Table 1 Key components of successful, culturally competent Birthing on Country Service Models, reproduced with permission [19]
From: The Indigenous Birthing in an Urban Setting study: the IBUS study
Birthing on Country Maternity services designed by & delivered for Aboriginal & Torres Strait Islander women & families | ||
Governance Indigenous control, community development approach, shared vision cultural guidance & oversight | ||
Philosophy & Overarching Principles Respect for & incorporation of Indigenous knowledge & traditional practice; respect for family & mens’ involvement; partnership approach; women’s business; continuity of carer; connection with country/land; capacity building approach - particularly with training & education; holistic definition of health; choice; evidenced-based clinical practice; social model of health & wellbeing | ||
Skill Acquisition, Training & Education Partnership approach/ two-way learning; appropriately trained & supported; competency based; delivered on-site; career pathway from maternity workers to midwifery; health literacy for women & families | Service Characteristics Culturally competent service & staff; community based; specific location; designated ongoing funding; welcoming flexible service focusing on relationships & trust; outreach, transport, child friendly & group sessions; social, cultural, biomedical & community risk assessment criteria; clinical & cultural governance, interdisciplinary perinatal committee; effective IT; integrated services | Monitoring & Evaluation Designated funding for monitoring & evaluation; continuous quality assurance; audit activities & recall register |
Results Community healing as evidenced by: reduced family separation at critical times, restoration of skills & pride; capacity building in the community; supporting community & family relationships; reduced family violence; increased communication & liaison with other health professionals & service providers; comprehensive, holistic, tailored care; improved maternal & infant health outcomes. | ||