Co-production in public health research: The UK MAMAH Study involving underserved migrant mothers

PROBLEM: Research suggests some migrant women are at higher risk of mortality and morbidity in the perinatal period, however there is a gap in co-produced research to improve care. DESCRIPTION OF THE PROBLEM: The UK National Institute for Health and Care Research defines co-production as ‘an approach in which researchers, practitioners, and members of the public work together, sharing power and responsibility'. Here we summarise learning from the Migration and Maternal Health (MAMAH) Study which aims to co-produce solutions to improve maternity care for migrant women in the UK. RESULTS: We struggled to access comprehensive training on co-production, particularly in how to counter power dynamics and recruit a broad range of public participants. Early in the study we appointed a ‘Lead Patient Advisor’ (a migrant women with experience of pregnancy in the UK) who manages the relationship between the academics and the patient advisors. Additionally, we reimburse women's time, childcare, and travel. We have found that online meetings are preferable as women do not need to travel or arrange childcare. We meet our patient advisory panel four times per year. Some women have been directly involved in research such as systematic review screening and qualitative interviewing and have been given formal research training. LESSONS: Our initial research priorities didn't align with those of the women, and this has helped us to reshape our work. Women say that having a Lead Patient Advisor has made it easier to participate, particularly given some of the issues discussed are traumatic. To mitigate this, we have created additional support resources and offered formal debriefing. Using online interpreters has been challenging, and we have recently split into different language groups to maximise engagement. Overall, we have learned that taking a truly co-produced approach is expensive and time-consuming but has ensured our research prioritises the views of migrant women giving birth in the UK. KEY MESSAGES: • Co-production approaches are increasingly important to funders and represent a key opportunity for researchers to ensure their work has real-world impact. • There is an urgent need for improved training and resources to better equip public health researchers to take a co-production approach.