Harnessing cross-country administrative data to evaluate national policy impacts on maternal, infant and child health and health inequalities-MatCHNet

Lead Research Organisation: University of Glasgow
Department Name: MRC Social & Public Health Services Unit

Abstract

Many chronic diseases have their origins in infancy and childhood and are socially patterned. The social determinants of health are complex and inter-related and may be influenced by population characteristics, policies, and service provision. UK national and devolved governments have introduced many policies in maternal and early years, but most of these policies have not been evaluated. They have been rolled out across the whole country and it is difficult to evaluate policies that apply to the whole population. In addition finding appropriate data, comparison groups and methods to evaluate these policies is problematic. Each of the four UK countries has its own administrative data collection systems which collect different information. However, there have been innovations in cross-government sector linked, population-level administrative data (which span family members, policy areas and the lifecourse) which provide opportunities to evaluate policies which may address chronic disease and reduce health inequalities.

The Maternal and Child Health Network (MatCH-Net) will develop a multidisciplinary, community of public health researchers, methodologists, policy makers and service providers who together can prioritise national policy interventions, or social, environmental or service determinants of adverse child outcomes that can be feasibly and validly evaluated. The multidisciplinary network, with research users embedded from the start, aims to prioritise such policies, identify comparable administrative data sources and measures, and consolidate and disseminate methods for robust evaluation of national policies.

By working together with users, MatCH-Net will lay the groundwork for the evaluation of upstream, national polices, which are prioritised by users, such as policy makers, practitioners, multi-sectoral public organisations and third sector organisations. All network activities will therefore be relevant and accessible to these four key groups to ensure maximum engagement of these potential beneficiaries.

The policy-makers will be play an important role in the prioritisation of policies for evaluation. In addition they will learn from policy implementation outwith their own particular remit, department and policy context and thus consider other policy approaches which can have far reaching impacts on NCD prevention and wider societal and economic benefits. Administrative Data Holders from the four UK countries and different policy sectors will attend all events, but will play a key role in those around routine data. Researchers will learn about the data that are available and data holders can learn from each other about optimal data collection, storage, and sharing. They will have an understanding of the potential for linking their data sets with other departmental data and gain an insight into how their data can be used and enhanced to evaluate policies to improve maternal and child health.

Longer-term benefits of MatCH-Net to policy makers, practitioners and families will be the future research that will flow from the foundational work undertaken by the network. This will lead to an improved and rich evidence base for social policy affecting the determinants of early childhood outcomes. By definition these whole population social policy interventions have the potential to impact on the lives of families across the UK.

The sustainability of MatCH-Net will be ensured by the preparation of grant funding applications to evaluate the policies prioritised by the workshops and activities with the stakeholders and users. Within these proposals we will request small amounts of funding to enable network activities to continue in the longer term.

Technical Summary

The impact of fetal, infant and child health on NCDs is well-recognised. Upstream, structural factors, which are complex and inter-related, are likely to the the most fruitful for the prevention of NCDs and inequality reduction. However the evidence base to support this is limited due to difficulties in evaluating policies, which cannot be evaluated in trials. Innovations in linked, population-level administrative data (which span family members, disciplines and the lifecourse), variations between the UK countries, and continously advancing methodological options, provide unrivalled opportunities to identify which social and public health strategies are most likely to improve chronic disease and reduce health inequalities.
The Maternal and Child Health Network (MatCH-Net) will develop a sustainable, multidisciplinary community of researchers and methodologists and key stakeholders: policy makers, service providers and multi-sectoral public and third sector organisations. This cross-country network is key, as data systems have evolved separately between the UK countries and policy contexts diverge with more devolution of powers.
The network will lay essential foundations for future research, through three iterative objectives: 1) mapping policy variations over time and between countries and prioritising those for evaluation; 2) identifying comparable administrative data sources and indicators for national evaluation; and 3) consolidating and disseminating methods for robust evaluation of national policies.
All network activities will be relevant and accessible to our key stakeholders to ensure maximum engagement of these potential beneficiaries. Network members will work together to prioritise research questions and pump prime funds will be used to pilot the most promising of these. The full funding applications that follow will request small amounts of funding to enable network activities to continue in longer term.

This grant is funded by the UK Prevention Research Partnership (UKPRP) which is administered by the Medical Research Council on behalf of the UKPRP's 12 funding partners: British Heart Foundation; Cancer Research UK; Chief Scientist Office of the Scottish Government Health and Social Care Directorates; Engineering and Physical Sciences Research Council; Economic and Social Research Council; Health and Social Care Research and Development Division, Welsh Government; Health and Social Care Public Health Agency, Northern Ireland; Medical Research Council; Natural Environment Research Council; National Institute for Health Research; The Health Foundation; The Wellcome Trust.

Planned Impact

The Maternal and Child Health Network (MatCH-Net) will be of interest to a wide variety of stakeholders from within and beyond the traditional, academic prevention of non-communicable diseases field. MatCH-Net has an inclusive perspective and as such membership of the network will be open to anyone with an interest in maternal and child health; using routine data for research and robust methods for policy analysis. This approach will allow for all potential beneficiaries of the future research proposals (after the end of the UKPRP funding) to have an opportunity to engage with the network. There are five main beneficiaries: 1) Policy-makers from national and devolved government departments and national Public Health Agencies; 2) Administrative Data Holders; 3) Third sector organisations and practitioners; 4) the General Public; 5) Academics (covered in separate section).

Immediate benefits to network members will lead to improved shared understanding of 1) the variation across nations and time of UK social policy likely to impact on early childhood outcomes and their variation; 2) comparable population based administrative data available across settings providing information on interventions, confounders, and outcomes; and 3) robust methodological approaches from various disciplines to assess the impact of policy interventions. Immediate benefits to other policy makers, practitioners, and lay representatives will be the opportunity to influence the priorities of the network through our activities and engagement work.

Short-term benefits to policy makers from various departments (e.g. health, education, welfare) in devolved administrations across the UK will be improved understanding of differences in policy interventions and timelines across nations and opportunities to learn from these policy variations.
Short-term benefits to public will occur via public engagement activities. Individual children and their families, will gain experience of Science, Technology, Engineering, Maths (STEM) through the activities around data linkage. They will also have a better understanding of where tax payers money gets spent across government departments and will have an opportunity to influence researchers. These interactions with the public might alter research questions.

Policy makers and third sector will be able to shape the network priorities and specifically the research questions, this will better suit their needs and the needs of their own beneficiaries (the public, specific interest groups). They will gain a greater appreciation of what can and cannot be achieved by researchers with the data and methods available. They will communicate to researchers what works well for them. Development of new working relationships with researchers will, in the medium term, increase and improve research being carried at the research-policy nexus. Achieving this through the network (as opposed for standalone projects, as is often the case) will enable longevity.

More distal benefits to policy makers, practitioners and families will be the future research that will flow from the foundational work undertaken by the network. This will lead to an enriched evidence base for social policy affecting the determinants of early childhood outcomes. By definition these whole population social policy interventions have the potential for impact on the lives of families across the UK.

Publications

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Dundas R (2022) Investing in early years to reduce non-communicable diseases in adults. in European journal of public health

 
Description Attended a private roundtable discussion on children and young people's wellbeing, with Labour frontbenchers.
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
 
Description Consultation Response to Work and Pensions Committee: Children in Poverty: Measurement and Targets
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description Participation in a national consultation - Consultation Response to ESRC Data Infrastructure Strategy (2021)
Geographic Reach National 
Policy Influence Type Participation in a national consultation
URL https://www.gla.ac.uk/media/Media_811080_smxx.pdf
 
Description UK Prevention Research Partnership - Community of Practice
Amount £300,000 (GBP)
Organisation Medical Research Council (MRC) 
Department UK PRP
Sector Public
Country United Kingdom
Start 01/2021 
End 12/2023
 
Description Updating Natural Experiment Guidance 
Organisation University of Bristol
Department School of Social and Community Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution Dundas is part of the management group that is taking forward the updating of the guidance for carrying out evaluations of natural experiments. She co-lead the workshop and will lead on sections of the guidance report.
Collaborator Contribution Partners also co-lead the workshop and will lead sections of the guidance report. One partner is seeking funding to support the development of the guidance.
Impact Outcomes - 2 day international, agenda setting workshop on natural experiment evaluation; funding proposal to NIHR/MRC Public health, policy evaluation, statistics, economics, sociology, social epidemiology
Start Year 2019
 
Description Updating Natural Experiment Guidance 
Organisation University of Cambridge
Country United Kingdom 
Sector Academic/University 
PI Contribution Dundas is part of the management group that is taking forward the updating of the guidance for carrying out evaluations of natural experiments. She co-lead the workshop and will lead on sections of the guidance report.
Collaborator Contribution Partners also co-lead the workshop and will lead sections of the guidance report. One partner is seeking funding to support the development of the guidance.
Impact Outcomes - 2 day international, agenda setting workshop on natural experiment evaluation; funding proposal to NIHR/MRC Public health, policy evaluation, statistics, economics, sociology, social epidemiology
Start Year 2019
 
Description Attendance at Covid-19 Data Dive - UK Data Service 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Opportunity to work with academics and data providers to investigate Covid-19 datasets in relation to child and maternal health. Took part in small group work to prepare presentation that was presented to around 50 attendees - this allowed MatCHNet's research and plans to be publicised.
Year(s) Of Engagement Activity 2020
 
Description Attendance at Westminster Health Forum policy conference: Improving baby and child health and reducing inequalities, priorities for commissioning and opportunities for improving the health outcomes for young children across healthcare 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Attendance at the event facilitated contact with key stakeholders in the area of child and maternal health. After the event, direct contact was made via email and Twitter to key attendees/organisations. This has resulted in increased social media followers for MatCHNet and names being added to our membership list.
Year(s) Of Engagement Activity 2020
 
Description Attended a private roundtable discussion on children and young people's wellbeing, with Labour frontbenchers. 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Contributed at a private roundtable discussion on children and young people's wellbeing, with Labour frontbenchers. Highlighted the importance of the early years, maternal health, data and the role that MatCHNet is playing. This discussion formed part of a wider project, initiated by Kier Starmer, on wellbeing and how politics and policy makers can make the country healthier and happier as we begin to think about recovery from the Covid-19 pandemic. These initial discussions will contribute to a political platform that can change the fortunes of children and young people in Britain so that each individual can fulfil their true potential.
Year(s) Of Engagement Activity 2021
 
Description MatCHNet Stakeholder Meetings (2021) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Three stakeholder discussions were held during 2021 (March, June, September 2021) to co-produce MatCHNet's research manifesto, to provide feedback/input on policy prioritisation, to give advice on further engagement and publication plans. The members provided input to the content of the research manifesto, policy summaries, and engagement activities. In terms of outcomes, the consultation discussions have specifically resulted in a lunchtime webinar series and policy briefings being drafted for publication.

The stakeholder group consists of members from all 4 UK Public Health Agencies, the Department for Health and Social Care (DHSC), the Northern Ireland Assembly, the Scottish Government, service providers, and third sector/advocacy organisations from across the 4 UK nations.
Year(s) Of Engagement Activity 2021
 
Description Organised Data Dive Event (May 2021) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact MatCHNet has identified three key challenges that must be tackled to provide the baseline knowledge and methodological foundation for cross-country analysis of national policies affecting child and maternal health. This Data Dive Event focused upon Challenge 2: To ascertain what administrative longitudinal data can be linked and harmonised across the 4 UK countries.

This event (consisting of two sessions) brought together 10 data experts from across the UK to discuss and map longitudinal and administrative data that links mothers and children. The group agreed on a common set of outcomes, examined data available across birth records (for mothers and babies), hospitalisation data, and health visiting data sources. Next, there was discussion to determine data availability across the 4 UK nations. The group also identified key factors to provide a basis for developing a template for detailed data mapping.
Year(s) Of Engagement Activity 2021
 
Description Presentation to Regional Webinar, Northern Ireland Celebration of International Day of the Midwife (JG - 2021) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Invited presentation to showcase MatCHNet and UKPRP to a regional webinar held to celebrate International Day of the Midwife on Wednesday 5 May 2021. This was organised by the NI Department of Health, in partnership with the Clinical Education Centre (CEC).

This was aimed at practitioners and organised by the Department of Health. It included several guest speakers including:
• Robin Swann MLA, Minister of Health for Northern Ireland
• Professor Fran McConville, Midwifery Adviser, World Health Organisation
• Trude Thommessen, Northern Europe Region Representative, International Confederation of Midwives
• Professor Charlotte McArdle, Chief Nursing Officer, Northern Ireland
Year(s) Of Engagement Activity 2021
 
Description Presentation to Society for Social Medicine and Population Health (ES) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Oral presentation to the Society for Social Medicine and Population Health outlining results from MatCHNet's policy mapping and prioritisation exercise. Audience included academics, postgraduate students as well as policymakers and practitioners.
Year(s) Of Engagement Activity 2021
URL https://jech.bmj.com/content/75/Suppl_1/A35.2
 
Description Public engagement & co-production project with a primary school class in Clydebank 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Over the course of three days at a primary school in a deprived area of Glasgow we:
1) Used public engagement activities (Best Start in Life, HealthyVille and the social determinants wordsearch) to discuss population health research in general.
2) Introduced the class to an administrative cohort which we use in our research to understand child health. We used the public engagement game 'Data Detective' to talk about how and why we link and analyze adminstrative data. The class identified some research questions for us (the researchers) to go away and look at in the data
3) reported back to the class the preliminary results from the questions they had posed. The class made some graphs to summarise the findings and we played a game developed specifically for this activity - Population Health Top Trumps - to start discussions on what findings might be most important for supporting child health.
Year(s) Of Engagement Activity 2021