, healthy life and disease control, and community health service utilization. Subjects were required to rate the level of importance and priority for the list of selected indicators and objectives regarding the Healthy People 2020 for the indigenous people. This survey was conducted during October to November, 2007. A total of 633 subjects were recruited in the survey and the response rate was 85%. Most of the health workers in the indigenous areas are indigenes. Bivariate analyses were employed to compare the perceptions of the health workers from indigenous areas vs. non-indigenous areas.

RESULTS: Among fourteen indicators of the life expectancy and mortality category, significance differences of rating as high priority was only found in the objective of “decreasing injuries mortality”(74.8% vs. 58.5%). Among twenty objectives of the healthy life and disease control category, significance priority differences were found in the objectives related to teenager fertility, prevalence of adult drinking, liver disease control, rheumatic diseases/gout control, and prevalence of HIV/AIDS. Furthermore, significance priority differences were found in seven out of eight objectives in the health service utilization category. The proportion of ranking the seven objectives as high priority in the indigenous area health workers (ranging from 47.4% to 71.1%) were significantly higher than that of non-indigenous health workers (ranging from 21.0% to 52.5%).

CONCLUSIONS: The perceptions of health objectives have significant geographic differences in terms of indigenous vs. non indigenous areas. It is important to assess indigenous people's primary health care and health promotion needs through the local health workers during the policy making process. Cultural sensitive approach in tailoring of interventions for specific perceptions should be enhanced.