Informed Decision Making: The interaction between sustainable maternity care services and community sustainability 

Health care decisions have profound impacts in rural areas. Improving and aiding in the quality of these decisions is therefore of great consequence. We are developing a decision framework by eliciting values and objectives of care providers, recipients and the broader community to aid decision-makers in the difficult task of providing rural maternity care with limited resources.

When a maternity service closes, women and families have to travel to receive care. As a result they lose personal and family supports and incur significant financial costs. First Nations communities lose important cultural/community context. Maternity care closures result in fewer numbers of physicians and nurses and other maternity support staff, leading to further difficulties in recruitment and retention. The loss of medical facilities also affects economic capital as businesses find it difficult to recruit employees, reducing community economic viability.

Loss of maternity/newborn services offers a clear example of the consequences of the lack of attention being given to the relationship between health care, sustainable communities and overall quality of life. In the present climate of economic restraint, policy/program decision-makers are forced to consider if low volume services, such as maternity care, are transferable. In developing our decision model, we are including relevant issues that tend to be overlooked, such as community sustainability, as well as core issues such as safety and costs of a high quality maternity service. Our proposal represents the first time that maternity care has been looked at as a key element in community viability/sustainability. The research is taking place in rural Northern BC. Employing established qualitative and decision-analysis techniques, the complexity of provision of local maternity care in these communities will be detailed through interviews & focus groups with affected parties, documents review & observations.