Pragmatic indicators for remote Aboriginal maternal and infant health care: why it matters and where to start.
OBJECTIVE
There are challenges in delivering maternal and infant health (MIH) care to remote Northern Territory (NT) communities. These include fragmented care with birthing in regional hospitals resulting in cultural and geographical dislocation for Aboriginal women. Many NT initiatives are aimed at improving care. Indicators for evaluating these for remote Aboriginal mothers and infants need to be clearer. We reviewed existing indicators to inform a set of pragmatic indicators for reporting improvement in remote MIH care.


METHODS
Scientific databases and grey literature (organisational websites and Google Scholar) were searched using the terms 'Aboriginal/maternal/infant/remote health/monitoring performance'. Key stakeholders identified omitted indicators sets. Relevant sets were reviewed and organised by indicator type, stage of patient journey, topic and theme.


RESULTS
Forty-two indicators sets were found. Seven focused on Aboriginal health, 23 on reproductive/maternal health, eight on child/infant health and four on other aspects, e.g. remote health. We identified more than 1,000 individual indicators. Of these, 656 were relevant for our purpose and were subsequently organised into 300 topics and 16 themes for antenatal, birth and postpartum, and infant care by indicator type.


CONCLUSIONS
There are many measures for monitoring health care delivery to mothers and infants. Few are framed around remote MIH services, despite poorer health outcomes of remote mothers and infants and the specific challenges with providing care in this setting. Establishing relevant indicators is vital to support relevant data collection and the development of appropriate policy for remote Aboriginal maternal and infant care.
Steenkamp
Malinda
M
Department of Rural Health, Northern Rivers University, School of Public Health, New South Wales. malinda.steenkamp@sydney.edu.au
Bar-Zeev
Sarah
S
Rumbold
Alice
A
Barclay
Lesley
L
Kildea
Sue
S
D002648:Child; D002662:Child Health Services / Q000592:standards*; D003266:Continuity of Patient Care / Q000592:standards*; D005260:Female; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D008427:Maternal Health Services / Q000592:standards*; D008429:Maternal Welfare; D015876:Northern Territory; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D019984:Quality Indicators, Health Care; D012424:Rural Population