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Sustainable Antenatal Care Services In An Urban Indigenous Community: The Townsville Experience, Kathryn S. Panaretto, Melvina R. Mitchell, Lynette Anderson, Sarah L. Larkins, Vivienne Manessis, Petra G. Buettner, David Watson

Aboriginal Policy Research Consortium International (APRCi)

Objective: To evaluate the impact of a sustained, community-based collaborative approach to antenatal care services for Indigenous women.

Design: Prospective quality improvement intervention, the Mums and Babies program, in a cohort of women attending Townsville Aboriginal and Islanders Health Service, 1 January 2000 – 31 December 2005 (MB group), compared with a historical control group (PreMB group), 1 January 1998 – 30 June 1999.

Main outcome measures: Proportion of women having inadequate antenatal care and

screening; perinatal indicators. Results: Thenumberofantenatalvisitsperpregnancyincreasedfromthree

(interquartilerange[IQR],twotosix)inthePreMBgrouptosix(IQR,fourtoten)inthe MB group (P < 0.001). There were significant improvements in care planning, completion of cycle-of-care, and antenatal education activities throughout the study period. About 90% of all women attending for antenatal care were screened for sexually transmitted diseases, 89% had measurement of haemoglobin level, and serological tests for hepatitis B and syphilis (minimum antenatal screening). There was increased attendance for dating and morphology scans. In the MB group compared with the PreMB group, there was a significant reduction in perinatal mortality (14 v 60 per 1000 births; P=0.014). Conclusion: Sustained access to a community-based, integrated, shared antenatal service has improved perinatal outcomes among Indigenous women in Townsville.

Social Support And Thriving Health: A New Approach To Understanding The Health Of Indigenous Canadians, Chantelle A.M. Richmond, Nancy A. Ross, Grace E. Egeland

Aboriginal Policy Research Consortium International (APRCi)

Objectives. We examined the importance of social support in promoting thriv- ing health among indigenous Canadians, a disadvantaged population.

Methods. We categorized the self-reported health status of 31 625 adult indig- enous Canadians as thriving (excellent, very good) or nonthriving (good, fair, poor). We measured social support with indices of positive interaction, emotional support, tangible support, and affection and intimacy. We used multivariable lo- gistic regression analyses to estimate odds of reporting thriving health, using social support as the key independent variable, and we controlled for educational attainment and labor force status.

Results. Compared with women reporting low levels of …