Sustainable antenatal care services in an urban Indigenous community: the Townsville experience
Panaretto, Kathryn S., Mitchell, Melvina R., Anderson, Lynette, Larkins, Sarah L., Manessis, Vivienne, Buettner, Petra G., and Watson, David (2007) Sustainable antenatal care services in an urban Indigenous community: the Townsville experience. Medical Journal of Australia, 187 (1). pp. 18-22.
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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.