Recent reviews of maternal health care have highlighted concerns regarding marked inequities in maternal health outcomes across regions, socio-economic groupings and ethnicity. Tools are needed to provide clear and objective information on these inequities that inform stakeholders, improve outcomes and hold policymakers and political leaders to account.

The evolution of a framework for assessing responses to inequity in maternal health policy

In 2023, colleagues from the University of Southampton conducted a preliminary review of maternal health policy through an equity lens. This review revealed that, although equity and marginalised groups were frequently acknowledged, there was a lack of concrete guidance and recommendations within policies to address and monitor inequities. This initiative garnered significant interest, leading to the suggestion that the underlying framework used for the preliminary work could be further developed using a co-creation methodology to produce a tool for evaluating future maternal health policies for advocacy purposes.

Following the acquisition of seed funding, The University of Southampton collaborated with the White Ribbon Alliance UK to further develop a framework for assessing equity in maternal health policy. The team undertook a literature review to comprehensively identify potentially disadvantaged groups of women. In addition, we organised several stakeholder meetings with NGOs, user groups and academics involved in maternal health advocacy to discuss and identify dimensions of equity policy and key metrics.

This enabled us to develop a prototype of the Inequities in Maternal Policy & Care Tracking (IMPACT) framework:

Potential Uses of IMPACT

 This initial work concentrated on national-level advocacy. However, discussions also underscored that the experience of service users is often more influenced by the interpretation and implementation of policies at the local level than national policy itself.

Consequently, it was suggested that the framework could be effectively developed to provide a tool for assessing, planning, and evaluating maternal health services in three use cases: Advocacy, Service Improvement, and Provision of Service.

Next steps

We are currently pursuing both seed funding and potential larger funding opportunities, as well as developing a paper based on our work for publication in a peer-reviewed journal.

As part of a possible larger grant, we are also looking at the data needs of ICSs and ICBs to underpin the use of these tools to help identify and target vulnerable groups.  This will include reviews of data resources for estimates for vulnerable service user groups and explore opportunities to capture and present data using Artificial Intelligence (AI).

Want to get involved?

We are currently exploring the use of the tool at the service improvement level and are keen to speak with and build partnerships with those working on commissioning and service provision who might be interested in helping us to explore if and how it could best be developed.  If you’re interested in supporting our work, please consider engaging on one of more of the following:

1)     Participate in a 1-hour interview and discussion on Teams with the IMPACT team to enable us to gather the info we require to support our grant proposal for the next phase of the project. In this session we will also answer any questions you have on the project and gather you feedback.

2)     Review and feedback on this document to help us improve it before we disseminate to additional stakeholders and/or potential funders.

3)     Join the IMPACT working group which currently meets every 6-8 weeks for one hour. We provide updates on the project progress, ask for feedback on burning questions, and answer any questions posed by working group members. Please note that members of this working group will have a direct and powerful impact on the future phases of IMPACT once funding is approved.

If you’d like to participate in any of the activities listed above, please email Sarah Neal, Professor of Global Health at University of Southampton (S.Neal@soton.ac.uk) and Julie Boddy, Movement Director at White Ribbon Alliance UK (julie@whiteribbonalliance.org.uk).