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Case study: Using a NIHR Development and Skills Enhancement award to evaluate maternal and newborn inequalities through health data-science

The NIHR aims to support individuals on their trajectory to becoming future leaders in research. The NIHR Development and Skills Enhancement (DSE) award is a post-doctoral level award aimed at supporting NIHR Academy members to gain specific skills and experience to support the next phase of their research career. Read more about the NIHR Development and Skills Enhancement Award

Working towards reducing health inequalities

Dr Hannah Rayment-Jones is a midwife in receipt of the NIHR DSE Award, which supports post-doctoral level NIHR Academy Members to gain specific skills and experience to support the next phase of their research career. The award supports a mixture of applications in areas of strategic importance and researcher-led applications.

Hannah’s area of focus is to explore how maternity care can improve clinical outcomes and experiences for Black and minority ethnic women and those with social risk factors. With nearly a decade of experience as a clinical midwife across a range of hospital and community settings Hannah moved into research in 2017 through the NIHR’s Doctoral Research Fellowship. 

 “My goal was, and still is, to contribute to the knowledge base around reducing the stark health inequalities for pregnant women and their babies.”

Balancing data analysis with a patient-centred approach to involvement and engagement

Social risk factors such as minority ethnic groups, young motherhood, poverty, migrant or refugee status, mental illness, substance abuse and homelessness are associated with poor childbirth outcomes and experiences of maternity care. Recent national reports have highlighted how pregnancies to these women are over 50% more likely to end in stillbirth or neonatal death and carry an increased risk of premature birth and maternal death. 

“A particularly important contribution to knowledge was the identification of causal mechanisms for the inequalities often seen in maternal and infant health outcomes, such as women’s perceptions of surveillance, discrimination and paternalistic maternity care.” 

Using her DSE award to develop skills in health data science, Hannah is theorising and analysing maternal and health data to better understand what improves health inequalities. Her research highlights how carefully considered place-based care with a focus on continuity can improve health inequality through the creation of safe, familiar spaces and trusting relationships with care providers to enable women to identify their specific needs.

“The award has provided me with both the financial means and the time to undertake courses in data science, statistical analysis, coding languages and data visualisation. Public and patient involvement plays a significant part of my fellowship project and I am dedicated to continuing this high standard of engagement in future research.”

How the NIHR Academy is supporting future research leaders

Hannah’s research findings have been communicated at a number of scientific conferences, high profile NHS reports and peer-reviewed journals. Her research has been cited in the NHS Equity and equality guidance for local maternity systems, Implementing Better Births strategy, RCM position statement, and the NHS Race and Health Observatory review of ethnic inequalities in healthcare. Hannah was also a founding member and chair for the Institute of Women and Children’s Health PPIE group at King’s College London, developing the PPIE strategy. Hannah expects to continue her journey as a research leader improving care for women and their families and is looking towards a further NIHR Advanced Fellowship application bringing together large cohort analysis and realist methodology to explore pregnancy outcomes, service use and interventions to reduce health inequalities for women and children in their early years.

“Aside from the vast training opportunities, being a member of the NIHR Academy has enabled me to network with researchers in my field and those using similar methodologies. This has given me the opportunity to develop a supportive network and feel part of something collaborative.”

During her award Hannah added to her family and took a period of maternity leave. She also furloughed her fellowship for three months to support her children during the pandemic when schools were closed.