An holistic economic evaluation of an Aboriginal community-controlled midwifery programme in Western Sydney

Jan, Stephen; Conaty, Stephen; Hecker, Rosalind; Bartlett, Mark J.; Delaney, Sheilah; Capon, Anthony

doi:10.1258/135581904322716067

Cited by 39 publications

(135 citation statements)

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“…Interventions in Guatemala [83][84][85] attempted to integrate local Indigenous practices with biomedical care practices but did not sufficiently involve Indigenous community members in the design or implementation stages, which led to a birthing centre that was unused for three months and services that excluded Mayan midwives 83,90,91 and the United States of America 81,91 provide examples of successful culturally safe maternal healthcare programs that have been community controlled. These programs empowered participants, built trusting patient-provider relationships, improved preconception health knowledge and improved the health outcomes of mothers and babies 83,90,91 . To increase the likelihood of success, culturally safe programs should be developed with the input and participation of the target Indigenous community 83,90,91 .…”

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confidence: 99%

“…These programs empowered participants, built trusting patient-provider relationships, improved preconception health knowledge and improved the health outcomes of mothers and babies 83,90,91 . To increase the likelihood of success, culturally safe programs should be developed with the input and participation of the target Indigenous community 83,90,91 . The existence of health inequities between Indigenous and non-Indigenous women in urban areas reinforces the need to address structural barriers to health.…”

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confidence: 99%

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Canadian Indigenous Womens Perspectives of Maternal Health and Health Care Services: A Systematic Review

Sharma¹,

Kolahdooz²,

Launier³

et al. 2016

Divers Equal Health Care

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Development of policies and interventions to address health disparities between Indigenous and non-Indigenous populations requires a comprehensive understanding of Indigenous people's experiences and perspectives of healthcare services. We systematically reviewed the published literature on Canadian Indigenous women's experiences and perspectives of maternal healthcare during pregnancy, childbirth, and the postpartum period. Major bibliographic databases (including PubMed, CINAHL, EMBASE, SCOPUS, and SSCI) were searched for published studies (1990( -March 2015 in English. Reference lists of identified articles were searched to identify additional articles. 92 articles were retrieved for further review, of which 16 studies were included: 8 on maternal healthcare and/or medical evacuation; 3 on gestational diabetes mellitus; 3 on the impact of policies on maternal health; and 2 on maternal weight changes and/or breastfeeding. The included studies described 1043 participants: Indigenous peoples (n=918) and non-Indigenous peoples (n=125) who were mothers or pregnant women (n=814), healthcare providers or workers in a health-related field (n=132), and fathers, Elders, or other community members (n=97). Availability of healthcare resources, healthcare services' consideration of socio-economic or lifestyle barriers to health, and the impact of colonization on interactions with healthcare providers were main factors that impacted Indigenous women's maternal health experiences. Medical evacuation was often due to limited maternity care options available in remote communities, and was associated with emotional, physical, and financial stress. This review highlights the importance of consistent health policies and practices for maternal health in Canada and providing culturally safe and patient-centered maternity healthcare services within indigenous communities.

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confidence: 99%

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confidence: 99%

Canadian Indigenous Womens Perspectives of Maternal Health and Health Care Services: A Systematic Review

Sharma¹,

Kolahdooz²,

Launier³

et al. 2016

Divers Equal Health Care

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“…All studies but two were conducted in high-income, OECD-member countries: Australia ( n = 6) (Nel and Pashen 2003; Jan et al 2004; NSW Health 2005; Panaretto et al 2005, 2007; Kildea et al 2012), the United States of America (USA) ( n = 4) (Julnes et al 1994; Thompson et al 1998; Jewell and Russell 2000; Marsiglia et al 2010), the United Kingdom (UK) ( n = 2) (Mason 1990; Parsons and Day 1992) and Israel ( n = 1) (Bilenko et al 2007). The two exceptions were conducted in Peru (McQuestion and Velasquez 2006; Gabrysch et al 2009).…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of interventions to provide culturally appropriate maternity care in increasing uptake of skilled maternity care: a systematic review

Coast

Jones

Lattof

et al. 2016

Health Policy Plan.

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Addressing cultural factors that affect uptake of skilled maternity care is recognized as an important step in improving maternal and newborn health. This article describes a systematic review to examine the evidence available on the effects of interventions to provide culturally appropriate maternity care on the use of skilled maternity care during pregnancy, for birth or in the postpartum period. Items published in English, French and/or Spanish between 1 January 1990 and 31 March 2014 were considered. Fifteen studies describing a range of interventions met the inclusion criteria. Data were extracted on population and intervention characteristics; study design; definitions and data for relevant outcomes; and the contexts and conditions in which interventions occurred. Because most of the included studies focus on antenatal care outcomes, evidence of impact is particularly limited for care seeking for birth and after birth. Evidence in this review is clustered within a small number of countries, and evidence from low- and middle-income countries is notably lacking. Interventions largely had positive effects on uptake of skilled maternity care. Cultural factors are often not the sole factor affecting populations’ use of maternity care services. Broader social, economic, geographical and political factors interacted with cultural factors to affect targeted populations’ access to services in included studies. Programmes and policies should seek to establish an enabling environment and support respectful dialogue with communities to improve use of skilled maternity care. Whilst issues of culture are being recognized by programmes and researchers as being important, interventions that explicitly incorporate issues of culture are rarely evaluated.

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“…Of the eight cost-analysis studies, six found interventions would be cost-saving over time relative to the comparison [17],[20],[22],[24],[25],[30]. The study of the group midwifery program in the Top End of Australia found no significant cost differences between the provided intervention and usual care [33], while the urban midwifery program was deemed not cost-saving although qualitative results demonstrated that patients valued the service [11]. The cost-benefit analyses carried out all found the injury prevention interventions to be cost-beneficial in that they had benefit-cost ratios above one [34].…”

Section: Resultsmentioning

confidence: 99%

Global Systematic Review of the Cost-Effectiveness of Indigenous Health Interventions

et al. 2014

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BackgroundIndigenous populations around the world have consistently been shown to bear a greater burden of disease, death and disability than their non-Indigenous counterparts. Despite this, little is known about what constitutes cost-effective interventions in these groups. The objective of this paper was to assess the global cost-effectiveness literature in Indigenous health to identify characteristics of successful and unsuccessful interventions and highlight areas for further research.Methods and FindingsA systematic review of the published literature was carried out. MEDLINE, PSYCINFO, ECONLIT, EMBASE and CINAHL were searched with terms to identify cost-effectiveness evaluations of interventions in Indigenous populations around the world. The WHO definition was followed in identifying Indigenous populations. 19 studies reporting on 27 interventions were included in the review. The majority of studies came from high-income nations with only two studies of interventions in low and middle-income nations. 22 of the 27 interventions included in the analysis were found to be cost-effective or cost-saving by the respective studies. There were only two studies that focused on Indigenous communities in urban areas, neither of which was found to be cost-effective. There was little attention paid to Indigenous conceptions of health in included studies. Of the 27 included studies, 23 were interventions that specifically targeted Indigenous populations. Outreach programs were shown to be consistently cost-effective.ConclusionThe comprehensive review found only a small number of studies examining the cost-effectiveness of interventions into Indigenous communities around the world. Given the persistent disparities in health outcomes faced by these populations and commitments from governments around the world to improving these outcomes, it is an area where the health economics and public health fields can play an important role in improving the health of millions of people.

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An holistic economic evaluation of an Aboriginal community-controlled midwifery programme in Western Sydney

Cited by 39 publications

References 0 publications

Canadian Indigenous Womens Perspectives of Maternal Health and Health Care Services: A Systematic Review

Canadian Indigenous Womens Perspectives of Maternal Health and Health Care Services: A Systematic Review

Effectiveness of interventions to provide culturally appropriate maternity care in increasing uptake of skilled maternity care: a systematic review

Global Systematic Review of the Cost-Effectiveness of Indigenous Health Interventions

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