Grant: CIHR Fellowship

Canadians benefit from an excellent perinatal health care system. However, some problems persist as evidenced by disparities in illness and death among mothers and babies. Rates of serious illness/ death among mothers and babies vary significantly by region, socio-economic status, location of residence, Aboriginal status and other factors. The delivery of perinatal health care, particularly in rural and remote regions, faces significant challenges. Challenges associated with regionalized perinatal care include geography, climate, highly variable emergency transport service provision, organizational differences between provinces in the provision of care for pregnant women and newborns at different levels of perinatal risk, and the absence of a national program for evaluating and improving regionalization. Besides developing innovative ways to address existing challenges and financial constraints, Canada requires a systems approach for continuous evaluation of the structure, processes and outcomes of perinatal regionalization in order to encourage knowledge-based improvement. This project will provide an assessment of perinatal health services across Canada using a systems approach. Using indicators of maternal, fetal and neonatal tiers of service, we will evaluate the functioning of hospitals in all provinces/territories. Maternal, fetal and neonatal morbidity and morbidity rates will also be assessed especially in rural and remote communities. The project will identify problems with regionalization of perinatal care and ascertain lacunae in the organization of services. Recommendations will be formulated in collaboration with provincial/territorial stakeholders. This initiative has the potential to significantly enhance the care of mothers and babies in Canada.