Performance indicators for maternity care in a circumpolar context: a scoping review

Area of Science:

• Public Health
• Maternal Health
• Healthcare Systems

Background:

• Harsh circumpolar climates and dispersed populations lead to centralized maternity care and reduced local services.
• Routine evacuation for birth from remote areas to urban centers creates a tension between patient safety and culturally responsive care.
• This centralization raises concerns about meeting the diverse health needs and values of circumpolar populations.

Purpose of the Study:

• To identify recommended performance and quality indicators for circumpolar maternity care systems.
• To assess the alignment of existing indicators with the specific needs of remote and Indigenous populations.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (Scopus, Ebscohost, Global Health) and grey literature.
• Inclusion criteria focused on maternal health indicators for Indigenous women and those in circumpolar/remote regions.
• Two independent reviewers screened articles and extracted relevant data on health indicators.

Main Results:

• Twenty-six documents yielded 81 unique health indicators, primarily focusing on antenatal and intra-partum care processes and outcomes.
• Governmental indicator sets rarely incorporated the specific needs and priorities of Indigenous peoples.
• Existing performance reporting in circumpolar maternity care often lacks consideration for local values and priorities.

Conclusions:

• While circumpolar health systems report on maternity care, local priorities and values are inadequately captured.
• There is a need to enhance maternity care indicator sets to better reflect the unique needs of circumpolar populations.
• Future development of indicators must actively involve northern stakeholders to ensure relevance and cultural appropriateness.