Enabling the context for Aboriginal and Torres Strait Islander Community Controlled Birthing on Country services: Participatory action research.

Roe, Y; Allen, J; Haora, P; Hickey, S; Briggs, M; Wilkes, L; Nelson, C; Watego, K; Coddington, R; Ireland, S; Kruske, S; Gao, Y; Kildea, S

Enabling the context for Aboriginal and Torres Strait Islander Community Controlled Birthing on Country services: Participatory action research.

Roe, Y Allen, J Haora, P Hickey, S Briggs, M Wilkes, L Nelson, C Watego, K Coddington, R Ireland, S Kruske, S

Gao, Y Kildea, S

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Publisher:: Elsevier
Publication Type:: Journal Article
Citation:: Women Birth, 2023, 37, (2), pp. 368-378
Issue Date:: 2023-12-13

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Field	Value	Language
dc.contributor.author	Roe, Y
dc.contributor.author	Allen, J
dc.contributor.author	Haora, P
dc.contributor.author	Hickey, S
dc.contributor.author	Briggs, M
dc.contributor.author	Wilkes, L
dc.contributor.author	Nelson, C
dc.contributor.author	Watego, K
dc.contributor.author	Coddington, R
dc.contributor.author	Ireland, S
dc.contributor.author	Kruske, S https://orcid.org/0000-0002-2317-3954
dc.contributor.author	Gao, Y
dc.contributor.author	Kildea, S
dc.date.accessioned	2024-03-15T05:09:53Z
dc.date.available	2023-11-24
dc.date.available	2024-03-15T05:09:53Z
dc.date.issued	2023-12-13
dc.identifier.citation	Women Birth, 2023, 37, (2), pp. 368-378
dc.identifier.issn	1871-5192
dc.identifier.issn	1878-1799
dc.identifier.uri	http://hdl.handle.net/10453/176785
dc.description.abstract	PROBLEM: Establishment of Birthing on Country services owned and governed by Aboriginal and Torres Strait Islander Community Controlled Health Services has been slow. BACKGROUND: Birthing on Country services have demonstrated health and cost benefits and require redesign of maternity care. During the Building On Our Strengths feasibility study, use of endorsed midwives and licensing of birth centres has proven difficult. QUESTION: What prevents Community Controlled Health Services from implementing Birthing on Country services in Queensland and New South Wales? METHODS: Participatory action research identified implementation barriers. We conducted iterative document analysis of instruments to inform government lobbying through synthesis of policy, economic, social, technological, legal, and environmental factors. FINDINGS: Through cycles of participatory action research, we analysed 17 documents: 1) policy barriers prevent Community Controlled Health Services from employing endorsed midwives to provide intrapartum care in public hospitals; 2) economic barriers include lack of sustainable funding stream and inadequate Medicare-billing for endorsed midwives; and 3) legal barriers require a medical practitioner in a birth centre. While social barriers (e.g., colonisation, medicalisation) underpin regulations, these were beyond the scope; technological and environmental barriers were not identified. DISCUSSION: Findings are consistent with the literature on barriers to midwifery practice. Recommendations include a national audit of barriers to Birthing on Country services including healthcare practice insurance, and development of a funding stream. Additionally, private maternity facility regulation must align with evidence on safe birth centre operation. CONCLUSION: Government can address barriers to scale-up of Aboriginal and Torres Strait Islander Community Controlled Birthing on Country services.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier
dc.relation.ispartof	Women Birth
dc.relation.isbasedon	10.1016/j.wombi.2023.11.007
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	11 Medical and Health Sciences
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.subject.classification	3215 Reproductive medicine
dc.subject.classification	4204 Midwifery
dc.subject.mesh	Humans
dc.subject.mesh	Pregnancy
dc.subject.mesh	Aged
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Health Services, Indigenous
dc.subject.mesh	Medicare
dc.subject.mesh	Health Services Research
dc.subject.mesh	United States
dc.subject.mesh	Queensland
dc.subject.mesh	Female
dc.subject.mesh	Australian Aboriginal and Torres Strait Islander Peoples
dc.title	Enabling the context for Aboriginal and Torres Strait Islander Community Controlled Birthing on Country services: Participatory action research.
dc.type	Journal Article
utslib.citation.volume	37
utslib.location.activity	Netherlands
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access	*
dc.date.updated	2024-03-15T05:09:51Z
pubs.issue	2
pubs.publication-status	Published online
pubs.volume	37
utslib.citation.issue	2

Abstract:

PROBLEM: Establishment of Birthing on Country services owned and governed by Aboriginal and Torres Strait Islander Community Controlled Health Services has been slow. BACKGROUND: Birthing on Country services have demonstrated health and cost benefits and require redesign of maternity care. During the Building On Our Strengths feasibility study, use of endorsed midwives and licensing of birth centres has proven difficult. QUESTION: What prevents Community Controlled Health Services from implementing Birthing on Country services in Queensland and New South Wales? METHODS: Participatory action research identified implementation barriers. We conducted iterative document analysis of instruments to inform government lobbying through synthesis of policy, economic, social, technological, legal, and environmental factors. FINDINGS: Through cycles of participatory action research, we analysed 17 documents: 1) policy barriers prevent Community Controlled Health Services from employing endorsed midwives to provide intrapartum care in public hospitals; 2) economic barriers include lack of sustainable funding stream and inadequate Medicare-billing for endorsed midwives; and 3) legal barriers require a medical practitioner in a birth centre. While social barriers (e.g., colonisation, medicalisation) underpin regulations, these were beyond the scope; technological and environmental barriers were not identified. DISCUSSION: Findings are consistent with the literature on barriers to midwifery practice. Recommendations include a national audit of barriers to Birthing on Country services including healthcare practice insurance, and development of a funding stream. Additionally, private maternity facility regulation must align with evidence on safe birth centre operation. CONCLUSION: Government can address barriers to scale-up of Aboriginal and Torres Strait Islander Community Controlled Birthing on Country services.

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http://hdl.handle.net/10453/176785