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

Rumbold, Alice R., Bailie, Ross S., Si, Damin, Dowden, Michelle C., Kennedy, Catherine M., Cox, Rhonda J., O'Donoghue, Lynette, Liddle, Helen E., Kwedza, Ru K., Thompson, Sandra C., Burke, Hugh P., Brown, Alex D. H., Weeramanthri, Tarun and Connors, Christine M. (2011) Delivery of maternal health care in Indigenous primary care services: Baseline data for an ongoing quality improvement initiative. BMC Pregnancy and Childbirth, 11 16: 1-10. doi:10.1186/1471-2393-11-16

Author Rumbold, Alice R.
Bailie, Ross S.
Si, Damin
Dowden, Michelle C.
Kennedy, Catherine M.
Cox, Rhonda J.
O'Donoghue, Lynette
Liddle, Helen E.
Kwedza, Ru K.
Thompson, Sandra C.
Burke, Hugh P.
Brown, Alex D. H.
Weeramanthri, Tarun
Connors, Christine M.
Title Delivery of maternal health care in Indigenous primary care services: Baseline data for an ongoing quality improvement initiative
Journal name BMC Pregnancy and Childbirth   Check publisher's open access policy
ISSN 1471-2393
Publication date 2011-03-01
Sub-type Article (original research)
DOI 10.1186/1471-2393-11-16
Open Access Status DOI
Volume 11
Issue 16
Start page 1
End page 10
Total pages 10
Place of publication London, United Kingdom
Publisher BioMed Central
Language eng
Formatted abstract
Background: Australia’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. 

Methods: We 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. 

Results: The 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. 

Conclusion: Participating 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. 
Keyword Routine Antenatal Care
Pregnancy Outcomes
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
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