Bridging the Gap: Using an interrupted time series design to evaluate systems reform addressing refugee maternal and child health inequalities

Jane Yelland, Elisha May Riggs, Josef Szwarc, Susan Casey, Wendy Dawson, Dannielle Vanpraag, Christine East, Euan Morrison Wallace, Glyn Teale, Bernadette Harrison, Pauline Petschel, John Furler, Sharon Goldfield, Fiona Mensah, Mary Anne Biro, Suzanne Margaret Willey, I-Hao Cheng, Rhonda Small, Stephanie Janne Brown

Research output: Contribution to journalArticleOther

24 Citations (Scopus)


Background: The risk of poor maternal and perinatal outcomes in high-income countries such as Australia is greatest for those experiencing extreme social and economic disadvantage. Australian data show that women of refugee background have higher rates of stillbirth, fetal death in utero and perinatal mortality compared with Australian born women. Policy and health system responses to such inequities have been slow and poorly integrated. This protocol describes an innovative programme of quality improvement and reform in publically funded universal health services in Melbourne, Australia, that aims to address refugee maternal and child health inequalities. Methods/design: A partnership of 11 organisations spanning health services, government and research is working to achieve change in the way that maternity and early childhood health services support families of refugee background. The aims of the programme are to improve access to universal health care for families of refugee background and build organisational and system capacity to address modifiable risk factors for poor maternal and child health outcomes. Quality improvement initiatives are iterative, co-designed by partners and implemented using the Plan Do Study Act framework in four maternity hospitals and two local government maternal and child health services. Discussion: It is envisaged that the Bridging the Gap program will provide essential evidence to support service and policy innovation and knowledge about what it takes to implement sustainable improvements in the way that health services support vulnerable populations, within the constraints of existing resources.

Original languageEnglish
Article number62
Pages (from-to)1 - 13
Number of pages13
JournalImplementation Science
Issue number1
Publication statusPublished - 30 Apr 2015


  • Partnerships
  • Process evaluation
  • Quality improvement
  • Refugee families
  • Time series design
  • Universal health services

Cite this