Rebecca Rich1, Thomsen D'Hont2, Kellie E Murphy3, Jeremy Veillard4, Susan Chatwood5. 1. Department of Obstetrics & Gynaecology, University of Alberta, Royal Alexandra Hospital, 5S Robbins Pavilion, 10240 Kingsway Avenue, Edmonton, AB, T5H 3V9, Canada. rrich@ualberta.ca. 2. Department of Family Medicine, University of Alberta, Suite 205 College Plaza 8215 - 112 St, Edmonton, AB, T6G 2C8, Canada. 3. Division of Maternal Fetal Medicine, Obstetrics & Gynaecology, University of Toronto, Mount Sinai Hospital, Room 3-918, 700 University Avenue, Toronto, ON, M5G 1Z5, Canada. 4. Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada. 5. School of Public Health, University of Alberta, 3-279 Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada.
Abstract
BACKGROUND: Meaningful performance measurement requires indicators to be scientifically robust and strategically focused. For many circumpolar states, indicators aligned with national strategies may ignore the priorities of northern, remote, or Indigenous populations. The aim of this project was to identify contextually appropriate performance indicators for maternity care in circumpolar regions. METHODS: Fourteen maternity care and health systems experts participated in a modified Delphi consensus process. The list of proposed indicators was derived from a previously published scoping review. Fourteen participants rated each proposed indicator according to importance, circumpolar relevance, validity, and reliability and suggested additional indicators for consideration. RESULTS: Consensus was achieved after two rounds, as measured by a Cronbach's alpha of 0.87. Eleven indicators, many of which represented physical health outcomes, were ranked highly on all four criteria. Twenty-nine additional indicators, largely focused on social determinants of health, health care responsiveness, and accessibility, were identified for further research. Travel for care, cultural safety and upstream structural determinants of health were identified as important themes. CONCLUSIONS: This study identified the important gaps between current performance measurement strategies and the context and values that permeate maternal-child health in circumpolar regions. The indicators identified in this study provide an important foundation for ongoing work. We recommend that future work encompass an appreciation for the intersectoral nature of social, structural, and colonial determinants of maternal-child health in circumpolar regions.
BACKGROUND: Meaningful performance measurement requires indicators to be scientifically robust and strategically focused. For many circumpolar states, indicators aligned with national strategies may ignore the priorities of northern, remote, or Indigenous populations. The aim of this project was to identify contextually appropriate performance indicators for maternity care in circumpolar regions. METHODS: Fourteen maternity care and health systems experts participated in a modified Delphi consensus process. The list of proposed indicators was derived from a previously published scoping review. Fourteen participants rated each proposed indicator according to importance, circumpolar relevance, validity, and reliability and suggested additional indicators for consideration. RESULTS: Consensus was achieved after two rounds, as measured by a Cronbach's alpha of 0.87. Eleven indicators, many of which represented physical health outcomes, were ranked highly on all four criteria. Twenty-nine additional indicators, largely focused on social determinants of health, health care responsiveness, and accessibility, were identified for further research. Travel for care, cultural safety and upstream structural determinants of health were identified as important themes. CONCLUSIONS: This study identified the important gaps between current performance measurement strategies and the context and values that permeate maternal-child health in circumpolar regions. The indicators identified in this study provide an important foundation for ongoing work. We recommend that future work encompass an appreciation for the intersectoral nature of social, structural, and colonial determinants of maternal-child health in circumpolar regions.
Entities:
Keywords:
Arctic regions; Indigenous health services; health care quality indicators; infant health; maternal health
Authors: F Carinci; K Van Gool; J Mainz; J Veillard; E C Pichora; J M Januel; I Arispe; S M Kim; N S Klazinga Journal: Int J Qual Health Care Date: 2015-03-10 Impact factor: 2.038