Measuring what matters in delivering services to remote‐dwelling Indigenous mothers and infants in the Northern Territory, Australia

Malinda Steenkamp · Alice R. Rumbold · Sue V. Kildea · Sarah Bar‐Zeev · Sue Kruske · Terry Dunbar +1 more

15 citations0/0 files storedAustralian Journal of Rural Health

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Indigenous Health, Education, and Rights Maternal and Neonatal Healthcare Delphi Technique in Research

Abstract

PROBLEM: In the Northern Territory, 64% of Indigenous births are to remote-dwelling mothers. Delivering high-quality health care in remote areas is challenging, but service improvements, informed by participative action research, are under way. Evaluation of these initiatives requires appropriate indicators. Few of the many existing maternal and infant health indicators are specifically framed for the remote context or exemplify an Indigenous consumer perspective. We aimed to identify an indicator framework with appropriate indicators to demonstrate improvements in health outcomes, determinants of health and health system performance for remote-dwelling mothers and infants from pregnancy to first birthday. DESIGN: We reviewed existing indicators; invited input from experts; investigated existing administrative data collections and examined findings from a record audit, ethnographic work and the evaluation of the Darwin Midwifery Group Practice. SETTING: Northern Territory. PROCESS: About 660 potentially relevant indicators were identified. We adapted the Aboriginal and Torres Strait Islander Health Performance Framework and populated the resulting framework with chosen indicators. We chose the indicators best able to monitor the impact of changes to remote service delivery by eliminating duplicated or irrelevant indicators using expert opinion, triangulating data and identifying key issues for remote maternal and infant health service improvements. LESSONS LEARNT: We propose 31 indicators to monitor service delivery to remote-dwelling Indigenous mothers and infants. Our inclusive indicator framework covers the period from pregnancy to the first year of life and includes existing indicators, but also introduces novel ones. We also attempt to highlight an Indigenous consumer.

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References

2011Delivery of maternal health care in Indigenous primary care services: baseline data for an ongoing quality improvement initiative 2012Growing Up Our Way 2010Niyith Nniyith Watmam (the quiet story): Exploring the experiences of Aboriginal women who give birth in their remote community 2012A population-based investigation into inequalities amongst Indigenous mothers and newborns by place of residence in the Northern territory, Australia 2012Use of health services by remote dwelling Aboriginal infants in tropical northern Australia: a retrospective cohort study 2013Use of Maternal Health Services by Remote Dwelling Aboriginal Women in Northern Australia and Their Disease Burden

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