Delivery of maternal health care in Indigenous primary care services: baseline data for an ongoing quality improvement initiative

BMC Pregnancy and Childbirth

Research Article

Damin Si¹  Alex DH Brown²  Rhonda J Cox³  Sandra C Thompson³  Alice R Rumbold⁴  Hugh P Burke⁵  Catherine M Kennedy⁵  Helen E Liddle⁶  Ross S Bailie⁷  Lynette O'Donoghue⁷  Michelle C Dowden⁸  Christine M Connors⁹  Tarun Weeramanthri^1,10  Ru K Kwedza^1,11 

[1] Centre for Chronic Disease, The University of Queensland, Brisbane, QLD, Australia;Centre for Indigenous Vascular and Diabetes Research, Baker IDI Heart and Diabetes Institute, Alice Springs, NT, Australia;Combined Universities Centre for Rural Health, University of Western Australia, Australia;Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, SA, Australia;Menzies School of Health Research, Darwin, NT, Australia;Marri Ma Health Aboriginal Corporation, Broken Hill, NSW, Australia;Menzies School of Health Research, Alice Springs, NT, Australia;Menzies School of Health Research, Darwin, NT, Australia;Ngalkanbuy Health Service, Elcho Island, NT, Australia;Northern Territory Department of Health and Families, Darwin, NT, Australia;Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia;Queensland Health, Brisbane, QLD, Australia;

关键词: Gestational Diabetes Mellitus;    Antenatal Care;    Sudden Infant Death Syndrome;    Maternity Care;    Torres Strait Islander;   

DOI  :  10.1186/1471-2393-11-16

 received in 2010-10-07, accepted in 2011-03-07,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundAustralia's Aboriginal and Torres Strait Islander (Indigenous) populations have disproportionately high rates of adverse perinatal outcomes relative to other Australians. Poorer access to good quality maternal health care is a key driver of this disparity. The aim of this study was to describe patterns of delivery of maternity care and service gaps in primary care services in Australian Indigenous communities.MethodsWe undertook a cross-sectional baseline audit for a quality improvement intervention. Medical records of 535 women from 34 Indigenous community health centres in five regions (Top End of Northern Territory 13, Central Australia 2, Far West New South Wales 6, Western Australia 9, and North Queensland 4) were audited. The main outcome measures included: adherence to recommended protocols and procedures in the antenatal and postnatal periods including: clinical, laboratory and ultrasound investigations; screening for gestational diabetes and Group B Streptococcus; brief intervention/advice on health-related behaviours and risks; and follow up of identified health problems.ResultsThe proportion of women presenting for their first antenatal visit in the first trimester ranged from 34% to 49% between regions; consequently, documentation of care early in pregnancy was poor. Overall, documentation of routine antenatal investigations and brief interventions/advice regarding health behaviours varied, and generally indicated that these services were underutilised. For example, 46% of known smokers received smoking cessation advice/counselling; 52% of all women received antenatal education and 51% had investigation for gestational diabetes. Overall, there was relatively good documentation of follow up of identified problems related to hypertension or diabetes, with over 70% of identified women being referred to a GP/Obstetrician.ConclusionParticipating services had both strengths and weaknesses in the delivery of maternal health care. Increasing access to evidence-based screening and health information (most notably around smoking cessation) were consistently identified as opportunities for improvement across services.

【 授权许可】

CC BY   
© Rumbold et al; licensee BioMed Central Ltd. 2011