Feasibility issues impacting optimal levels of maternity care in rural communities: implementing the Rural Birth Index in British Columbia

BMC Health Services Research

Research

Nicky Cairncross¹  Stefan Grzybowski²  Jude Kornelsen²  Stephanie Lin³  Glenys Webster⁴  Erin Lindstrom⁵ 

[1]Advocate for Service Quality, Government of British Columbia, Victoria, BC, Canada

[2]Centre for Rural Health Research, Department of Family Practice, University of British Columbia, Vancouver, BC, Canada

[3]Food & Nutritional Sciences, University of British Columbia, Vancouver, BC, Canada

[4]Office of the Representative of Children and Youth of British Columbia (RCY BC), Victoria, BC, Canada

[5]Women’s & Maternal Health, Public Health Prevention and Planning Branch, Population and Public Health Division, Ministry of Health, Victoria, BC, Canada

关键词: Rural maternity care;    Health service planning;    Population need;   

DOI  :  10.1186/s12913-022-09008-9

 received in 2022-07-20, accepted in 2022-12-26,  发布年份 2022

来源: Springer

【 摘 要 】

IntroductionThe continued attrition of maternity services across rural communities in high resource countries demands a rigorous, systematic approach to determining population level need, including a clear understanding of feasibility issues that may constrain achieving and sustaining recommended levels of services. The Rural Birth Index (RBI) proposes a robust and objective methodology to determine such need along with attention to the feasibility of implementation.BackgroundPredictions of appropriate levels of maternity care in rural communities require consideration of the feasibility of implementation. Although previous work has focused on essential considerations that impact feasibility, there is little research documenting the barriers to implementation from the perspective of rural care providers and administrators.MethodsWe conducted in-depth, qualitative research interviews with rural community health care administrators and providers (n = 14) to understand the challenges of offering maternity care in 10 rural communities across British Columbia (BC).ResultsParticipants articulated three thematic challenges to providing maternity services in their communities: maintaining clinical skills and financial stability in the context of low procedural volume, recruitment and retention of care providers and challenges with patient transport.ConclusionsCurrent models of compensation for maternity care are inadequate and inflexible and underscore many of the challenges to implementing a level of care that is based on population need. Re-thinking provision of care as a social obligation to actualize our system commitment to equity instead of working to achieve economies of scale is the first step to use equitable care. Addressing remuneration will provide the groundwork for solving other barriers to sustainable care.

【 授权许可】

CC BY   
© The Author(s) 2023