Identifying maternity services in public hospitals in rural and remote Australia
Authors: Longman Jo , Pilcher Jennifer M. , Donoghue Deborah A. , Rolfe Margaret , Kildea Sue V. , Kruske Sue , Oats Jeremy J. N. , Morgan Geoffrey G. , Barclay Lesley M. 
Published: June 2014

Objective
This paper articulates the importance of accurately identifying maternity services. It describes the process and challenges of identifying the number, level and networks of rural and remote maternity services in public hospitals serving communities of between 1000 and 25 000 people across Australia, and presents the findings of this process.

Methods
Health departments and the national government’s websites, along with lists of public hospitals, were used to identify all rural and remote Australian public hospitals offering maternity services in small towns. State perinatal reports were reviewed to establish numbers of births by hospital. The level of maternity services and networks of hospitals within which services functioned were determined via discussion with senior jurisdictional representatives.

Results
In all, 198 rural and remote public hospitals offering maternity services were identified. There were challenges in sourcing information on maternity services to generate an accurate national picture. The nature of information about maternity services held centrally by jurisdictions varied, and different frameworks were used to describe minimum requirements for service levels. Service networks appeared to be based on a combination of individual links, geography and transport infrastructure.

Conclusions
The lack of readily available centralised and comparable information on rural and remote maternity services has implications for policy review and development, equity, safety and quality, network development and planning. Accountability for services and capacity to identify problems is also compromised.

What is known about the topic?
Australian birthing services have previously been identified for hospitals with 50 or more births a year. Less is known about public hospitals with fewer than 50 births a year or those with only antenatal and postnatal services, particularly in rural and remote locations, or how maternity services information may be identified from publicly available sources.

What does this paper add?
This paper describes the process and challenges of identifying maternity services in rural and remote public hospitals serving towns of between 1000 and 25 000, and presents the findings of this process.

What are the implications for practitioners?
Nationally accessible, reliable and comparable information is important for health planners, policy makers and health practitioners. This paper provides useful information on the variations in the capability and location of maternity services across Australia. Opportunities exist for consistent collection, collation and reporting of maternity services across rural and remote Australia. This will ensure quality and safety of services, contribute to policy review, support the development and maintenance of service networks, and assist in planning services and expenditure, as well as in the identification of problems. It is therefore key to providing equitable services across the country.