The Waijungbah Jarjums model of care has been developed alongside the local Aboriginal and Torres Strait Islander community in collaboration with Gold Coast Hospital and Health Service (GCHHS), Women’s Newborn and Children’s Service. Waijungbah Jarjums offers continuity of care by a known Aboriginal and/or Torres Strait Islander midwife and child health nurse from conception to the first 1000 days or 2 years of age. The Gold Coast local Aboriginal and Torres Strait Islander community conceptualised a model of care that meets their wants and needs in relation to maternal and child health care and GCHHS has implemented it alongside them, held accountable to Aboriginal and Torres Strait Islander Governance through the Waijungbah Jarjums working group.
The service is guided by two prominent models of care ‘Birthing on Country’ and the ‘First 1000 Days Australia’ and adapted to meet the needs of the local Aboriginal and Torres Strait Islander community, the first time these two models have (through a co-design process) been integrated. The model was conceptualised by the community in June 2019 and implementation began in September 2020 with the first birth occurring in December 2019.
Purpose of the Evaluation
This report presents the findings from a preliminary process and outcomes evaluation of the Waijungbah Jarjums model of care. Specifically, the evaluation sought to understand:
Process
Awareness and adoption of the model, and if the model was being delivered as intended
The sustainability of the model of care
The experience of Waijungbah Jarjums midwives, mothers, HHS staff, the Aboriginal and
Torres Strait Islander community, and other key stakeholders of the model of care
If the model of care is perceived to be accessible and culturally safe
Outcomes
If the model of care is culturally and clinically safe for mothers and jarjums (babies)
The effectiveness of the model of care on key clinical outcomes, compared with the mainstream GCHHS services
The experience and satisfaction of the mothers and their families who engaged in the model of care
What the key enablers and barriers of the model are
Finally, the evaluation also conducted some preliminary analysis of the cost effectiveness of the model to quantify the costs, comparative to the GCHHS standard services.
Methodology
Both primary and secondary data was collected to provide insight into the effectiveness and outcomes of the Waijungbah Jarjums model. This included quantitative data (e.g. clinical outcomes, validated scales) and qualitative data (e.g. interviews and yarning circles). While the evaluation was not a randomised control trial, where possible comparisons have been made to the standard model of care in the same location, and data was then triangulated from all sources to provide insight into the proposed evaluation questions.
Key Recommendations
Overall, continued investment and long-term,sustainable funding options should be considered for the Waijungbah Jarjums model, which has demonstrated in only a 6-month period outcomes which indicate that it is an effective and cost-effective, clinically and culturally safe model of care. The significant media attention for the model has also been a good indicator of its success. Further, recommendations include:
Continued investment in the Waijungbah Jarjums model and its iterative design based on best practice, community needs, and the RISE framework
Scale up of the midwifery group practice so that the model can care for more Aboriginal and/or Torres Strait Islander mothers in the Gold Coast area
Maintain local community connections and Aboriginal and/or Torres Strait Islander governance in working groups and/or steering committees
Consider and invest in a one-stop community hub, advertising and growth of the model of care ongoing
Continue to develop the culturally safe workforce, both within the model of care and in the wider HHS service
Continue to maintain current partnerships (e.g. YRACA, membership with First 1000 days Australia Regional Alliance) and explore new partnership opportunities (e.g. with local early learning centres)
“So I really think that as midwives, we have a really big job. Then doing that first 1000 days training, and that solidified our role even more. We don’t just have an obligation to this generation of babies, we have the ability to positively impact three or four generations after this baby that we birth. I really believe that through that and through optimal maternity care, that we will change the narrative for our people's health.”
Waijungbah Jarjums look more into your culture, link you in with cultural ties, follow cultural protocols and create strong babies, strong families and aa strong culture - Waijungbah Jarjums Consumer
“We are so privileged as a service to be honoured with the role of walking beside women and their families as their midwife whilst they bring our future ancestors into the world. The most rewarding part of my work is seeing the massive transformation that has occurred within the HHS over the life of the Project. The fact that now the management of Womens Newborns and Childrens Unit truly acknowledges and see’s First Peoples staff’s innate cultural knowledge’s and supports our ways of knowing, being and doing within a large organisation is a transformation I could have never imagined seeing or being a part of in my life time.”