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Sustainable antenatal care services in an urban Indigenous community: the Townsville experience
Author(s) -
Panaretto Kathryn S,
Mitchell Melvina R,
Anderson Lynette,
Larkins Sarah L,
Manessis Vivienne,
Buettner Petra G,
Watson David
Publication year - 2007
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2007.tb01109.x
Subject(s) - medicine , attendance , interquartile range , pregnancy , family medicine , obstetrics , surgery , biology , economics , genetics , economic growth
Objective: To evaluate the impact of a sustained, community‐based collaborative approach to antenatal care services for Indigenous women. Design: Prospective quality improvement intervention, the Mums and Babies program, in a cohort of women attending Townsville Aboriginal and Islanders Health Service, 1 January 2000 – 31 December 2005 (MB group), compared with a historical control group (PreMB group), 1 January 1998 – 30 June 1999. Main outcome measures: Proportion of women having inadequate antenatal care and screening; perinatal indicators. Results: The number of antenatal visits per pregnancy increased from three (interquartile range [IQR], two to six) in the PreMB group to six (IQR, four to ten) in the MB group ( P < 0.001). There were significant improvements in care planning, completion of cycle‐of‐care, and antenatal education activities throughout the study period. About 90% of all women attending for antenatal care were screened for sexually transmitted diseases, 89% had measurement of haemoglobin level, and serological tests for hepatitis B and syphilis (minimum antenatal screening). There was increased attendance for dating and morphology scans. In the MB group compared with the PreMB group, there was a significant reduction in perinatal mortality (14 v 60 per 1000 births; P = 0.014). Conclusion: Sustained access to a community‐based, integrated, shared antenatal service has improved perinatal outcomes among Indigenous women in Townsville.