RESUMO
PROBLEM BEING ADDRESSED: Aboriginal and non-Aboriginal women in rural and remote settings struggle to access obstetric care close to home. Objective of the program: To deliver a full range of modern and safe obstetric care to 28 remote Aboriginal communities served by rural-based health care. PROGRAM DESCRIPTION: Rural family physicians provide intrapartum, cesarean delivery and anesthesia services to 350 rural, primarily Aboriginal women in a collegial, supportive environment. CONCLUSION: Rural and remote obstetric services need support before they fail. Patient volume, remote location and organizational culture are key elements. Evidence teaches us that outcomes are best when women deliver closer to home.
Assuntos
Indígenas Norte-Americanos , Serviços de Saúde Materna/organização & administração , Obstetrícia/organização & administração , Serviços de Saúde Rural/organização & administração , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Ontário , Cultura Organizacional , Gravidez , Desenvolvimento de Programas , Avaliação de Programas e Projetos de SaúdeRESUMO
Diabetes among First Nations peoples has reached epidemic proportions, and diabetes prevalence, complications, and mortality rates are higher than in Whites. The purpose of this grounded theory study was to investigate the experience of Type 2 diabetes in First Nations adults. Ten individuals living in one reserve community, in southwestern Ontario, participated in this research. Participants were interviewed on two occasions by a First Nations nurse. All interviews were audiotaped and transcribed verbatim. A three-phase process of integration emerged, similar to the process of integration discovered in prior research with Type 1 diabetic Whites. However, there were some important differences in the characteristics of these three phases. In addition, there were surprising findings related to beliefs about the type of diabetes educator desired by these First Nations clients.
