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The Ontario Midwifery Program

The Ontario Midwifery Program. Program Evaluation Proposal. Summer 2002. OMP Program Overview What the Literature Shows Description of Evaluation Proposal Questions (and a Few Answers). Agenda. OMP Program Overview. Overview. Literature. Proposed Evaluation. Questions. History.

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The Ontario Midwifery Program

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  1. The Ontario Midwifery Program Program Evaluation Proposal Summer 2002

  2. OMP Program Overview • What the Literature Shows • Description of Evaluation Proposal • Questions (and a Few Answers) Agenda

  3. OMP Program Overview Overview Literature Proposed Evaluation Questions

  4. History Overview • Midwifery became regulated in Ontario in 1994 • Midwifery care existed previously but wasn’t covered by OHIP • The Ontario Midwifery Program was formed as a result • Other provinces followed suit by regulating midwifery services Literature Proposed Evaluation Questions

  5. Midwifery Service Components Overview • Midwifery Education • Midwifery Practice • Midwifery Research • The current study is limited in scope to midwifery practice only Literature Proposed Evaluation Questions

  6. Program Components Overview • Education/Prevention • Pre-natal care • Labour/Birth care • Post-partum care • Counseling/Support Literature Proposed Evaluation Questions

  7. Overview Literature Proposed Evaluation Questions

  8. What the Literature Shows Overview Literature Proposed Evaluation Questions

  9. In General Overview • No studies found evaluating funding formula/method/process • Some cost-effectiveness studies • Focused more on outcomes however • Showed some improved outcomes for midwifery over obstetrics Literature Proposed Evaluation Questions

  10. Quebec Pilot Overview • Multi-faceted evaluation • “Set up for failure”, but also for success • Lots of opposition to midwifery services in Quebec • Midwifery regulation was adopted in the end however • Outcome measures showed positive improvements over obstetric care Literature Proposed Evaluation Questions

  11. Description of Evaluation Proposal Overview Literature Proposed Evaluation Questions

  12. Two Parts Overview • Process Evaluation: • Funding methods and effectiveness • Outcome Evaluation: • Economic cost-effectiveness analysis Literature Proposed Evaluation Questions

  13. Design Overview • Comparative data analysis approach • Economic cost-effectiveness analysis will also be used • The sample population consists of low-risk pregnant women receiving maternity care in 2000, 2001, and 2002 in Ontario, Canada Literature Proposed Evaluation Questions

  14. Outcome Measures Overview • Number of prenatal visits per client • Epidural use during labour • Use of delivery aid devices • Caesarean section required • Episiotomy required • Resuscitation required • Length of hospital stay Literature Proposed Evaluation Questions

  15. Limitations Overview • The client viewpoint is used rather than the preferred societal viewpoint. • The use of TPAs is a recent addition to the OMP and therefore data availability may be limited. • A cost-effectiveness analysis doesn’t give as complete a picture. • Comparing obstetric care data to midwifery care data may be inherently difficult. Literature Proposed Evaluation Questions

  16. Questions? Overview Literature Proposed Evaluation Questions

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