Policy Implications for Controlling Communicable Diseases in Indigenous Communities: Case of Strongyloidiasis in Australia





Indigenous Australia, Aboriginal Australia, community, Strongyloides stercoralis, Strongyloidiasis, parasitic infection, chronic disease, institutional racism, policy, disparity, neglected tropical disease, epidemiology


The objective of this paper is to document the knowledge and experiences of healthcare professionals and researchers in Australia about the barriers to controlling Strongyloides stercoralis in Australian Indigenous communities. Qualitative research methods were used to conduct in-depth semi-structured interviews, which were digitally recorded, transcribed, and participant-checked. Data were thematically analysed to identify significant themes. Five major themes were identified:

1)    Barriers to health/treatment;

2)    Access to healthcare;

3)    Policy;

4)    Learning opportunity; and

5)    Ideas for intervention.

The findings suggest that Australian Indigenous communities will continue to suffer increased morbidity and mortality due to a lack of control or prevention of Strongyloides stercoralis. Issues such as institutional racism, improvements to health promotion, education, socioeconomic determinants, and health care system policy and procedures need to be addressed. This study identifies several direct implications for Indigenous health:

  • The need for increased knowledge and understanding of the risks to health for Indigenous community members;
  • The need for prevention policy development for neglected tropical diseases in Indigenous communities;
  • The need for increased knowledge and understanding of the treatment, diagnosis, and healthcare access concerning Strongyloides stercoralis for health professionals and policymakers who work within Indigenous health;
  • The need to raise awareness of systematic institutional racism in the control and prevention of neglected tropical diseases in Indigenous communities; and
  • The need for a health promotion framework that can provide the basis for multiple-level interventions to control and prevent Strongyloides in Indigenous communities.

Author Biographies

Adrian Miller, Charles Darwin University

Pro Vice Chancellor, Indigenous Leadership

Charles Darwin University


Michelle L Smith, University of British Columbia University of Alberta

Adjunct Professor,
School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia;

TREC Regional Research Coordinator (BC Interior),
TREC Translating Research in Elder Care, Faculty of Nursing, University of Alberta

Jenni A Judd, CQ University of Australia Wide Bay Hospital and Health Services Bundaberg Health Promotions Pty Ltd

Professor of Health Promotion,
School of Health, Medical and Applied Sciences, Higher Education Division
CQ University Australia; Wide Bay Hospital and Health Services; Bundaberg Health Promotions Pty Ltd

Rick Speare, James Cook University Tropical Health Solutions Pty Ltd

Emeritus Professor, Director, 

College of Public Health, Medical and Veterinary Sciences

James Cook University; 

Tropical Health Solutions Pty Ltd