Birthing on Country
Centre for Research Excellence
Achieving equity in birth outcomes, health status and life expectancy for Aboriginal and Torres Strait Islander families in urban Southeast Queensland.
Photograph: Pat Josse
About the Birthing on Country Centre for Research Excellence (BoC CRE)
For the past ten years there has been little or no improvement in key MNCH indicators when comparing First Nations to other Australian women. Maternal death remains 4.6 times higher, perinatal deaths 1.7 times higher with preterm birth 1.6 times higher, and unchanged in 10 years. Preterm birth is the largest contributor to child mortality ( x 2.4 times ), associated with significant childhood disability and chronic diseases in adulthood. First Nations children are eight times more likely to be involved with government agencies for possible child apprehension, and 10 times more likely to be removed from their families than other children.
We have the following resources that will help us to achieve our goals:
1. BOC CRE $2.5 mill funding
2. First Nations leadership
3. Experts with years of experience in the field and strong networks
4. Committed, enthusiastic team within the BOC CRE and the Molly Centre
5. Community support
6. Strong partnerships
7. University support- In kind and financial
8. 5years to make a difference
Our goals are to have redesigned maternal, newborn and child health (MNCH) and support services in multiple locations making a positive impact on Australia’s First Nations families. R1. Estimating the life long impact of the Birthing in Our Community (BiOC) Service on health adjusted life expectancy (HALE) BOOST 2: Extending the Building on Our Strengths (BOOSt) Study, NHMRC (GNT1135125) 2018-22 Redesigning services and developing the remote exemplar site North West Qld.
Primarily, mothers, babies, families and communities are the target group . We plan to grow the number of First Nations midwives, MNCH nurses and researchers. Djagamirrs will be trained and employed in several sites across the NT and QLD.
Within 2-3 years we will have established exemplar redesigned maternal, newborn and child health (MNCH) and support services in demonstration sites in Brisbane, Queensland (urban), Nowra, NSW (regional), Alice Springs, NT (remote) and very remote (Galiwin’ku, Elcho Island, NT). We will have developed, trialled and evaluated djagamirr programs in several sites in remote areas of the NT and norht Queensland.
In 5 yrs we will have supported the establishment and evaluation of redesigned maternal, newborn and child health (MNCH) and support services in multiple locations making a positive impact on Australia’s First Nations families; including a reduction in preterm birth (<37-weeks) and family strengthening to reduce infant removal (<12-months). Our research is underpinned by the understanding that effective interventions during pregnancy and early life must address the social and cultural determinants of health including income, employment, education and access to culturally safe health care. Our participatory action research approach will have privileged First Nations ways of seeing, knowing and doing, bringing community knowledge into the research framework. This will have formed the interface of our entire program of research.
Estimating the life long impact of the Birthing in Our Community (BiOC) Service on health adjusted life expectancy (HALE)
BOOST 2: Extending the Building on Our Strengths (BOOSt) Study, NHMRC (GNT1135125) 2018-22
Redesigning services and developing the remote exemplar site North West Qld
Reducing preterm birth First Nations Australians: A cluster RCT comparing Birthing on Country Services to standard care
Australian Yolŋu Doula Support Course, Prime Ministers and Cabinet 2018-20
Supporting the retention of First Nations students in midwifery5 Jul 2019
The RISE Birthing on Country short course and toolkit to support scale-up
Preventing unborn notifications in pregnancy, and child removal at birth
Healing the Past by Nurturing the Future: Implementing trauma-integrated care
Increasing support within the first 1,000 days for vulnerable babies
Father Inclusive Practice for the Birthing in Our Community Service
Community engagement & ownership: Identifying causal pathways for health gains
The best start in life for Yolŋu famlies in the Galiwin’ku community
"I think there's other parts of the State and other parts of the country that could learn a lot with what's happened here, [the partnership comes] from very humble beginnings. No one went and dropped a bucket of millions into [the region]. We've had to work for every single cent and it's amazing what happens when relationships are based on, on real commitment, because... dollars don't buy commitment. [SP8]"
Timeline Year 1
The Birthing on Country CRE Team
A/Prof Yu Gao
Dr Anton Clifford-Motopi
Dr Sophie Hickey
Dr Sarah Ireland
Dr Penny Haora, midwife
Prof Jeffrey Braithwaite
Prof Cathy Turner
Dr Steve Begg
Prof Gill Westhorpe
Ms Virginia Barnyarla, Representative for Molly Wardaguga's family
BoC CRE Publications
Experiences of health service providers establishing an Aboriginal-Mainstream Partnership to improve maternity care for Aboriginal and Torres Strait Islander families in an urban setting. Evaluation Program and Planning.
Hickey, S., Couchman, K., Stapleton, H., Roe, Y. & S. Kildea (accepted, in press)
Establishing new teams aiming to provide culturally safe care. Women and Birth, 32(5):466–475.
Hickey, S, Kildea, S., Couchman, K, Watego-Ivory, K., West, R., Kruske, S., Blackman, R., Watego, S. & Y. Roe (2019)
Implementing Birthing on Country services for the best start in life for Aboriginal and Torres Strait families: The RISE Framework. Women and Birth, 32(5):449–459.
Kildea, S., Hickey, S., Barclay, L., Kruske, S., Nelson, C., Sherwood, J., Allen, J., Gao, Y., Blackman, R. & Y. Roe (2019)
Reducing preterm birth amongst Aboriginal and Torres Strait Islander babies: A prospective cohort study, Brisbane, Australia. EClinical Medicine - Published by The Lancet, 12:43-51.
Kildea, S., Hickey, S., Gao, Y., Kruske, S., Nelson, C., Blackman, R., Tracy, S., Hurst, C., Williamson, D. & Y. Roe (2019
The Indigenous Birthing in an Urban Setting Study: The IBUS study (Study Protocol). BMC Pregnancy and Childbirth, 18:431.
Hickey, S., Roe, Y., Gao, Y., Nelson, C., Carson, A., Currie, J., Reynolds, M., Wilson, K., Kruske, S,. Blackman, R., Passey, M., Clifford, A., Tracy, S., West, R., Williamson, D., Kosiak, M., Watego, S., Webster, J. & S. Kildea (2018)
Participatory action research opens doors: Mentoring Indigenous researchers to improve midwifery in urban Australia. Women and Birth, 31(4): 263–268.
Hickey, S., Maidment, S., Heinemann, K., Roe, Y., & S. Kildea (2018) Participatory action research opens doors: Mentoring Indigenous researchers to improve midwifery in urban Australia. Women and Birth, 31(4): 263–268.
Birthing on Country (in Our Community): A case study of engaging stakeholders and developing a best practice Indigenous maternity service in an urban setting. Australian Health Review, 42(2):230-238.
Kildea, S., Hickey, S., Nelson, C., Currie, J., Carson, A., Reynolds, M., Wilson, K., Kruske, S., Passey, M., Roe, Y., West, R., Clifford, A., Kosiak, M., Watego, S., & S. Tracy (2018)