Ahead of Women's Health Week (7-11 September 2020), the Federal Health Minister, The Hon Greg Hunt, has announced a $1.9 million MRFF Primary Health Care Research grant for the Monash University-led ORIENT study.
ORIENT is a five-year study which aims to improve women's access to sexual and reproductive health services in primary care and focuses on two of the MRFF primary health care research priorities: rural and regional access to services and workforce issues including scope of practice.
Based within SPHERE, the NHMRC Centre of Research Excellence in Sexual and Reproductive Health for Women in Primary Care, and led by Professor Danielle Mazza, Head of the Monash University Department of General Practice, ORIENT will test the effectiveness and cost-effectiveness of a nurse-led model of care in general practice to increase long acting reversible contraception (LARC) uptake and improve access to early medical abortion services in rural and regional areas.
Accessing effective contraception and abortion services for women living rural and regional areas can be extremely challenging. Women in rural areas are 1.4 times more likely to experience an unintended pregnancy than women living in metropolitan areas, primarily due to geographical isolation and a lack of access to contraception and abortion services.
LARCs (implants or intrauterine devices - IUDs) are the most effective way of preventing unintended pregnancies, but only 11 per cent of Australian women currently use them. The COVID pandemic has made access even more difficult despite early medical abortion (EMA) and contraception having been declared an essential service. This is particularly the case for highly time-sensitive EMAs that must be undertaken before nine weeks' gestation in Australia.
"Women in rural and regional areas have high rates of unintended pregnancies and difficulty accessing the most effective forms of contraception (implants and intrauterine devices) and early medical abortion" Professor Danielle Mazza said, "ORIENT will address this through innovative workforce solutions involving nurse led models of care, tasksharing and where appropriate telehealth". Targeting a key goal of the National Women's Health Strategy and addressing community and key stakeholder calls for greater access to these services, the ORIENT team seeks to broaden the scope of work of practice nurses to address these needs.
ORIENT's multidisciplinary team comprises leading national and international researchers, who are collaboratively working with consumers, practitioners and key stakeholders in areas of primary care, rural sexual health, contraception, and abortion.
Working together with key stakeholders such as the Australian College of Rural and Remote Medicine, the Australian Practice Nurse Association, the Royal Australian College of General Practitioners, the Centre of Excellence in Rural Sexual Health, and family planning organisations, ORIENT will co-design, implement and evaluate a nurse-led model of care in rural and regional general practice settings. This model will be supported by academic detailing, a virtual community of practice and training on the insertion and removal of implants.
