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.

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.

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