Healthy Pregnancy 4 All-3

For this study we apply a multiple case study design, in which we conduct action oriented research in 6 Dutch municipalities. We aim to highlight differences and similarities in municipal approaches to health inequalities, as well as existing developments to implement social obstetrics, while taking background characteristics, such as size and location of the municipality into account. The commonality that allows for comparison of the participating municipalities are the relatively poor perinatal health outcomes. Elements of action research that we apply are individual interviews and interactive group sessions with various relevant stakeholders from the medical sector, social sector, public health sector, and the municipal government. With this approach we aim to investigate which transition in institutional structures, culture, and practices is needed to enable the integration of perinatal health into municipal approaches and policies concerning health inequities. Knowledge generated by this study can contribute to the development of an approach to perinatal health inequities that can be implemented in all municipalities in the Netherlands, regardless of their size, location, and previous experience with addressing perinatal health inequities.

Knowledge generated by this study can contribute to the development of an approach to perinatal health inequities that can be implemented in all municipalities in the Netherlands, regardless of their size, location, and previous experience with addressing perinatal health inequities.

Jan 2018-Dec 2018: identification and selection of the six participating municipalities
Jan 2019-Dec 2019: interviews and interactive group sessions.
Jan 2020-Dec 2020: preparation of action-agendas for the participating municipalities, administration of the questionnaire and organising a closing symposium

In each participating municipality we will conduct multiple interviews with key stakeholders involved in social obstetrics. By the means of these interviews, we will gather information about what is currently being done within and across different sectors to reduce perinatal health inequities within the participating municipalities. After completion of the interviews, we will organise two successive interactive group sessions within each municipality. During these group sessions, participants collectively go through a participatory process of 1) problem structuring, 2) envisioning, 3) agenda-building, and 4) developing a portfolio of action-oriented experiments. After the completion of the two group sessions, the research team draws up a report for each of the six participating municipalities, in which relevant insights from the baseline measurement, the interviews, the group sessions, and the action-agenda will be summarised. Additionally, a questionnaire will be administered approximately one year after completion of the group sessions, in order to provide insight into (1) the actions taken in the period after the formation of the action-agenda, (2) the extent to which sustainable cross-sectoral collaborations are built, and (3) the extent to which perinatal health has been integrated into local approaches aimed at addressing health inequities.Finally, at the end of the HP4All-3 study period a symposium will be organised in which the research team will share their key findings of the HP4All-3 research program with key stakeholders involved in social obstetrics within the participating municipalities.