Travel for care, cultural safety and upstream structural determinants of health were identified as important themes. Twenty-nine additional indicators, largely focused on social determinants of health, health care responsiveness, and accessibility, were identified for further research. Eleven indicators, many of which represented physical health outcomes, were ranked highly on all four criteria. ResultsĬonsensus was achieved after two rounds, as measured by a Cronbach’s alpha of 0.87. Fourteen participants rated each proposed indicator according to importance, circumpolar relevance, validity, and reliability and suggested additional indicators for consideration. The list of proposed indicators was derived from a previously published scoping review. Methodsįourteen maternity care and health systems experts participated in a modified Delphi consensus process. The aim of this project was to identify contextually appropriate performance indicators for maternity care in circumpolar regions. For many circumpolar states, indicators aligned with national strategies may ignore the priorities of northern, remote, or Indigenous populations. Meaningful performance measurement requires indicators to be scientifically robust and strategically focused.
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