title: Elements of cultural competence in an Australian Aboriginal maternity program.
abstract: BACKGROUND
  Pregnancy, labour and neonatal health outcomes for Australian Aboriginal women and their infants are frequently worse than those of the general population. Provision of culturally competent services may reduce these differences by improving access to timely and regular antenatal care. In an effort to address these issues, the Aboriginal Maternity Group Practice Program commenced in south metropolitan Perth, Western Australia, in 2011. The program employed Aboriginal Grandmothers, Aboriginal Health Officers and midwives working in a partnership model with pre-existing maternity services in the area.
  
  
  OBJECTIVE
  To identify elements of the Aboriginal Maternity Group Practice Program that contributed to the provision of a culturally competent service.
  
  
  METHODS
  The Organisational Cultural Competence Assessment Tool was used to analyse qualitative data obtained from surveys of 16 program clients and 22 individuals from partner organisations, and interviews with 15 staff.
  
  
  RESULTS
  The study found that the partnership model positively impacted on the level of culturally appropriate care provided by other health service staff, particularly in hospitals. Two-way learning was a feature. Providing transport, team home visits and employing Aboriginal staff improved access to care. Grandmothers successfully brought young pregnant women into the program through their community networks, and were able to positively influence healthy lifestyle behaviours for clients.
  
  
  CONCLUSIONS
  Many elements of the Aboriginal Maternity Group Practice Program contributed to the provision of a culturally competent service. These features could be considered for inclusion in antenatal care models under development in other regions with culturally diverse populations.
authors.affiliation: South Metropolitan Population Health Unit, Western Australian Department of Health, Australia. Electronic address: christina.bertilone@health.wa.gov.au.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Bertilone
authors.affiliation: South Metropolitan Population Health Unit, Western Australian Department of Health, Australia.
authors.forename: Suzanne P
authors.initials: SP
authors.lastname: McEvoy
authors.affiliation: South Metropolitan Population Health Unit, Western Australian Department of Health, Australia.
authors.forename: Dena
authors.initials: D
authors.lastname: Gower
authors.affiliation: South Metropolitan Population Health Unit, Western Australian Department of Health, Australia.
authors.forename: Nola
authors.initials: N
authors.lastname: Naylor
authors.affiliation: South Metropolitan Population Health Unit, Western Australian Department of Health, Australia.
authors.forename: June
authors.initials: J
authors.lastname: Doyle
authors.affiliation: South Metropolitan Population Health Unit, Western Australian Department of Health, Australia.
authors.forename: Val
authors.initials: V
authors.lastname: Swift-Otero
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D054521:Cultural Competency; D018864:Cultural Diversity; D005260:Female; D006303:Health Services, Indigenous / Q000592:standards*; D006771:Hospitals, Maternity / Q000592:standards*; D006801:Humans; D009721:Nurse Midwives / Q000592:standards*; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D011795:Surveys and Questionnaires; D014904:Western Australia
keywords: Aboriginal; Antenatal care; Culturally competent care; Indigenous health services; Pregnancy