Bar-Zeev Sarah, Barclay Lesley, Kruske Sue, Kildea Sue
School of Public Health, Faculty of Medicine, University Centre for Rural Health, North Coast, The University of Sydney, New South Wales 2006, Australia.
University Centre for Rural Health, North Coast, School of Public Health, Faculty of Medicine, The University of Sydney, New South Wales 2006, Australia.
Midwifery. 2014 Mar;30(3):289-96. doi: 10.1016/j.midw.2013.04.009. Epub 2013 Jul 1.
there is a significant gap in pregnancy and birth outcomes for Australian Aboriginal and Torres Strait Islander women compared with other Australian women. The provision of appropriate and high quality antenatal care is one way of reducing these disparities. The aim of this study was to assess adherence to antenatal guidelines by clinicians and identify factors affecting the quality of antenatal care delivery to remote dwelling Aboriginal women.
a mixed method study drew data from 27 semi-structured interviews with clinicians and a retrospective cohort study of Aboriginal women from two remote communities in Northern Australia, who gave birth from 2004-2006 (n=412). Medical records from remote health centres and the regional hospital were audited.
the majority of women attended antenatal care and adherence to some routine antenatal screening guidelines was high. There was poor adherence to local guidelines for follow-up of highly prevalent problems including anaemia, smoking, urinary tract infections and sexually transmitted infections. Multiple factors influenced the quality of antenatal care.
the resourcing and organisation of health services and the beliefs, attitudes and practices of clinicians were the major factors affecting the quality of care. There is an urgent need to address the identified issues in order to achieve equity in women's access to high quality antenatal care with the aim of closing the gap in maternal and neonatal health outcomes.
与其他澳大利亚女性相比，澳大利亚原住民和托雷斯海峡岛民女性在妊娠和分娩结局方面存在显著差距。提供适当且高质量的产前护理是减少这些差异的一种方式。本研究的目的是评估临床医生对产前指南的遵循情况，并确定影响为居住在偏远地区的原住民女性提供产前护理质量的因素。
一项混合方法研究从对临床医生的27次半结构化访谈以及对2004年至2006年在澳大利亚北部两个偏远社区分娩的原住民女性（n = 412）的回顾性队列研究中获取数据。对偏远健康中心和地区医院的病历进行了审核。
大多数女性接受了产前护理，并且对一些常规产前筛查指南的遵循情况良好。对包括贫血、吸烟、尿路感染和性传播感染等高度普遍问题的本地随访指南的遵循情况较差。多种因素影响了产前护理的质量。
卫生服务的资源配置和组织以及临床医生的信念、态度和做法是影响护理质量的主要因素。迫切需要解决已确定的问题，以实现女性获得高质量产前护理的公平性，从而缩小母婴健康结局方面的差距。
