About the Study
The Group Pregnancy Care study is implementing and evaluating a new approach to antenatal and postnatal care that involves inter-agency collaboration between public maternity hospitals, refugee settlement agencies, and maternal and child health (MCH) services. The aim of the program is to provide multifaceted, culturally appropriate preventive health care, information and support to refugee women during and after pregnancy in a group setting. The program is cost-free; provides care and information that is woman-directed, culturally appropriate and in women’s language; and facilitates links and referrals to services as necessary.
The organisations and staff involved have agreed to apply these principles:
- Community consultation and engagement
- Establish rapport with the woman and when present her family
- Giving women time and space to ask questions, check understanding and consent for medical tests and other procedures and Inform family of procedures, when appropriate
- Provide an on-site interpreter for pregnancy appointments
- Continuity of care (including interpreters and bicultural workers)
- Support women and her family’s pathway through the health system
- Promote women’s understanding of preventative health
- Respect, empathy, openness and sensitivity to cultural difference
- Recognise and understand the refugee re-settlement experience
- Work within a social model of health
- Outreach, referral and service co-ordination
- Client feedback and evaluation.
The key elements of the program include:
- local partnerships between public maternity hospitals, maternal and child health services and multicultural agencies
- community and stakeholder involvement in the co-design of each local program
- establishment of a multidisciplinary care team
- fortnightly group information sessions co-facilitated by a midwife, maternal and child health nurse and a community and language specific bicultural worker - alongside pregnancy care with a midwife and professional interpreter
- locating the program in a community setting close to where families live
- flexibility to embed the model in ways that work for health services and communities.
Evaluation will involve:
- use of routinely collected hospital data to compare health service use and maternal and infant outcomes before and after program implementation using an interrupted time-series design
- interviews with women participating in the program at 30 weeks gestation and at 4 months postpartum
- audit of hospital medical records for all participating women
- focus groups with participating women and service providers
- assessment of cost effectiveness.