Aboriginal and Torres Strait Islander women are disproportionately impacted by hyperglycaemia in pregnancy. There are multiple barriers to providing care for women with hyperglycaemia in pregnancy in regional and remote Australia, including high staff turnover, fragmentation between services, limited clinician confidence, and lack of clarity around clinician roles relating to service provision.
The Diabetes Across the Lifecourse: Northern Australia Partnership (formerly the Northern Territory and Far North Queensland Diabetes in Pregnancy Partnership) is a collaboration between researchers, clinicians and policymakers. Since 2011 in the Northern Territory and 2015 in Far North Queensland the Partnership has worked to improve systems of care for women with hyperglycaemia in pregnancy, addressing identified barriers to care and opportunities for improvement. Activities of the Partnership include clinician education, updating relevant guidelines and policies and embedding these in practice, improving of recall and reminder systems, and implementing a Diabetes in Pregnancy Clinical Register for epidemiological and quality improvement purposes. The establishment of an Indigenous Reference Group, providing an Aboriginal voice which guides priority-setting and culturally safe research practices, has been key to the Partnership’s work.
The Partnership has led to improved communication between care providers and increased clinician knowledge and confidence in managing hyperglycaemia in pregnancy. Clinicians also report a greater emphasis on care being patient-centred, with more flexibility for women to choose the location of their care and clinicians placing a high priority on effective cross-cultural communication.
Currently the Partnership is working with Aboriginal and Torres Strait Islander women, families and communities to co-design improved supports for women and families impacted by hyperglycaemia in pregnancy. Additionally, on advice of the Partnership’s Indigenous Reference Group, work of the Partnership has expanded to include young people with type 2 diabetes, acknowledging the intergenerational impact hyperglycaemia in pregnancy has on Aboriginal and Torres Strait Islander communities.