Rural Maternity Care

Couchie, Carol; Ehman, William; Graves, Lisa; Grzybowski, Stefan; Medves, Jennifer; Dupuis, Kaitlin; Dunikowski, Lynn; Marturano, Patricia; Senikas, Vyta; Wilson, Ruth; Wootton, John

doi:10.1016/s1701-2163(16)35414-7

Cited by 25 publications

(14 citation statements)

References 21 publications

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“… • Generalists often perform less complex gastrointestinal endoscopies. Miller et al [ 93 ] Canada 2012 Position paper and a literature review • Provides an overview of current information on issues in maternity care relevant to rural populations. • Importance of collaborative practice models in rural and remote maternity care, including GP surgeons (with obstetrics) and GP anaesthetists, with support from enhanced roles for nurses and nurse practitioners.…”

Section: Resultsmentioning

confidence: 99%

International approaches to rural generalist medicine: a scoping review

Schubert

Evans

Battye³

et al. 2018

Hum Resour Health

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BackgroundContemporary approaches to rural generalist medicine training and models of care are developing internationally as part of an integrated response to common challenges faced by rural and remote health services and policymakers (addressing health inequities, workforce shortages, service sustainability concerns). The aim of this study was to review the literature relevant to rural generalist medicine.MethodsA scoping review was undertaken to answer the broad question ‘What is documented on rural generalist medicine?’ Literature from January 1988 to April 2017 was searched and, after final eligibility filtering (according to established inclusion and exclusion criteria), 102 articles in English language were included for final analysis.ResultsIncluded papers were analysed and categorised by geographic region, study design and subject themes. The majority of articles (80%) came from Australia/New Zealand and North America, reflecting the relative maturity of programmes supporting rural generalist medicine in those countries. The most common publication type was descriptive opinion pieces (37%), highlighting both a need and an opportunity to undertake and publish more systematic research in this area.Important themes emerging from the review were:DefinitionExisting pathways and programmesScope of practice and service modelsEnablers and barriers to recruitment and retentionReform recommendationsThere were some variations to, or criticisms of, the definition of rural generalist medicine as applied to this review, although this was only true of a small number of included articles. Across remaining themes, there were many similarities and consistent approaches to rural generalist medicine between countries, with some variations reflecting environmental context and programme maturity. This review identified recent literature from countries with emerging interest in rural generalist medicine in response to problematic rural health service delivery.ConclusionsSupported, coordinated rural generalist medicine programmes are being established or developed in a number of countries as part of an integrated response to rural health and workforce concerns. Findings of this review highlight an opportunity to better share the development and evaluation of best practice models in rural generalist medicine.

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Section: Resultsmentioning

confidence: 99%

International approaches to rural generalist medicine: a scoping review

Schubert

Evans

Battye³

et al. 2018

Hum Resour Health

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“…The Society of Obstetricians and Gynaecologists of Canada (SOGC) noted in a joint position paper on “Rural Maternity Care” that in instances in which women need to leave their community for birth, they “should be supported both financially and emotionally” [ 31 ]. This was not the case among women who participated in our study as there were no additional financial supports to offset the cost and emotional burden of traveling for maternity care [ 31 ]. The delivery of HMHB as a CPNP program in rural Alberta, however, enabled providers to facilitate the women’s health in pregnancy and postpartum.…”

Section: Discussionmentioning

confidence: 99%

Nurturing maternal health in the midst of difficult life circumstances: a qualitative study of women and providers connected to a community-based perinatal program

Quintanilha

Mayan

Raine

et al. 2018

BMC Pregnancy Childbirth

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BackgroundMany socioecological and structural factors affect women’s diets, physical activity, and her access and receptivity to perinatal care. We sought to explore women’s and providers’ perceptions and experiences of health in the pre- and post-natal period while facing difficult life circumstances, and accessing a community-based program partially funded by Canada Prenatal Nutrition Program (CPNP) in Alberta, Canada.MethodsFollowing the principles of community-based participatory research, we conducted a focused ethnography that involved five focus groups with women (28 in total), eight one-on-one interviews with program providers, and observations of program activities. Data were analyzed through qualitative content analysis to inductively derive codes and categories.ResultsWomen perceived eating healthy foods, taking prenatal vitamins, and being physically active as key health behaviours during pregnancy and postpartum. However, they were commonly coping with many difficult life circumstances, and faced health barriers for themselves and their babies. These barriers included pregnancy or birth complications, family and spousal issues, financial difficulties, and living rurally. On the other hand, women and providers identified many aspects of the community-based program that addressed the burden of adversities as enablers to better health during pregnancy and postpartum.ConclusionCommunity-based programs have an important role in alleviating some of the burden of coping with difficult life circumstances for women. With such potential, community-based programs need to be well supported through policies. Policies supporting these programs, and ensuring adequate funding, can enable more equitable services to rural women and truly promote maternal health during pregnancy and postpartum.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-1951-6) contains supplementary material, which is available to authorized users.

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“…5. Stimulating physician interest to practice in remote areas through multiple approaches: encouragement of interprofessional health care teams, establishment of appropriate remuneration models that reflect population demand and skills required to address rural health-related challenges 13 and use of technology to facilitate distant learning. Facilitating the development of interprofessional and collaborative health care teams would also be conducive to the provision of integrated and higher-quality care, and the diffusion of workload placed on individual physicians.…”

Section: Proposed Recommendationsmentioning

confidence: 99%

“…Facilitating the development of interprofessional and collaborative health care teams would also be conducive to the provision of integrated and higher-quality care, and the diffusion of workload placed on individual physicians. 13 Ultimately, while these approaches will require years of investment and effort to make a recognizable impact, they are intended to offer lasting improvements in both the quality and availability of rural maternity care services.…”

Section: Proposed Recommendationsmentioning

confidence: 99%