A call for culture-centred care: Is continuity of care possible if culture remains an appendix in the mainstream health care system for Aboriginal families [across the first 1000 days] in South Australia?

Abstract Background:Aboriginal women and their infants experience significant disadvantage in health outcomes compared to their non-Aboriginal counterparts. Access to timely, effective, and appropriate maternal and child health care can contribute to reducing these existing health disparities. This research sought to explore factors that contribute to continuity of care for Aboriginal women and their infants living in metropolitan South Australia. This paper reports on the perspectives of health care workers in mainstream health services from the antenatal period to the end of an infants’ second birthday. It explores health workers’ perspectives of what contributes to positive care experiences and satisfaction with care provided to Aboriginal women and their infants in mainstream health.Methods: Eight focus groups were held with 52 health professionals. Participants included Aboriginal Cultural Consultants (n=7), Aboriginal Maternal Infant Care Workers (n=3), Midwives (n=3) and Child and Family Nurses(n=39). Data was inductively coded and thematically analysed.Results: Three key themes emerged: the system takes priority, culture is not central in approaches to care, and ‘we’ve got to be allowed to do it in a different way’. Conclusions: This research highlights a lack of continuity of care for Aboriginal families accessing mainstream health services from the antenatal period through to an infants’ first 1000 days of life. This research has implications for communities, and it calls for strategies to enhance continuity, and healthcare services to provide appropriate and culturally safe care. Findings will inform and guide future changes to improve continuity of care for Aboriginal families and infants in the first 1000 days.