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:

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

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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