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Improving health service delivery for women with diabetes in pregnancy in remote Australia: survey of care in the Northern Territory Diabetes in Pregnancy Partnership

Edwards, Laura, Connors, Christine M., Whitbread, Cherie, Brown, Alex, Oats, Jeremy and Maple-Brown, Louise J. (2014). Improving health service delivery for women with diabetes in pregnancy in remote Australia: survey of care in the Northern Territory Diabetes in Pregnancy Partnership. Australian and New Zealand Journal of Obstetrics and Gynaecology,54:534-540.

Document type: Journal Article
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IRMA ID 84473293xPUB1
Title Improving health service delivery for women with diabetes in pregnancy in remote Australia: survey of care in the Northern Territory Diabetes in Pregnancy Partnership
Author Edwards, Laura
Connors, Christine M.
Whitbread, Cherie
Brown, Alex
Oats, Jeremy
Maple-Brown, Louise J.
Journal Name Australian and New Zealand Journal of Obstetrics and Gynaecology
Publication Date 2014
Volume Number 54
ISSN 1479-828X   (check CDU catalogue open catalogue search in new window)
Start Page 534
End Page 540
Total Pages 7
Place of Publication Australia
Publisher Wiley-Blackwell Publishing Asia
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
In the Northern Territory (NT), 38% of 3500 births each year are to Indigenous women, 80% of whom live in regional and remote areas. Compared with the general Australian population, rates of pre-existing type 2 diabetes in pregnancy are 10-fold higher and rates of gestational diabetes are 1.5-fold higher among Indigenous women. Current practices in screening for diabetes in pregnancy in remote Australia are not known.
Aims
To assess current health service delivery for NT women with diabetes in pregnancy (DIP) by surveying healthcare professionals' views and practices in DIP screening and management.
Materials and Methods
A cross-sectional survey of NT healthcare professionals providing clinical care for women with DIP was conducted based on pre-identified themes of communication, care-coordination, education, orientation and guidelines, logistics and access, and information technology.
Results
Of the 116 responders to the survey, 78% were primary healthcare professionals, 32% midwives and 25% general practitioners. High staff turnover was evident: of Central Australian professionals, only 33% (urban) and 18% (regional/remote) had been in their current position over 5 years. DIP screening was conducted at first antenatal visit by 66% and at 24–28-week gestation by 81%. Only 50% of respondents agreed that most women at their health service received appropriate care for DIP, and 41% of primary care practitioners were neutral or not confident in their skills to manage DIP.
Conclusions
It is promising that many healthcare professionals report following new guidelines in conducting early pregnancy screening for DIP in high risk women. Several challenges were identified in healthcare delivery to a high risk population in remote Australia.
Keywords Gestational diabetes
Health services
Healthcare delivery
Pregnancy in diabetics
Rural health
DOI http://dx.doi.org/10.1111/ajo.12246   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Description for Link Link to publisher's version
URL http://onlinelibrary.wiley.com/doi/10.1111/ajo.12246/abstract
 
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