EP17.35: Scaling‐up the initial maternity assessment and planning service: closing the gap in antenatal care for women in regional and remote Australia

To describe the “scale-up” of an established tertiary centre multidisciplinary population-based screening and assessment service to include a remote healthcare setting in Australia. Implementation science methodology was used prospectively to provide both a definition and a framework to successfully “scale-up” an established metropolitan first trimester population-based initial maternity assessment and planning (IMAP) service to incorporate a remote Australian healthcare setting. (The IMAP service is described in detail in another submitted abstract). A codesign approach engaged key stakeholders within a remote Australian maternity healthcare setting to successfully “scale-up” the IMAP service. An implementation science framework was followed to ensure systematic approach including a groundwork phase (incorporating financial, staffing, resource, and clinic capacity planning), an implementation phase (including clinic structure planning, service initiation and progressive supported service decentralization) and a sustaining phase (ensuring that the service is embedded within routine antenatal care). Since establishment of the service in 2023, over 200 women have been seen with an associated increase in the proportion of local women accessing first trimester ultrasound. The proportion of local women not attending for antenatal care within the first trimester has fallen to <20% following IMAP service initiation. This is the first study to describe the successful rural or remote scale-up of a population-based first trimester screening service linked to early preventative maternity care. Increasing barriers to antenatal care for women living in regional settings are well described and this study confirms the feasibility of scaling-up a service which “inverts the pyramid” of antenatal care to improve equity of care for women irrespective of geographical location.