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.
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.
Authors: R Kirkham; J A Boyle; C Whitbread; M Dowden; C Connors; S Corpus; L McCarthy; J Oats; H D McIntyre; E Moore; K O'Dea; A Brown; L Maple-Brown Journal: BMC Health Serv Res Date: 2017-08-03 Impact factor: 2.655
Authors: Pupalan Iyngkaran; Nadarajan Kangaharan; Hendrik Zimmet; Margaret Arstall; Rob Minson; Merlin C Thomas; Peter Bergin; John Atherton; Peter MacDonald; David L Hare; John D Horowitz; Marcus Ilton Journal: Curr Cardiol Rev Date: 2016
Authors: R Kirkham; N Trap-Jensen; J A Boyle; F Barzi; E L M Barr; C Whitbread; P Van Dokkum; M Kirkwood; C Connors; E Moore; P Zimmet; S Corpus; A J Hanley; K O'Dea; J Oats; H D McIntyre; A Brown; J E Shaw; L Maple-Brown Journal: BMC Pregnancy Childbirth Date: 2019-10-28 Impact factor: 3.007
Authors: Anna Wood; Diana MacKay; Dana Fitzsimmons; Ruth Derkenne; Renae Kirkham; Jacqueline A Boyle; Christine Connors; Cherie Whitbread; Alison Welsh; Alex Brown; Jonathan E Shaw; Louise Maple-Brown Journal: Int J Environ Res Public Health Date: 2020-01-22 Impact factor: 3.390