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The aim of the project is to improve the health and wellbeing of women and their U5 children, by considering and addressing risk through the lens of social, cultural and environmental vulnerability.
Overview
While it has long been known that sociocultural factors play a key role in health behaviours and outcomes, health programs and systems have applied a limited understanding of how these contribute to morbidity and harm, and placed more emphasis on improving conditions at the clinical touchpoints of the health journey.
“More access to medical care alone will not address the social, economic and environmental factors that lead to disparities in the onset and prevalence of [poor health]; disease-by-disease funding makes it more difficult to focus on and address common causal pathways across conditions; and stage-by-stage services can result in missed opportunities and inefficient use of resources.”
Fine A , Kotelchuck M. Rethinking MCH: The Lifecourse Model as an Organising Framework, Concept Paper
Pathways aims to provide innovative data, insights and a process for considering, identifying and addressing the social, cultural and environmental dimensions that influence health outcomes and behaviours in reproductive maternal newborn child health and nutrition.
How might we consider the social, cultural and environmental vulnerabilities of pregnant women, young mothers and their children in the design and implementation of health products and services?
At the core, Pathways will provide a population representative household segmentation for Kenya, Bihar and Northern Nigeria based on a household's risk to poor health to outline the associated socio-cultural, economic and environmental factors. Applying this segmentation to health programming will guide action in a more holistic way and help governments and organisations better identify vulnerable families and individuals for more effective and targeted health interventions.
Approach
Pathways employed a design-driven interdisciplinary approach to investigate vulnerability and risk to poor health outcomes and behaviours. The project integrates human-centred design, anthropology, behavioural science and data science combining qualitative and quantitative data collection and analysis in an iterative design process.
The team conducted qualitative research combining ethnographic research methods with design research and a behavioural science methodology called Ethnolabs (TM) by FinalMile to discover and map the factors influencing health care seeking and taking behaviours of vulnerable women and their families in Kenya, Bihar and Uttar Pradesh. The data was analysed and synthesised into different qualitative outputs to describe the moments, vulnerabilities and support networks that impact their pursuit to healthy lives. In addition this data informed the design of a quantitative household survey with the aim of gathering population representative data to understand which families are at highest risk and which contributing factors matter most.
During the COVID-19 pandemic, the team was able to conduct additional remote research that informed an understanding of how the pandemic amplified vulnerability and heightened thresholds to access care for already vulnerable families. The narratives collected were published as part of the Goalkeepers report in 2020.
Outputs
Pathways will provide a design framework (estimated completion May 2022) for global and national stakeholders in reproductive maternal new born and child health to create more targeted and nuanced care interventions comprised of the following elements:
- A vulnerability approach to intervention design: An interdisciplinary, integrated approach for framing and identifying global RMNCH+N issues and outcomes
- A series of knowledge products to guide action: Knowledge products provide insight into the sociocultural and environmental risk factors that contribute to poor RMNCH+N outcomes in the project’s various geographies
- A human centred design process: A process and tools for applying the approach and knowledge products to the development of effective solutions
The data will be available as a global good in a digital format later in 2022.
