How this research will be carried out?
This project will use a mixed methods design and will comprise the following components:
1. A systematic literature review to consolidate and synthesise existing literature on care-seeking behaviour, specifically facilitators and barriers to women identifying themselves as viable candidates to seek care.
2. Quantitative analysis using the eLIXIR, Born in South London database to investigate comparative rates of use between different groups, in pre- during- and para-pandemic periods. The database contains linked, routinely collected maternal and neonatal health records, primary care data, and socio-demographic information from women giving birth at two acute NHS hospitals in south London and is representative of the local population.
3. Qualitative exploration using participatory appraisal activities and in-depth interviews to elaborate on statistical findings. In this component, the project aims to explore in detail, women's experiences with seeking care, nuanced social and cultural factors that impact their decision making, and changes that needs to be made to increase uptake and use.
How will patients and the public be involved?
This project will benefit from strong links to the project specific patient and public involvement and engagement (PPIE) groups of the eLIXIR study and the ARC South London adopted RESILIENT study, both of which comprises women from underserved groups who have given birth in south London, have lived experience of accessing complex care during pregnancy, and are passionate about supporting research in maternal health inequalities. The project will be presented to these groups at regular intervals to help guide the research process and ensure relevance of the methods and results. Additionally, selected patients and the public will be involved in co-production of research in the qualitative component of this project, through participatory appraisal methods.
Potential benefits of the study
The findings of this project will be used to better target interventions and to develop a more patient-centred and culturally-competent service, for pregnant women from underserved groups who we know are at risk of poorer health outcomes, and thereby reduce the health inequality gap. By actively engaging with the community, this project hopes to critically examine and shift the narrative on social and racial inequality in healthcare and help us to envision a better future for maternity services in a diverse inner-city population.
This project is funded by Tisha Dasgupta’s Doctoral training grant from the Economic and Social Science Research Council and the London Interdisciplinary Social Science Doctoral Training Partnership [ES/P00703/1]. It was adopted by ARC South London in February 2023 and will be completed by September 2028.