Maternal Child Health Program Derbarl Yerrigan Health Service Building on Identity and Strength: Implementation of Two New Models of Health Care 1.

Transcription

1 Maternal Child Health Program Derbarl Yerrigan Health Service Building on Identity and Strength: Implementation of Two New Models of Health Care 1. Maternal and Child Health Model of Care in the Aboriginal Controlled Health Sector 2. Aboriginal Health Worker and Midwifery Led Antenatal and Postnatal Care

2 Noongar People...

3 The Team Gai l Jil l Pam Rache l Lie sl

4 Gail Yarran Registered Nurse The Bridge

5 The underlying aim in providing maternity care is to improve outcomes for women and their infants. Australian Government Department of Health. (2009) Improving maternity service in Australia. The report of the maternity services review. 3.2 Indigenous. Retrieved November 1 st, 2016 from: KEYISSUES~MSR-REPORT-INEQUALITY~MSR-REPORT-INDIGENOUS

6 Indigenous women are less likely to access antenatal care in the first trimester of pregnancy when many risk factors could be addressed.

7 When services are not culturally appropriate, women are less likely to attend.

8 Objectives - to answer the questions: 1. Why is culturally sensitive care so imperative? 2. Why is Maternal Child Health important? 3. Why do we do it, how do we do it, what do we do? 4. What models of care do we use? 5. How do we perform against national key performance indicators?

9 Implementation of Two New Models of Health Care 1.Maternal and Child Health Model of Care in the Aboriginal Controlled Health Sector 2.Aboriginal Health Worker and Midwifery Led Antenatal and Postnatal Care

10 People s beliefs matter...

11 In order to treat me equally you may have to treat me differently. Equal opportunities commission

12 Maternal and Child Health Model Community-based and/or community controlled services A specific service location intended for women and children Providing continuity of care and broad spectrum of service Integration with other services Outreach activities Home visiting A welcoming and safe environment Flexibility in service delivery and appointment times Focus on communication, relationship building, and development of trust Respect for Aboriginal and Torres Strait Islander people and their culture Respect for family involvement in health issues and child care Having an appropriately trained workforce Valuing Aboriginal and Torres Strait Islander staff and female staff Provision of transport Provision of childcare of playgroups. MCH models of care are most effective a meeting families needs and tackling inequalities when they are planned and delivered within a community focused and culturally secure health and social model of care. Integration of MCH within a comprehensive primary health model which values multiagency working is a key means of delivering this model of care. McHugh, A-M. and Hornbuckle, J. (2011). Maternal and Child Health Model of Care in the Aboriginal Community Controlled Health Sector. Aboriginal Health Council of Western Australia

13 Objective of MCH model of care: To halve the gap in mortality rates for Indigenous children under five within a decade Progress towards these outcomes will be achieved by integrated service provision to: Improve uptake or early antenatal care Address early detection of and initiate action to address developmental delay, abnormalities and ill-health Supporting strong parent-child attachment and positive parenting resulting in better social and emotional wellbeing and readiness to learn Care that safeguards children and keeps them healthy Prevention of serious and communicable diseases Identification of factors that could influence the health and well being in families Better short term and long term outcomes for women, children and families who are at risk of social exclusion Improving immediate health of mums and bubs Improving long term health of the population

14 Maternal and Child Health Model of Care Principles: All Aboriginal and Torres Strait Islander families will have access to high quality integrated services with the overall aim of minimizing health inequalities A focus on prevention and early intervention Commitment to collaboration across all stakeholders Recognition of the importance of pregnancy, childbirth and early childhood as personal, cultural, family and social experiences. Safe evidence based MCH care provision is paramount cultural safety is inherent within this principles Recognition of the importance of consumer engagement and community participation as integral to the planning, implementation and evaluation of clinical care provided The Model of Care will be underpinned by a clinical governance framework which supports the quality of car provided by: Encouraging clinical excellence Enabling a culture of continuous quality improvement Ensuring integrated continuity of care for families via clear referral pathways and formalized networks Ensuring clear accountability for all care provided Hornbuckle, A-M. and Hornbuckle, J. (2011). Maternal and Child Health Model of Care in the Aboriginal Community Controlled Health Sector. Aboriginal Health Council of Western Australia.

15 Aboriginal Health Worker and Midwifery Led Antenatal and Postnatal Model of Care Eligible Midwives Uncomplicated pregnancies Shared referrals for complex needs GPs Consultants Tertiary Hospitals

16 - Culturally sensitive care. - Culturally appropriate care. - Health care delivery that way the client needs it.

17 3 1 Why? To empower parents to care for their babies and themselves to the best of their ability To give choice Knowledge To make a difference Better health outcomes for babies and mums How? What? Pregnancy cares Immunizations Monitoring developmental milestones Pap smears Sexual health Education 2 Culturally Safe Advocacy Support Midwifery and Aboriginal Health Worker led care Community informed Woman centered Community engagement Referrals

18 National Key Performance Indicators (4 for Maternal Child Health) 1. Birth weights recorded 2. Smoking status of women who gave birth 3. First antenatal care visit 4. Immunisation rates Plus related NKPIs (including by not specific to Maternal Child Health) 5. Cervical Screening 6. Health assessments and early detection of chronic disease

19 80% Percentage of Indigenous Babies born in previous 12 months where birthweights were recorded. 70% 60% 50% 40% 30% 20% 10% 0% DYHS Service Western Australia Major Cities National Jun-15 Jun-16

20 Service Overview Immunisation Rates: age and year category of Indigenous children who are fully immunised. 77% 87% 96% 47% 62% 54% IMMUNISATION: CHILDREN 12 TO <24 MONTHS IMMUNISATION: CHILDREN 24 TO <36 MONTHS IMMUNISATION: CHILDREN 60 TO<72 MONTHS

21 1600 Pap Smears performed by DYHS

22 First, children are the future of society, and their mothers are guardians of that future. Mothers are much more than caregivers and homemakers, undervalued as these roles often are. They transmit the cultural history of families and communities along with social norms and traditions. Mothers influence early behaviour and establish lifestyle patterns that not only determine their children s future development and capacity for health, but shape societies. Because of this, society values the health of its mothers and children for its own sake and not merely a a contribution to the wealth of the nation. World Health Organisation 2005

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