1. Improving the management of Diabetes in Pregnancy in Remote Australia: The NT & FNQ Diabetes in Pregnancy Partnership

2. Aims and Objectives
Aim: To improve systems of care and services for women with diabetes in pregnancy (DIP) in remote Australia.
Objectives:
expand the Northern Territory (NT) DIP Clinical Register
establish a DIP Clinical Register in Far North Queensland (FNQ)
enhance models of care for managing DIP
improve maternal health post-partum for NT and FNQ Indigenous women with DIP with a systems-based intervention.

3. Achievements
Commenced complex health systems intervention to improve maternal health post-partum; intervention components are:
↑ workforce capacity (skills, knowledge, health literacy)
access to healthcare through culturally appropriate pathways
Information management & communication of information (including clinical register reports)
Policy & guidelines
DIP Clinical register
(outcome measures, feedback)

4. Milestones DIP Clinical Register: Expanded in NT (>2000 women)
Established in FNQ (800 women)
Enhanced models of care for managing DIP:
Regional workshops
Annual symposium
Guidelines
Complex post-partum systems intervention:
System changes, health prof education
Pilot post-partum individual intervention (Kirkham R et al, ANZJOG 2018): difficult to reach women (phone/ SMS), nil ↑ health check completion rate

5. Engagement with policy makers
Engaged in DIP Partnership since prior to funding
Strong relationships continue
Actively contribute to planning, design, conduct and interpretation
Actively contribute in-kind to current and future planned related work
Formed NT Diabetes Clinical Network in 2018, Chaired by lead investigator, supported by policy makers
work of this project is 1 of 3 priorities
agreed by Network for

6. Challenges
High staff turnover in remote primary and hospital-based health care
remoteness impacts communication & access to health care
language barriers impact communication & health literacy
use of multiple electronic health systems