Elements of cultural competence in an Australian Aboriginal maternity program

Bertilone, Christina; McEvoy, Suzanne; Gower, Dena; Naylor, Nola; Doyle, June; Swift-Otero, Val

doi:10.1016/j.wombi.2016.09.007

Cited by 26 publications

(41 citation statements)

References 12 publications

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“…Training contributes substantially to health service providers understanding Aboriginal culture and can break down barriers not only in the health system but within the wider community 25 . Continuous quality improvement, using tools such as the Organisational Cultural Competence Assessment Tool and implementing cultural training into health professional university training have all been shown to elicit awareness and positive organisational change 26–28 . Despite some success, there is still more that needs to be done.…”

Section: Discussionmentioning

confidence: 99%

“…25 Continuous quality improvement, using tools such as the Organisational Cultural Competence Assessment Tool and implementing cultural training into health professional university training have all been shown to elicit awareness and positive organisational change. [26][27][28] Despite some success, there is still more that needs to be done. Across Australia, many tertiary hospitals have recognised that mainstream hospitals are not responsive to Aboriginal people's cultural needs.…”

Section: Discussionmentioning

confidence: 99%

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Understanding an Aboriginal and Torres Strait Islander child’s journey through paediatric care in Western Australia

Strobel

Moylan

Durey

et al. 2020

Australian and New Zealand Journal of Public Health

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Objective: To explore caregiver perspectives of their children’s journey through the specialist paediatric service, the Aboriginal Ambulatory Care Coordination Program (AACC), and non‐AACC services at the Perth Children’s Hospital. Methods: Eighteen semi‐structured interviews with families of Aboriginal children were completed. Indigenous research methodology and a phenomenological approach guided data collection and analysis. Results: Four key themes were identified from interviews: hospital admissions, discharge and follow‐up outpatient appointments; communication; financial burden; and cultural issues. Our findings suggest Aboriginal children and their caregivers using the AACC program had more positive and culturally secure experiences than those using non‐AACC services. However, barriers relating to health providers’ understanding of Aboriginal cultural issues and lived experience were commonly discussed, regardless of which service families received. Conclusions: Australian Aboriginal children have an increased use of tertiary hospital care compared to non‐Indigenous children. Healthcare programs specifically designed for Aboriginal children and their families can improve their experience of care in hospital. However, improvements in cultural awareness for other hospital staff is still needed. Implications for public health: Dedicated Aboriginal programs in mainstream services can successfully improve cultural care to their clients, which is fundamental to improving service delivery for families.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Understanding an Aboriginal and Torres Strait Islander child’s journey through paediatric care in Western Australia

Strobel

Moylan

Durey

et al. 2020

Australian and New Zealand Journal of Public Health

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“…Moreover, the lack of understanding and trust for Aboriginal women often results in service disengagement and non‐attendance to antenatal clinics, consequently increasing the risk of missed RHD diagnosis or severity . There is increasing evidence to suggest that maternity services that incorporate Birthing on Country principles, such as Aboriginal mothers and babies partnership models, have earlier and increased engagement along with improved maternal and perinatal outcomes . Appropriate preconception care provides opportunities to optimise cardiac status prior to pregnancy and offer medical and/or surgical intervention when appropriate, thus reducing morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

Rheumatic heart disease in pregnancy: Profile of women admitted to a Western Australian tertiary obstetric hospital

Ongzalima

Greenland

Vaughan

et al. 2019

Aust NZ J Obst Gynaeco

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This retrospective study assessed maternal and perinatal outcomes for women with rheumatic heart disease (RHD) admitted to the largest tertiary obstetric hospital in Western Australia from 2009 to 2016. Of 54 women identified, 75.9% were Indigenous, 59.3% lived in rural areas and 40.7% had severe RHD. Heart failure developed in 10% who gave birth. Indigenous women were younger, had higher gravidity (P = 0.0305), were more likely to receive secondary prophylaxis (P = 0.0041) and have sub-optimal antenatal clinic attendance (P = 0.0078). There were no maternal deaths and two perinatal deaths (4.0%), reflecting vigilance in the obstetric management of women with RHD in Western Australia.

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“…Among Australian Aboriginal women, poor uptake of health services is associated with geographic isolation, cost, language barriers, lack of trust, previous negative experiences and culturally inappropriate or unsafe delivery and practices [9,20,26,27]. Aboriginal women are less likely than their non-Aboriginal counterparts to attend mainstream health services, commence antenatal care at the recommended time, and attend the recommended number of antenatal visits [10,19,28].…”

Section: Introductionmentioning

confidence: 99%

Aboriginal and Torres Strait Islander family access to continuity of health care services in the first 1000 days of life: a systematic review of the literature

Sivertsen

Anikeeva

Deverix

et al. 2020

BMC Health Serv Res

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Background: Aboriginal women and their infants experience significant disadvantage in health outcomes compared to their non-Aboriginal counterparts. Access to timely, effective and appropriate maternal and child healthcare can contribute to reducing these existing health disparities. However, accessing mainstream healthcare services often results in high levels of fear and anxiety, and low attendance at subsequent appointments among Aboriginal women, due to inefficient communication, poor service coordination and a lack of continuity of care. Methods: This integrative literature review sought to explore factors that contribute to continuity of care and consider service features that contribute to positive care experiences and satisfaction with care received by Aboriginal women and their infants. In total, 28 studies were included in the review and were thematically analysed using Braun and Clarke's six steps of thematic analysis. This was followed by a collaborative, computer-assisted qualitative analysis, which resulted in the emergence of five key themes: lack of continuity of care, impact of lack of continuity of care, continuity of care interventions, impact of continuity of care interventions, and strategies to improve continuity of care. Results: Most studies focused on health services in rural or remote Aboriginal communities and there was a lack of documented evidence of continuity of care (or lack thereof) for Aboriginal women living and birthing in regional and metropolitan areas. The majority of studies focused explicitly on continuity of care during the antenatal, birthing and immediate postnatal period, with only two studies considering continuity through to an infant's first 1000 days. Conclusion: The review highlights a lack of studies exploring continuity of care for Aboriginal families from the antenatal period through to an infants' first 1000 days of life. Included studies identified a lack of continuity in the antenatal, peri-and postnatal periods in both regional and metropolitan settings. This, along with identified strategies for enhancing continuity, have implications for communities, and healthcare services to provide appropriate and culturally safe care. It also marks an urgent need to incorporate and extend continuity of care and carer through to the first 1000 days for successful maternal and infant health outcomes for Aboriginal peoples.

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Elements of cultural competence in an Australian Aboriginal maternity program

Cited by 26 publications

References 12 publications

Understanding an Aboriginal and Torres Strait Islander child’s journey through paediatric care in Western Australia

Understanding an Aboriginal and Torres Strait Islander child’s journey through paediatric care in Western Australia

Rheumatic heart disease in pregnancy: Profile of women admitted to a Western Australian tertiary obstetric hospital

Aboriginal and Torres Strait Islander family access to continuity of health care services in the first 1000 days of life: a systematic review of the literature

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