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Box 5.3.2(continued)The service uses an electronic registration and recall system to keep track ofappointments and vaccinations. Women using the program are invited to participate inthe early postnatal care and education program. Home visits are provided if desired.• 88 per cent of Aboriginal women in the Macleay area presented for antenatal carebefore 20 weeks gestation.• 93 per cent of women use the postnatal service.• Child immunisation coverage has increased to 95.2 per cent.• The rate of premature birth is lower than for the total NSW Aboriginal population, butthere is significant variation over time. In 2004-05 the rate was 10.5 per cent.(Aspery, Jarrett and Donovan 1998).Koori Maternity Strategy, VictoriaThe main aim of the service is to provide culturally appropriate maternity care to Kooriwomen and align their birthing experiences and outcomes with those experienced byall Australian women. The strategy operates across Victoria.The program provides both ante and postnatal care, antenatal education, birthingsupport and a health service for children in early childhood. Transport is provided formothers to facilitate access to the clinic. Aboriginal women still have their babies in thelocal hospital, but it is not uncommon for them to be discharged after only two days.The birthing program is able to provide support for mothers in this situation, particularlyin relation to continuation of breastfeeding after discharge from hospital.A self assessment of the strengths of the program pointed to the culturalappropriateness of the service provided, its flexibility and reliability, with confidentialityassured, and to the fact that it is community based, owned and controlled.There has been an increase in Koori women accessing antenatal care and earlier inpregnancy. Social networks have improved and better working relationships withmainstream organisations have been established (Dwyer 2005).Marrang Aboriginal Child and Family Health Model, NSWThe Marrang Aboriginal Child and Family Health Model was developed to improveaccess and health outcomes for Aboriginal families in Orange, NSW. It is based on atwo person team consisting of an Aboriginal Health Worker and a child and familyhealth nurse dedicated to servicing Aboriginal families. The model engages Aboriginalfamilies in a culturally appropriate manner.(Continued next page)5.20 OVERCOMINGINDIGENOUSDISADVANTAGE 2007