Can we count? Enumerating births in two remote Aboriginal communities in the Northern Territory

Steenkamp, Malinda; Johnstone, Kim; Bar-Zeev, Sarah

doi:10.1111/j.1753-6405.2012.00871.x

Cited by 5 publications

(7 citation statements)

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“…preterm birth <37 weeks; Baseline: 21% (2004–06) [ 16 ] vs 13.7% (Australian Aboriginal, 2006) and 5.1% (Australia non-Aboriginal 2006) [ 32 ]. Given the rate and acuity of presentations, along with our data on infants that had already been hospitalised as neonates and our epidemiological evidence on birth rates [ 26 ], staffing was clearly inadequate and compared poorly with the improved model of maternity care [ 18 , 31 ].…”

Section: Resultsmentioning

confidence: 99%

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Improving Aboriginal maternal and infant health services in the ‘Top End’ of Australia; synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change

Barclay

Kruske

Bar-Zeev

et al. 2014

BMC Health Serv Res

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BackgroundHealth services research is a well-articulated research methodology and can be a powerful vehicle to implement sustainable health service reform. This paper presents a summary of a five-year collaborative program between stakeholders and researchers that led to sustainable improvements in the maternity services for remote-dwelling Aboriginal women and their infants in the Top End (TE) of Australia.MethodsA mixed-methods health services research program of work was designed, using a participatory approach. The study area consisted of two large remote Aboriginal communities in the Top End of Australia and the hospital in the regional centre (RC) that provided birth and tertiary care for these communities. The stakeholders included consumers, midwives, doctors, nurses, Aboriginal Health Workers (AHW), managers, policy makers and support staff. Data were sourced from: hospital and health centre records; perinatal data sets and costing data sets; observations of maternal and infant health service delivery and parenting styles; formal and informal interviews with providers and women and focus groups. Studies examined: indicator sets that identify best care, the impact of quality of care and remoteness on health outcomes, discrepancies in the birth counts in a range of different data sets and ethnographic studies of ‘out of hospital’ or health centre birth and parenting. A new model of maternity care was introduced by the health service aiming to improve care following the findings of our research. Some of these improvements introduced during the five-year research program of research were evaluated.ResultsCost effective improvements were made to the acceptability, quality and outcomes of maternity care. However, our synthesis identified system-wide problems that still account for poor quality of infant services, specifically, unacceptable standards of infant care and parent support, no apparent relationship between volume and acuity of presentations and staff numbers with the required skills for providing care for infants, and an ‘outpatient’ model of care. Services were also characterised by absent Aboriginal leadership and inadequate coordination between remote and tertiary services that is essential to improve quality of care and reduce ‘system-introduced’ risk.ConclusionEvidence-informed redesign of maternity services and delivery of care has improved clinical effectiveness and quality for women. However, more work is needed to address substandard care provided for infants and their parents.

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Section: Resultsmentioning

confidence: 99%

“…We compared the numbers of births for our sites using community birth records, birth registrations and the midwives’ data collection [ 26 ]. Birth registration and perinatal data sets appear to underestimate birth counts when verified locally with community birth records.…”

Section: Resultsmentioning

confidence: 99%

Improving Aboriginal maternal and infant health services in the ‘Top End’ of Australia; synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change

Barclay

Kruske

Bar-Zeev

et al. 2014

BMC Health Serv Res

Self Cite

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“…Institutional environments can significantly regulate individuals' behaviors [95] and organizational actions [96], thereby affecting entrepreneurial activities [31]. Stachowiak and Stryjakiewicz [97] emphasized that institutions have played an important role for regional development. The theoretical boundary of institutional theory has continually expanded and ranged from political science to economics.…”

Section: Proposed Mooring Factors On Green Entrepreneurship Intentionsmentioning

confidence: 99%

Entrepreneurs and Environmental Sustainability in the Digital Era: Regional and Institutional Perspectives

Zhou

Anwar

et al. 2020

IJERPH

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Climate change and environmental degradation have negatively affected the sustainable development of mankind. The “green” concept has been gradually accepted by the public, thereby strongly promoting “green” business forms and social innovation. This study adopts related information and technology knowledge and experience and warm glow (altruistic value) for business initiatives as push factors, market opportunity (MO) and personal innovativeness (PI) in technology as pull factors, and institutional theory (regulatory support and normative support) as mooring factors. These factors are employed to analyze the switching intentions of individuals toward green entrepreneurship, which is a new persuasive psychological model based on Push–Pull–Mooring model (PPM). The survey questionnaires are collected from a total of 1562 respondents through WeChat in mainland China. The study findings present all variables that significantly affect individuals’ switching intentions toward green entrepreneurs. PI exhibits the most significant impact on intention of individuals toward green entrepreneurship, while the interaction between the mooring factor and MO on switching intentions to green entrepreneurship is relatively weak. Finally, the study contributes theoretical and practical implications for increasing intentions toward green entrepreneurship.

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“…Others have also commented on difficulties in accessing accurate, timely and consistent maternity services data across jurisdictions. 1,39 Given these caveats, we identified 198 public hospitals in rural and remote Australia offering maternity services recognisable as Levels One to Five of the National Maternity Services Capability Framework, 139 of which provided birthing services. Previous estimates (2009) for the whole country were of 394 maternity units, including private hospitals.…”

Section: Discussionmentioning

confidence: 99%

Identifying maternity services in public hospitals in rural and remote Australia

Longman

Pilcher

Donoghue

et al. 2014

Aust. Health Review

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Objective. This paper articulates the importance of accurately identifying maternity services. It describes the process and challenges of identifying the number, level and networks of rural and remote maternity services in public hospitals serving communities of between 1000 and 25 000 people across Australia, and presents the findings of this process.Methods. Health departments and the national government's websites, along with lists of public hospitals, were used to identify all rural and remote Australian public hospitals offering maternity services in small towns. State perinatal reports were reviewed to establish numbers of births by hospital. The level of maternity services and networks of hospitals within which services functioned were determined via discussion with senior jurisdictional representatives.Results. In all, 198 rural and remote public hospitals offering maternity services were identified. There were challenges in sourcing information on maternity services to generate an accurate national picture. The nature of information about maternity services held centrally by jurisdictions varied, and different frameworks were used to describe minimum requirements for service levels. Service networks appeared to be based on a combination of individual links, geography and transport infrastructure.Conclusions. The lack of readily available centralised and comparable information on rural and remote maternity services has implications for policy review and development, equity, safety and quality, network development and planning. Accountability for services and capacity to identify problems is also compromised.What is known about the topic? Australian birthing services have previously been identified for hospitals with 50 or more births a year. Less is known about public hospitals with fewer than 50 births a year or those with only antenatal and postnatal services, particularly in rural and remote locations, or how maternity services information may be identified from publicly available sources. HEALTH SERVICES RESEARCHWhat does this paper add? This paper describes the process and challenges of identifying maternity services in rural and remote public hospitals serving towns of between 1000 and 25 000, and presents the findings of this process. What are the implications for practitioners? Nationally accessible, reliable and comparable information is important for health planners, policy makers and health practitioners. This paper provides useful information on the variations in the capability and location of maternity services across Australia. Opportunities exist for consistent collection, collation and reporting of maternity services across rural and remote Australia. This will ensure quality and safety of services, contribute to policy review, support the development and maintenance of service networks, and assist in planning services and expenditure, as well as in the identification of problems. It is therefore key to providing equitable services across the country.

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Can we count? Enumerating births in two remote Aboriginal communities in the Northern Territory

Abstract: Objective: To examine the accuracy of birth counts for two remote Aboriginal communities in the Top End of the Northern Territory.

Cited by 5 publications

References 7 publications

Improving Aboriginal maternal and infant health services in the ‘Top End’ of Australia; synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change

Improving Aboriginal maternal and infant health services in the ‘Top End’ of Australia; synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change

Entrepreneurs and Environmental Sustainability in the Digital Era: Regional and Institutional Perspectives

Identifying maternity services in public hospitals in rural and remote Australia

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