scholarly journals He Korowai Manaaki (Pregnancy Wraparound Care): Study Protocol for a Cluster Randomised Clinical Trial (Preprint)

2020 ◽  
Author(s):  
Bev Lawton ◽  
Francesca Storey ◽  
Nokuthaba Sibanda ◽  
Matthew Bennett ◽  
Charles Lambert ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Maternity Care ◽  
Infant Health ◽  
Care Pathway ◽  
Randomised Clinical Trial ◽  
Health And Wellbeing ◽  
Cluster Randomised ◽  
Maternal And Infant Health ◽  
Care Practices ◽  
Primary Care Practices

BACKGROUND Maternal and infant health inequities between Māori (the Indigenous peoples of Aotearoa New Zealand) and New Zealand European (NZE) women are well documented and cannot be explained solely by socioeconomic status. A research centre-iwi (tribal group) partnership aims to address these disparities and improve maternal and infant health outcomes by implementing an augmented maternity care pathway (He Korowai Manaaki) to improve access to services and evidence informed care. OBJECTIVE The objective of this study is to test whether an augmented maternity care pathway improves Māori infant health outcomes. METHODS This is a Kaupapa Māori (by, with and for Māori) cluster randomised clinical trial involving eight primary care practices allocated to either an intervention or control arm. The intervention arm comprises an augmented maternity care pathway (He Korowai Manaaki) offering clinical care through additional paid health care appointments and improved access to social supports (e.g. housing, transport). The control arm is usual care. The primary outcome is increased timely vaccination for Māori infants, defined as all age appropriate vaccinations completed by 6 months of age. RESULTS Recruitment commenced in November 2018 and was completed June 2020 with 251 enrolled women recruited in intervention primary care practices before 20 weeks pregnant. Publication of results is anticipated late 2023. CONCLUSIONS The results will inform primary health care policy including whether the provision of augmented maternal care pathways reduces disparities in the structural determinants of health. If effective He Korowai Manaaki will strengthen the health and wellbeing of pregnant Māori women and their babies and improve their health outcomes, laying a strong foundation for lifelong health and wellbeing. CLINICALTRIAL ACTRN12619001155189 http://www.ANZCTR.org.au/ACTRN12619001155189.aspx

Birthing on Country (in Our Community): a case study of engaging stakeholders and developing a best-practice Indigenous maternity service in an urban setting

2018 ◽  
Vol 42 (2) ◽  
pp. 230 ◽  
Author(s):  
Sue Kildea ◽  
Sophie Hickey ◽  
Carmel Nelson ◽  
Jody Currie ◽  
Adrian Carson ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Maternity Care ◽  
Best Practice ◽  
Torres Strait Islander ◽  
Infant Health ◽  
Urban Setting ◽  
World Cafe ◽  
Maternal And Infant Health ◽  
Torres Strait ◽  
Partnership Program

Developing high-quality and culturally responsive maternal and infant health services is a critical part of ‘closing the gap’ in health disparities between Aboriginal and Torres Strait Islander people and other Australians. The National Maternity Services Plan led work that describes and recommends Birthing on Country best-practice maternity care adaptable from urban to very remote settings, yet few examples exist in Australia. This paper demonstrates Birthing on Country principles can be applied in the urban setting, presenting our experience establishing and developing a Birthing on Country partnership service model in Brisbane, Australia. An initial World Café workshop effectively engaged stakeholders, consumers and community members in service planning, resulting in a multiagency partnership program between a large inner city hospital and two local Aboriginal Community-Controlled Health Services (ACCHS). The Birthing in Our Community program includes: 24/7 midwifery care in pregnancy to six weeks postnatal by a named midwife, supported by Indigenous health workers and a team coordinator; partnership with the ACCHS; oversight from a steering committee, including Indigenous governance; clinical and cultural supervision; monthly cultural education days; and support for Indigenous student midwives through cadetships and placement within the partnership. Three years in, the partnership program is proving successful with clients, as well as showing early signs of improved maternal and infant health outcomes. What is known about the topic? Birthing on Country has been described as a metaphor for the best start in life for Aboriginal and Torres Strait Islander babies, and services that incorporate Birthing on Country principles can improve outcomes for mothers and babies. Currently, few such models exist in Australia. What does this paper add? This paper demonstrates that Birthing on Country principles can be successfully applied to the urban context. We present a real case example of the experience of setting up one such best-practice, community-engaged and informed partnership model of maternity and child healthcare in south-east Queensland. We share our experience using a World Café to facilitate community engagement, service delivery and workforce planning. What are the implications for practitioners? Health professionals providing maternity care for Aboriginal and Torres Strait Islander families are encouraged to incorporate Birthing on Country principles into their model of care to address the specific needs and demands of the local Indigenous community and improve maternal and infant health outcomes.

scholarly journals Effect of a Community Agency–Administered Nurse Home Visitation Program on Program Use and Maternal and Infant Health Outcomes

2019 ◽  
Vol 2 (11) ◽  
pp. e1914522 ◽  
Author(s):  
Kenneth A. Dodge ◽  
W. Benjamin Goodman ◽  
Yu Bai ◽  
Karen O’Donnell ◽  
Robert A. Murphy
Keyword(s):  
Health Outcomes ◽  
Infant Health ◽  
Home Visitation ◽  
Community Agency ◽  
Nurse Home ◽  
Maternal And Infant Health ◽  
Home Visitation Program

scholarly journals The Price of Labor: Evaluating the Impact of Eliminating User Fees on Maternal and Infant Health Outcomes

2018 ◽  
Vol 108 ◽  
pp. 412-415
Author(s):  
Anne Fitzpatrick
Keyword(s):  
Health Outcomes ◽  
Infant Health ◽  
Geographic Area ◽  
User Fees ◽  
African Countries ◽  
Maternal And Infant Health ◽  
User Fee ◽  
Sub Saharan ◽  
Dhs Surveys ◽  
The Impact

Since 2001, several sub-Saharan African countries have eliminated user fees for childbirth. Although intended to improve maternal and infant health outcomes, service quality also fell as facilities became overburdened. In this paper I combine DHS surveys on births from countries eliminating user fees. I identify the effect of user fee elimination using (i) a maternal fixed effect and (ii) an event study within a small geographic area. I find that user fees increase the likelihood of delivery at public sector facilities by 2-7 percentage points. I also find that user fee elimination reduces maternal mortality but may increase neonatal mortality.

scholarly journals Outcomes of Care for 1,892 Doula-Supported Adolescent Births in the United States: The DONA International Data Project, 2000 to 2013

2018 ◽  
Vol 27 (3) ◽  
pp. 135-147 ◽  
Author(s):  
Courtney L. Everson ◽  
Melissa Cheyney ◽  
Marit L. Bovbjerg
Keyword(s):  
United States ◽  
Health Outcomes ◽  
Infant Health ◽  
Perinatal Care ◽  
The United States ◽  
National Sample ◽  
Outcomes Of Care ◽  
Adolescent Deliveries ◽  
Maternal And Infant Health ◽  
International Data

This is the largest study to-date to report on outcomes of care for a national sample of doula-supported adolescent births (n = 1,892, birth years 2000 to 2013). Descriptive statistics were calculated for maternal demographics, risk profiles, labor/birth interventions and occurrences, and birth outcomes. In this national sample, childbearing adolescents and their neonates experienced improved health outcomes and lower rates of intervention relative to national statistics for adolescent deliveries in the United States. Key findings are consistent with previous studies on the effects of doula care for marginalized and medically underserved communities. Results strengthen the case for doulas as a perinatal care strategy for improving maternal and infant health outcomes and decreasing inequities among childbearing adolescents.

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