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|Title:||The quality of maternal and infant health services and their utilisation by remote dwelling aboriginal families in the top end of Australia|
|Authors:||Bar-Zeev, Sarah Jane|
|Publisher:||University of Sydney|
Sydney Medical School
School of Public Health
|Abstract:||Aim The objective of this thesis was to investigate the quality of maternal and infant health services and their utilisation at the primary and referral level, by remote dwelling Aboriginal mothers and their infants. Methods Mixed methods were used. Health service use and the quality of service delivery were examined in a retrospective cohort study of 412 Aboriginal women during pregnancy, birth and postpartum and their infants (n=413) during the first year. In addition, 60 interviews were conducted with clinicians and 120 hours of participant observation were undertaken at regional hospital and remote health centres. Results Poor maternal and infant health outcomes, high demand for antenatal and infant care in the remote setting with insufficient staffing and system-wide deficiencies in the quality and coordination of care were identified. Conclusions The resourcing and organisation of health services and the beliefs, attitudes and practices of clinicians were important factors affecting the quality of care in these settings. A significant change to the organisation of services should be seen as a priority for health care planners. Service redesign based on continuity of care, adequate resourcing of services, work load reform including more efficient use of the Aboriginal Health Worker, child health nurse and midwifery workforce and the integration of community-based health service delivery could play a substantial role in improving outcomes.|
|Rights and Permissions:||The author retains copyright of this thesis. It may only be used for the purposes of research and study. It must not be used for any other purposes and may not be transmitted or shared with others without prior permission.|
|Type of Work:||PhD Doctorate|
|Type of Publication:||Doctor of Philosophy Ph.D.|
|Appears in Collections:||Sydney Digital Theses (Open Access)|
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|Bar-Zeev, Sarah Jane - Final thesis.pdf||3.46 MB||Adobe PDF||View/Open|
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