Primary health care for Aboriginal women and children in the year after birth: findings from a population-based study in South Australia.
OBJECTIVE
To investigate the extent to which Aboriginal women access primary care for themselves and their infant in the year after childbirth.


METHODS
Cross sectional population-based survey of women giving birth to Aboriginal babies in South Australia between July 2011 and June 2013.


RESULTS
A total of 344 women took part in the study 4-9 months after giving birth. The majority had seen a primary health care practitioner since the birth: 86% had seen a Child and Family Health Service (CaFHS) nurse, 81% a general practitioner (GP), and 61% an Aboriginal health worker (AHW). Women living in remote areas were more likely to have seen primary care practitioners than women living in Adelaide (GP: OR 2.3, 95% CI 1.0-5.2; CaFHS: OR 2.4, 95% CI 1.0-5.8; AHW: OR 5.2, 95% CI 2.8-9.8). Around 16% of women with gestational diabetes and 10% with hypertension had not seen a GP since the birth, and 24% of women who had a low birthweight infant had not seen a CaFHS nurse.


CONCLUSIONS
Despite high prevalence of maternal and infant morbidity, a sizeable minority of women did not access primary care practitioners postpartum. Implications for public health: Stronger efforts are needed to ensure Aboriginal women and families receive appropriate postnatal follow-up.
Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Victoria. jane.yelland@mcri.edu.au.|General Practice Academic Centre, University of Melbourne, Victoria. jane.yelland@mcri.edu.au.
Jane
J
Yelland
Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Victoria.
Donna
D
Weetra
Women's and Children's Health Network, Department for Health and Ageing, Government of South Australia.
Deanna
D
Stuart-Butler
Women's and Children's Health Network, Department for Health and Ageing, Government of South Australia.
Janiene
J
Deverix
Women's and Children's Health Network, Department for Health and Ageing, Government of South Australia.
Cathy
C
Leane
Women's and Children's Health Network, Department for Health and Ageing, Government of South Australia.
Jackie
J
Ah Kit
South Australian Health and Medical Research Institute.|Pangula Mannamurna Inc, South Australia.
Karen
K
Glover
Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Victoria.
Deirdre
D
Gartland
Department of Rural Health, University of Adelaide South Australia.
Jonathan
J
Newbury
Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Victoria.|General Practice Academic Centre, University of Melbourne, Victoria.|South Australian Health and Medical Research Institute.
Stephanie
S
Brown
D000293:Adolescent; D000328:Adult; D002662:Child Health Services / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006303:Health Services, Indigenous / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D013021:South Australia; D055815:Young Adult
Aboriginal maternal and child health; health disparities; population-based study; postpartum; primary health care