title: Measuring what matters in delivering services to remote-dwelling Indigenous mothers and infants in the Northern Territory, Australia.
abstract: OBJECTIVE
  In the Northern Territory, 64% of Indigenous births are to remote-dwelling mothers. Delivering high-quality health care in remote areas is challenging, but service improvements, informed by participative action research, are under way. Evaluation of these initiatives requires appropriate indicators. Few of the many existing maternal and infant health indicators are specifically framed for the remote context or exemplify an Indigenous consumer perspective. We aimed to identify an indicator framework with appropriate indicators to demonstrate improvements in health outcomes, determinants of health and health system performance for remote-dwelling mothers and infants from pregnancy to first birthday.
  
  
  METHODS
  We reviewed existing indicators; invited input from experts; investigated existing administrative data collections and examined findings from a record audit, ethnographic work and the evaluation of the Darwin Midwifery Group Practice.
  
  
  METHODS
  Northern Territory.
  
  
  METHODS
  About 660 potentially relevant indicators were identified. We adapted the Aboriginal and Torres Strait Islander Health Performance Framework and populated the resulting framework with chosen indicators. We chose the indicators best able to monitor the impact of changes to remote service delivery by eliminating duplicated or irrelevant indicators using expert opinion, triangulating data and identifying key issues for remote maternal and infant health service improvements.
  
  
  CONCLUSIONS
  We propose 31 indicators to monitor service delivery to remote-dwelling Indigenous mothers and infants. Our inclusive indicator framework covers the period from pregnancy to the first year of life and includes existing indicators, but also introduces novel ones. We also attempt to highlight an Indigenous consumer.
authors: University Centre for Rural Health North Coast, School of Public Health, The University of Sydney, Lismore, New South Wales, Australia. malinda.steenkamp@sydney.edu.au
authors: Malinda
authors: M
authors: Steenkamp
authors: Alice R
authors: AR
authors: Rumbold
authors: Sue
authors: S
authors: Kildea
authors: Sarah J
authors: SJ
authors: Bar-Zeev
authors: Sue
authors: S
authors: Kruske
authors: Terry
authors: T
authors: Dunbar
authors: Lesley
authors: L
authors: Barclay
mesh_terms: D055812:Community-Based Participatory Research / Q000379:methods; D005260:Female; D006303:Health Services, Indigenous / Q000592:standards*; D006801:Humans; D007223:Infant; D008430:Maternal-Child Health Centers / Q000592:standards*; D015876:Northern Territory; D011247:Pregnancy; D019984:Quality Indicators, Health Care; D019035:Rural Health Services / Q000592:standards*; D000095283:Australian Aboriginal and Torres Strait Islander Peoples