School of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, WA 6845, Australia; and Child and Adolescent Health Services, Western Australian Department of Health, 15 Hospital Avenue, Nedlands, WA 6009, Australia. Email:
Aust J Prim Health. 2021 Feb;27(1):57-61. doi: 10.1071/PY20105.
Comprehensive primary health care is integral to meaningful client-centred care, with nurses and midwives central to partnership approaches with individuals, families and communities. A primary health model of antenatal care is needed for Aboriginal and Torres Strait Islander women in rural and remote areas, where complex social determinants of health impact on pregnancy outcomes, early years and lifelong health. Staff experiences from a community midwifery-led antenatal program in a remote Western Australian setting were explored, with the aim of investigating program impacts from health service providers' perspectives. Interviews with 19 providers, including community midwives, child health nurses, program managers, a liaison officer, doctors and community agency staff, examined elements comprising a culturally safe community antenatal program for Aboriginal and Torres Strait Islander women, exploring program benefits and challenges. Thematic analysis derived five themes: Organisational and Accessibility Factors; Culturally Appropriate Support; Staff Availability and Competencies; Collaboration; and Sustainability. The ability of program staff to work in culturally safe partnerships with clients in collaboration with community agencies was essential to building meaningful and sustainable antenatal strategies. Midwifery primary health care competencies were viewed as a strong enabling factor, with potential to reduce health disparities in accordance with Australian Government and research recommendations.
综合初级卫生保健是实现有意义的以客户为中心的护理的组成部分，护士和助产士是与个人、家庭和社区建立伙伴关系的核心。农村和偏远地区的土著和托雷斯海峡岛民妇女需要初级卫生保健模式的产前护理，那里复杂的健康决定因素影响着妊娠结局、幼儿期和终身健康。探讨了西澳大利亚偏远地区社区助产士主导的产前项目的工作人员经验，旨在从卫生服务提供者的角度调查项目的影响。对 19 名提供者（包括社区助产士、儿童健康护士、项目管理人员、联络官员、医生和社区机构工作人员）进行了访谈，探讨了构成土著和托雷斯海峡岛民妇女文化安全社区产前项目的要素，探讨了项目的益处和挑战。主题分析得出了五个主题：组织和可及性因素；文化适宜的支持；员工的可用性和能力；协作；和可持续性。项目工作人员有能力与社区机构合作，与客户建立文化安全的伙伴关系，这对于制定有意义和可持续的产前战略至关重要。助产初级卫生保健能力被视为一个强有力的促进因素，有可能根据澳大利亚政府和研究建议减少健康差距。
