Abstract
Introduction: In Australia, maternal mortality, low birthweight, preterm birth, perinatal death and infant mortality are substantially higher for Aboriginal and Torres Strait Islander (called ‘Aboriginal’ hereafter) mothers and babies. Numerous government reports and inquiries have recommended that strategies to improve outcomes are urgently needed. Caseload midwifery is considered to be the ‘gold standard’ in maternity care, and is associated with better clinical and psychosocial outcomes however few Aboriginal women have access to this model.
Aim: We are undertaking a large National Health and Medical Research Council funded Partnership Project which aims to assess the research translation capacity of maternity services to implement, embed and sustain a caseload model specifically for Aboriginal women (and non-Aboriginal women having Aboriginal babies).
Methods: During 2017 and 2018, one regional and three metropolitan Victorian public hospitals began implementing and proactively offering caseload midwifery to Aboriginal women. We are measuring clinical outcomes, caseload uptake, economic impact, and acceptability of the model. Ethics approval has been obtained.
Results: Prior to the project commencing non-Aboriginal women were substantially less likely to receive caseload care. Since the model commenced at the first project site (March 2017), there has been a substantial increase in the number of Aboriginal women receiving caseload. Challenges in implementation at two sites related to revision of industrial agreements and lack of staff across the health service.
Conclusion and implications: Early findings show a subtantial increase in uptake of caseload at the first sites to proactively offer caseload to Aboriginal women with qualitative data to date showing high levels of satisfaction. A crucial aspect of project success to date has been engagement and collaboration with key Aboriginal community stakeholders. Models such as these can only succeed if they are based on the needs of women and their communities and ongoing consultation and engagement.
