An analysis of maternal health care services for Aboriginal women and infants living in remote Top E

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An analysis of maternal health care services
for Aboriginal women and infants living in remote
Top End communities
Sarah Bar-Zeev
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Research Question

• To investigate
• How are maternal health care services organised
  and delivered to women and infants from
  Maningrida and Wadeye?
• What is the impact of the way services are
  provided on the womens and infants outcomes and
  on the service providers in the maternal health
  care system?

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Aims

• To document the existing maternal and infant
  health services and service activities
• To assess the organisation, functioning and
  utilisation of maternal health care services
  currently provided to Aboriginal women and
  infants
• To analyse the health outcomes of Aboriginal
  women and infants from Maningrida and Wadeye

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Aims

• To describe maternal health service redesign and
  initiatives in other Indigenous populations that
  have improved health
• To use the data collected to describe the patient
  journey of Aboriginal women and infants from
  Maningrida through the current health system

CHARLES DARWIN UNIVERSITY
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Aims

• To identify elements of the current service that
  could be improved through service redesign
• Establish priorities and strategies for
  strengthening the current services available

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Methods

• Multiple field sites Wadeye, Maningrida,
• RDH, Darwin hostels
• Mixed methods approach
• Situational Analysis Framework
• What is this?
• Recommended methods
• Chart audit
• Interviews and focus groups
• Observations

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Retrospective Review

• Chart audits (mums and infants from Maningrida
  and Wadeye)
• RDH and community records
• 2004-2006 approx. 100 mother infant pairs per
  year
• Variables
• Characteristics and demographic data
• Health outcomes
• Patterns of service utilisation
• Frequency of travel out of community
• Number of care providers

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Patient Journey Modelling (PJM)

• A way of conceptually linking all of the data
• What is this?
• Health care quality improvement technique
• Used to model or map the patient movements
• Examine how efficiency in service provision can
  be improved
• Analysis crucial to inform the design of targeted
  strategies and redesign

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PJM continued

• Based in Maningrida
• Case study design map the journey of 8
  mother-infant pairs
• Data collection from patient records same
  variables as chart audits
• Women interviewed at 3-4 monthly intervals
• Timeframe for data collection 20 months
  (including recruitment period)

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PJM continued

• Additional mapping process
• Incorporate service provider perspective
• Interviews and focus group discussions
• Include representatives from every stage of
  patient journey
• Observation - Analysis of protocols and
  guidelines, work patterns, staffing organisation,
  care delivery
• Anticipated 50 participants

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How will the information be used?

• Findings delivered back to participants
  participatory process for strategy development
• Presented to steering committee, community
  councils, Local Reference Group and researchers
  for consideration and implementation

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Significance

• Detailed analysis of the organisation and
  delivery of maternal health care services in
  these communities does not currently exist
• Provide an understanding of the organisation and
  delivery of care from a variety of sources and
  perspectives
• Provide baseline data and evidence for service
  redesign

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Ethics

• Submitted in July awaiting outcome
• September Commence data collection
• October Interviews with service providers
• in Darwin
• November Community visits

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Thank You!