Abstract
Objective: Interventions to tackle the social determinants of health can improve outcomes during pregnancy and early childhood, leading to better health across the life course. Variation in content, timing and implementation of policies across the 4 UK nations allows for evaluation. We conducted a policy-mapping review (1981–2021) to identify relevant UK early years policies across the social determinants of health framework, and determine suitable candidates for evaluation using administrative data.
Methods: We used open keyword and category searches of UK and devolved Government websites, and hand searched policy reviews. Policies were rated and included using five criteria: (1) Potential for policy to affect maternal and child health outcomes; (2) Implementation variation across the UK; (3) Population reach and expected effect size; (4) Ability to identify exposed/eligible group in administrative data; (5) Potential to affect health inequalities. An expert consensus workshop determined a final shortlist.
Results: 336 policies and 306 strategy documents were identified. Policies were mainly excluded due to criteria 2–4, leaving 88. The consensus workshop identified three policy areas as suitable candidates for natural experiment evaluation using administrative data: pregnancy grants, early years education and childcare, and Universal Credit.
Conclusion: Our comprehensive policy review identifies valuable opportunities to evaluate sociostructural impacts on mother and child outcomes. However, many potentially impactful policies were excluded. This may lead to the inverse evidence law, where there is least evidence for policies believed to be most effective. This could be ameliorated by better access to administrative data, staged implementation of future policies or alternative evaluation methods.
Methods: We used open keyword and category searches of UK and devolved Government websites, and hand searched policy reviews. Policies were rated and included using five criteria: (1) Potential for policy to affect maternal and child health outcomes; (2) Implementation variation across the UK; (3) Population reach and expected effect size; (4) Ability to identify exposed/eligible group in administrative data; (5) Potential to affect health inequalities. An expert consensus workshop determined a final shortlist.
Results: 336 policies and 306 strategy documents were identified. Policies were mainly excluded due to criteria 2–4, leaving 88. The consensus workshop identified three policy areas as suitable candidates for natural experiment evaluation using administrative data: pregnancy grants, early years education and childcare, and Universal Credit.
Conclusion: Our comprehensive policy review identifies valuable opportunities to evaluate sociostructural impacts on mother and child outcomes. However, many potentially impactful policies were excluded. This may lead to the inverse evidence law, where there is least evidence for policies believed to be most effective. This could be ameliorated by better access to administrative data, staged implementation of future policies or alternative evaluation methods.
Original language | English |
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Article number | archdischild-2022-325219 |
Pages (from-to) | 1-7 |
Number of pages | 7 |
Journal | Archives of disease in childhood |
Early online date | 31 Mar 2023 |
DOIs | |
Publication status | Published online - 31 Mar 2023 |
Bibliographical note
Funding Information:All authors are members of, and receive support from, the UK Prevention Research Partnership Maternal and Child Health Network (MR/S037608/1). AP, AL and RD are supported by the Medical Research Council (MC_UU_00022/2) and the Scottish Government Chief Scientist Office (SPHSU17). AP also receives support from the Wellcome Trust (205412/Z/16/Z). This research was supported in part by the National Institute for Health and Care Research (NIHR) Great Ormond Street Hospital Biomedical Research Centre and the Health Data Research UK (grant No. LOND1), which is funded by the UK Medical Research Council and eight other funders. KLH is funded by the National Institute for Health and Care Research (NIHR) (17/99/19).
Publisher Copyright:
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.
Keywords
- child and maternal health
- administrative data
- policy mapping review
- UK nations
- child development
- child health