Provision of maternity care for women in remote Far West New South Wales: how far have we come?

BACKGROUND: The National Maternity Services Review in 2009 sought to address the ongoing issues of access, workforce capacity and inequalities in health outcomes for women and their babies in rural and remote Australia. The subsequent National Maternity Services Plan describes the type of care that should be offered to all women in Australia. OBJECTIVE: The aim of our study was to better understand the local context and progress in delivering recommendations of the National Plan to improve maternity services for women in remote communities of Far West New South Wales. DESIGN: Semistructured questionnaires. SETTING: Maternity care in Far West New South Wales involves long-standing partnerships between three service providers to provide antenatal and postnatal care to women in remote communities with birthing predominantly occurring at the Broken Hill Health Service. MAIN OUTCOME MEASURES: The degree of information sharing and communication, use of guidelines and policies, the effectiveness of workforce retention strategies and the current level of maternity care provided. PARTICIPANTS: Fourteen clinicians and policy makers. RESULTS: Participants reported clarity in roles and responsibilities of health staff, the appropriateness of antenatal care policies to the context, confidence in practising to their full professional scope and the existence of quality improvement initiatives across all providers. However, participants also reported being constrained by environmental and organisational factors in regards to risk assessment and referral of pregnant women. Key issues for local health service partners include adherence to antenatal care policies and a need to improve local workforce capacity. CONCLUSIONS: Local health service partners are demonstrably ready to address the modifiable factors of organisational capacity and interprofessional collaboration in accordance with the recommendations of the National Maternity Services Review.