Rural Surgical and Obstetrical Networks: New Opportunities

Robust local surgery programs are the cornerstones of rural health care infrastructure and are recognized to be essential for the sustainability of local maternity care. The capacity of rural communities to be a ‘first response’ to trauma, even when a patient may be transferred to higher levels of care, is crucial to the health of rural populations. The past two decades have seen the attrition of these local surgical programs, and the corresponding reduced access to care for vulnerable, rural and Indigenous populations.

The Rural Coordination Centre of BC has received funding from the Joint Standing Committee on Rural Health for an innovative project aimed at sustaining rural services, the Rural Surgical and Obstetrical Networks project. This funding will support the development of five foundational pillars including increased scope and volume, clinical coaching, telepresence technology, continuous quality improvement and evaluation in rural geographies across the province, underscored by a strong and robust evaluation. The evaluation pillar will be lead through the Centre for Rural Health Research and involve monitoring and reporting on province-wide clinical surgical and obstetrical outcomes and a process evaluation to assess the value of the networks themselves.

The Centre for Rural Health Research is looking for an evaluation coordinator to join our dynamic and creative team to work on developing and applying a provincial RSON evaluation framework. Click here for more information!



Updates from the Field


Jude and Kira are looking forward to continued community engagement in the North Island for the Building Blocks for Sustainable Rural Maternity Care project talking with moms, community members, health care providers, BC Emergency Health Services and health administrators.

Developing a framework for what sustainable rural maternity care in the North Island could look like is what we are working on now. With this aim, we are creating a plan by looking at the five community and provider-derived “building blocks for sustainable rural maternity care”. We will continue going back to the community over the course of the project to check back in.

As we prepare to travel back up to the North Island for a week in early October, we have reflected on findings from the previous three trips to the community. We have learned from communities (birthing women, families and elders as well as nurses, physicians and health administrators) what the experience of birth is for women on the North Island.

Click here to follow the Building Blocks for Sustainable Rural Maternity Care blog and keep up to date on the project!





The distribution of maternity services across rural and remote Australia: does it reflect population need?

Australia 2017 article screen shot

This paper systematically estimates measures of the need of the population within the catchment for a facility across rural and remote Australia. Equitable distribution of services should include adjustments in the provision and level of services in response to population characteristics. The authors propose that increasing levels of service will be associated with increasing numbers of births (need); and other dimensions of need which were increasing disadvantage (socioeconomic status) (vulnerability); increasing proportion of Aboriginal and Torres Strait Islanders in the population (vulnerability), and decreasing proximity to another facility capable of undertaking an emergency operative birth (C-section) (isolation). To do this, the association between existing birthing services and the characteristics of its populations was modeled using geographically defined service catchments. This is an ecological study which aims to examine the association between population-based characteristics of need including vulnerability and isolation and the provision of maternity services across rural and remote Australia.

This investigation identified disparities in the distribution of birthing services in rural and remote Australia. Population factors relating to vulnerability and isolation did not increase the likelihood of a local birthing facility, and very remote communities were less likely to have any service.

Findings were part of a larger CRHR-Australia collaboration which compared levels of service in both jurisdictions using the BC-developed Rural Birth Index. The application in both settings has allowed us to both evaluate the efficacy of the Rural Birth Index and compare rural maternity policy in rural Canada and Australia.

Click here to read the full article.

Building Blocks to Sustainable Rural Maternity Care: The North Island Project

Building Blocks to Sustainable Maternity Care The North Island Project aims to consider system supports necessary to sustain low volume services in British Columbia. This in-depth, community-driven investigation will use open-ended interviews and focus groups with community members to engage in feasibility analysis of each of the five Building Blocks to Sustainable Maternity Care.

Building Blocks to Sustainable Maternity Care

Click here to learn more about the Building Blocks for Sustainable Rural Maternity Care project and follow the progress.

CRHR to Release Documentary on Rural Birth: “Where was I born, mama?”

Below is the trailer for the original documentary, “Where was I born, Mama?” on the deeply personal, but ultimately shared challenges of giving birth in a community without birth services.


In BC alone, more than 1,000 rural women a year must travel more than 100 kilometers to give birth. This causes stress and anxiety and, in some instances, adverse maternal and newborn outcomes. Women who have to travel more than 4 hours have more than a three times higher rate of perinatal mortality. Where was I born, Mama? Is a documentary short film produced by the Centre for Rural Health Research to shed light on the implications of the loss of local maternity services for rural women and their families.

This film was produced by CRHR and directed by Tamara Wojciechowska.