Spatial variation in Aboriginal and Torres Strait Islander women's access to 4 types of maternal health services

Publication
Release Date: 20 Nov 2017
Author: AIHW

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This report examines spatial variation in Aboriginal and Torres Strait Islander women's access to hospitals with public birthing units and 3 other types of maternal health services. It also investigates possible high-level associations between access, maternal risk factors and birth outcomes.

ISSN: 978-1-76054-238-2
ISBN: 978-1-76054-239-9
Cat. no: IHW 187
Pages: 64

Findings from this report:

Over 25,000 Indigenous women aged 15–44 live more than a 1 hour’s drive to a public birthing unit
In 5 geographic areas, over 50% of Indigenous women aged 15–44 have no maternal health service within a 1 hour drive
The lowest levels of access to maternal health services are in Remote and Very Remote areas
Poorer access to maternal health services is associated with higher rates of pre-term birth and low birthweight

Acknowledgments
Abbreviations
Summary
- Access to services
- Association with area-level maternal risk factor and birth outcomes
1 Introduction
- Background
- Role of services
- Structure of the report
2 Methodology
- Types of services
- Geographic level of analysis
- Geographic levels for spatial analyses and reporting
  - Drive time analyses
  - Proportions of women of child-bearing age within/outside a 1 hour drive time to a service
  - Association between spatial accessibility and outcome variables
- Methods: spatial accessibility
  - Examining the association between access and outcomes
- Data sources
  - Service locations
    - Birthing units
    - ISPHCSs with antenatal/maternal services
    - RFDS locations
    - GP practice locations
    - Services not able to be included
  - Population data
  - Maternal risk factors and birth outcomes
  - Summary of sources
  - Data limitations
    - Services included in the analyses
    - Access to services
    - Antenatal care
    - Implications
3 Service accessibility
- Birthing units
  - Drive time to hospitals with public birthing units
- Spatial accessibility of antenatal and postnatal services
  - Drive time analyses
4 Associations between access to services, maternal risk factors and birth outcomes
- Descriptive statistics
- Statistical analyses
  - Statistically significant correlations
  - Non-statistically significant correlations
- Additional analyses
5 Conclusion
- Importance of factors in addition to access affecting the use of antenatal care
- Importance of the content of antenatal care
- Limitations
- Future work
Appendix A: Detailed methods
- Geocoding of service locations
- Population centroids
- Manual adjustment of area centroids
- Calculating drive times from population centroid-to-service locations
- Proportion of SA2 population within a 1 hour drive time of nearest service location
- Concordance of perinatal data to IREG/PHN
- Proportion of IREG/PHN populations within a 1 hour drive time of nearest service location
Appendix B: PHN results
- Descriptive statistics
- Statistical analyses
Glossary
References
List of tables
List of figures
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Spatial variation in Aboriginal and Torres Strait Islander women's access to 4 types of maternal health services

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