Pregnancy and the first five years of life are foundational to a child’s developmental, health and wellbeing outcomes, and a critical transitional time for mothers and families. Due to the ongoing impacts of colonisation and systemic discrimination, Aboriginal and Torres Strait Islander mothers and children are more likely to experience negative health and wellbeing outcomes than non-Indigenous mothers and children. Innovative programs are increasingly being developed and implemented across Australia to improve health and wellbeing for Aboriginal and Torres Strait Islander families during pregnancy, birth and the first five years. However, in the absence of a standard COS that centres Aboriginal and Torres Strait Islander concepts of health and wellbeing, evaluation and synthesis of this emerging evidence, and comparison between programs and interventions can be difficult.
Such a COS needs to be developed by and with Aboriginal and Torres Strait Islander peoples to ensure the COS is grounded in Indigenous concepts of health that centre what is important for social and emotional wellbeing from Aboriginal and Torres Strait Islander perspectives. It supports the rights of Indigenous peoples to set priorities. This reduces the risk of a deficit-based framing, supports self-determination and reduces power imbalances. It ensures strengths, resilience and culturally meaningful indicators of wellbeing are embedded. Aboriginal and Torres Strait Islander leadership strengthens the cultural authority, legitimacy and trustworthiness of the outcomes, increasing the likelihood that programs will be acceptable and useful, and that they will drive meaningful improvements in care and outcomes for Aboriginal and Torres Strait Islander families.
A standard COS should be grounded in Aboriginal and Torres Strait Islander models of social and emotional wellbeing and include wellbeing domains such as connection to culture, community, Country, family and kin, and spirituality as well as physical pregnancy and birth outcomes to ensure they are relevant and important for Aboriginal and Torres Strait Islander peoples. An Aboriginal and Torres Strait Islander-informed COS will enhance program evaluation and improve understanding of effective programs for improving Indigenous maternal and child health outcomes.
This study will conduct a scoping review, focus groups with Aboriginal and Torres Strait Islander families and community groups, a consensus workshop and a Delphi survey including experts in the field of Aboriginal and Torres Strait Islander maternal and child health and wellbeing to identify the most important outcomes to Aboriginal and Torres Strait Islander communities when evaluating programs.
While other maternal and perinatal COS’s have been developed, 1, 2 or are in development3, these focus on physical outcomes of pregnancy and birth for mother and baby1, do not consider Aboriginal and Torres Strait Islander conceptualisation of health and wellbeing2, 3, are explicitly region specific2, or specific to low- and middle- income country settings3.
To the best of our knowledge, no COS includes outcomes developed with Aboriginal and Torres Strait Islander peoples related to the social and emotional health and wellbeing of Aboriginal and Torres Strait Islander families throughout pregnancy, birth and the first five years.
1. Devane, D. Begley, C. M. Clarke, M. Horey, D. O. Boyle C. (2007). Evaluating maternity care: a core set of outcome measures. Study 108.
2. https://www.comet-initiative.org/Studies/Details/1723
3. https://www.comet-initiative.org/Studies/Details/2100
- Catherine Chamberlain - Principal Investigator (1)
- Odette Pearson - Principal Investigator (2,3)
- Yvonne Clarke (2,4)
- Emmanuel Gnanamanickam (4)
- Fiona Mensah (1,2,3)
- Melissa O’Donnell (4)
- Sally Brinkman (4)
- Aklilu Sinshaw (2)
- Leonie Segal (2,4)
- Kimberley A Jones (1)
- Tess Bright (1)
1. University of Melbourne, Parkville, Victoria, Australia,
2. South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia,
3. Murdoch Children's Research Institute, Parkville, Victoria, Australia,
4. Adelaide University, Adelaide, South Australia, Australia.
Disease Category: Pregnancy & childbirth
Disease Name: Maternity care
Age Range: 0 - 120
Sex: Either
Nature of Intervention: Any
- Clinical experts
- Consumers (caregivers)
- Consumers (patients)
- Families
- Researchers
- Service providers
- Service users
- COS for clinical trials or clinical research
- COS for practice
- Consensus meeting
- Delphi process
- Focus group(s)
- Literature review
- Semi structured discussion
A scoping review conducted in 2025/2026 to gather a preliminary list of potential outcomes. In 2026, focus groups with Aboriginal and Torres Strait Islander families and community groups will be held to gather input on outcomes important to the target population. In late 2026, a consensus meeting with experts in the field of Aboriginal and Torres Strait Islander perinatal health and wellbeing will be held prior to conducting a Delphi survey to finalise the COS. Fortnightly meetings will be attended by the project team.