Sustainable antenatal care services in an urban Indigenous community: the Townsville experience.
OBJECTIVE
To evaluate the impact of a sustained, community-based collaborative approach to antenatal care services for Indigenous women.


METHODS
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.


METHODS
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).


CONCLUSIONS
Sustained access to a community-based, integrated, shared antenatal service has improved perinatal outcomes among Indigenous women in Townsville.
Panaretto
Kathryn S
KS
Townsville Aboriginal and Islanders Health Service, Townsville, Queensland, Australia. katiepanaretto@qaihc.com.au
Mitchell
Melvina R
MR
Anderson
Lynette
L
Larkins
Sarah L
SL
Manessis
Vivienne
V
Buettner
Petra G
PG
Watson
David
D
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006303:Health Services, Indigenous; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care; D015397:Program Evaluation; D011793:Queensland; D019037:Urban Health Services