Fundamental to the work of the Alliance is the concept of equity. One of the key questions in establishing the three research priorities was:
Does the research have the potential to reduce inequities by including those most vulnerable to poor outcomes and/or enhancing the health and well-being of ALL childbearing women, infants, and families?
The hallmark of our research is that we work to ensure that we leave no one behind. This is a core aspect of the QMNC framework, which is founded on human rights principles – providing 'skilled, knowledgeable and compassionate care for all:
The other necessary aspect of this is to do it together with the genuine engagement and participation of women, families and communities to ensure that the approaches and solutions are co-created and available, accessible and acceptable to all.
There are many reasons why equity matters in research, and especially in research that aims to meet the needs of women and children. Women and children are already likely to experience some degree of disempowerment. Add to that factors such as poverty, language and communication barriers, being from a minority ethnic group, being very young, having less education, being subject to coercion and violence, or not having legal status because of being an asylum seeker or being trafficked. Such women and children experience the worst outcomes. At the same time, they are the people most likely to need the care of midwives, and where midwives can make the biggest difference. Researchers must work pro-actively to contact and include women who may be especially vulnerable, and to find out about their needs. The application of better methodological approaches is needed to enable researchers to do this effectively.
Such approaches would include:
- ensuring that all analysis of routine data sets includes an inequalities lens, such as analysis by markers of socio-economic status, education and ethnicity, etc., and consider the impact of multiple disadvantage.
- ensuring that all empirical studies work not to exclude people by virtue of factors such as language, by developing mechanisms for translation and pro-actively reaching out
- developing a programme of specific studies to examine the needs of the most vulnerable, guided by data on those who have the worst outcomes
- developing methodological approaches to do all this most sensitively and most effectively, working with pre-existing community groups to guide appropriate contact and communication, and ensuring community engagement and participation.