Community midwifery: a primary health care approach to care during pregnancy for Aboriginal and Torres Strait Islander women

Comprehensive primary health care is integral to meaningful client-centred care, with nurses and midwives central to partnership approaches with individuals, families and communities. A primary health model of antenatal care is needed for Aboriginal and Torres Strait Islander women in rural and remote areas, where complex social determinants of health impact on pregnancy outcomes, early years and lifelong health. Staff experiences from a community midwifery-led antenatal program in a remote Western Australian setting were explored, with the aim of investigating program impacts from health service providers’ perspectives. Interviews with 19 providers, including community midwives, child health nurses, program managers, a liaison officer, doctors and community agency staff, examined elements comprising a culturally safe community antenatal program for Aboriginal and Torres Strait Islander women, exploring program benefits and challenges. Thematic analysis derived five themes: Organisational and Accessibility Factors; Culturally Appropriate Support; Staff Availability and Competencies; Collaboration; and Sustainability. The ability of program staff to work in culturally safe partnerships with clients in collaboration with community agencies was essential to building meaningful and sustainable antenatal strategies. Midwifery primary health care competencies were viewed as a strong enabling factor, with potential to reduce health disparities in accordance with Australian Government and research recommendations.

Understanding the general practice nursing workforce in New Zealand: an overview of characteristics 2015–19

Limited knowledge about the nursing workforce in New Zealand general practice inhibits the optimal use of nurses in this increasingly complex setting. Using workforce survey data published biennially by the Nursing Council of New Zealand, this study describes the characteristics of nurses in general practice and contrasts them with the greater nursing workforce, including consideration of changes in the profiles between 2015 and 2019. The findings suggest the general practice nursing workforce is older, less diverse, more predominately New Zealand trained and very much more likely to work part-time than other nurses. There is evidence that nurses in general practice are increasingly primary health care focused, as they take on expanded roles and responsibilities. However, ambiguity about terminology and the inability to track individuals in the data are limitations of this study. Therefore, it was not possible to identify and describe cohorts of nurses in general practice by important characteristics, such as prescribing authority, regionality and rurality. A greater national focus on defining and tracking this pivotal workforce is called for to overcome role confusion and better facilitate the use of nursing scopes of practice.

Incorporating a health team as part of a disadvantaged high school’s interconnected community learning model

Child poverty rates in Australia remain consistently high, with one in six children living in poverty. High levels of disadvantage result in compounding effects over the life trajectory and include adverse adult health vocational outcomes, increased premature morbidity and mortality and an intergenerational effect. Access to and the availability of services, including health, are restricted due to a complex mix of reasons that include a disconnection between an enabling strategic intent and action. Many young people begin life (including prenatal) with undiagnosed or poorly managed health issues, which subsequently affect the full range of developmental milestones throughout their school years. To counter these gaps in young people’s educational outcomes, a disadvantaged public high school in south-west Sydney introduced, over 10 years, a seven-member school health team employed directly by the school as part of an interconnected model of learning. The focus of this study was to determine the view of staff about the effectiveness and impact of the team as it connects to this holistic model of learning. The comments by staff are very positive and the universal view is that the introduction of a comprehensive interconnected school health team to the high school setting is proving highly beneficial.