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.
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