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Health inequalities, access and diversity

NCT is concerned about health inequalities associated with maternity outcomes. There is a vast amount of evidence to show that pregnancy and other health outcomes are affected by a range of socio-economic indicators, such as social class and ethnicity. For example, the Confidential Enquiry into Maternal and Child Health (CEMACH) report on Perinatal mortality identifies how disadvantaged women and their babies are often exposed to multiple adversities such as poverty, language and communication difficulties and late or infrequent access to maternity care.

Poor and unequal access to health services are known to contribute to health inequalities and it is well known that those who are at the greatest risk of poor pregnancy outcomes are the least likely to access the care that they need. Refugees and asylum seekers, women who experience domestic abuse, women who have substance abuse or mental health problems and those living in high areas of deprivation are known to be the most likely to be poor or non-attenders for maternity care.

NCT would like to see health services providers developing practical ways to address the difficulties that pregnant women from socially disadvantaged groups have in accessing and staying in touch with maternity services. Local services need to be designed in a way so that they are flexible and able to identify and respond to women’s individual needs and provide targeted and appropriate care, whilst allowing women and their carers the opportunity to get to know one another and build a trusting relationship.

NCT is also concerned with health inequalities associated with breastfeeding. Babies who are not breastfed are shown to have increased risk of developing some infections and diseases in their first year of life, during childhood and in later life. As breastfeeding rates vary according to social factors such as mothers’ social class, age and educational background, this exacerbates health inequalities. An NCT Policy Briefing on Inequalities in Health Related to Infant Feeding is available below.

Good practice case studies addressing health inequalities, from NCT and other organisations and health care providers, are provided in the articles below.  

You may also be interested in NCT's reviews of evidence which are first published in the professional development journal New Digest.

Related documents

Health inequalities related to baby feeding NCT policy briefing PDF (PDF 38 Kb)
Health inequalities related to baby feeding NCT policy briefing
Reaching all parents: catering for younger mothers through NCT peer support training (2010)PDF (PDF 66 Kb)
Sarah Fisher, NCT researcher, discusses two NCT programmes aimed at young mothers with low levels of formal education, and looks at how NCT trainers met the challenges of running those programmes. New Digest July 2010.
Maternity care in the community: reaching out to the women of Newham (2010)PDF (PDF 18 Kb)
How the maternity service in the London Borough of Newham was transformed through a programme that responds to women's needs. New Digest article, April 2010.
Reaching all parents: Isolated and ignored – or welcomed and included? Working with deaf clients (2010)PDF (PDF 24 Kb)
Reaching all parents: Isolated and ignored – or welcomed and included? Working with deaf clients. New Digest article, January 2010.
Reaching all parents: Muslim women in Edinburgh (2010)PDF (PDF 19 Kb)
A pilot scheme to offer antenatal information and peer support to Muslim women. New Digest article, April 2010.
Supporting young mums in Stockport (2010)PDF (PDF 52 Kb)
Jackie Hughes talks about Stockport NHS Foundation Trust's success last year winning an award from the All Party Parliamentary Group on Maternity (APPGM) for providing inclusive services for disadvantaged groups and communities. New Digest July 2010.
Reaching all parents: to asylum-seeking and other vulnerable women in Leeds (2009)PDF (PDF 179 Kb)
Rose McCarthy describes how a long-standing collaboration between Sure Start and the NCT continues to help women in a deprived area of Yorkshire. Perspective;(2):8-9.
Reaching all parents: the Chinese community in Manchester (2009)PDF (PDF 46 Kb)
NorthWest Development Worker Ali MacLeod describes the NCT’s work with the Chinese women’s society in Manchester, Wai Yin. New Digest(47):9
The right support: helping parents with learning disabilities to parent well (2009)PDF (PDF 31 Kb)
The right support: helping parents with learning disabilities to parent well. New Digest article, January 2009.
Reaching all parents: Working with recovering drug users in Aberdeen (2009)PDF (PDF 35 Kb)
Working with recovering drug users in Aberdeen. This article describes a pioneering Scottish project to work with new fathers who are also recovering drug users. New Digest article, October 2009.
Reaching all parents: user involvement in socially diverse East Lancashire (2009)PDF (PDF 82 Kb)
how service user involvement has developed in East Lancashire and the role which the NCT has played in it. New Digest, April 2009.
A friend in need: woman to woman support in areas of high deprivation (2007)PDF (PDF 57 Kb)
A friend in need. The authors explain how woman-to-woman support has improved outcomes in an area of high deprivation. New Digest article, April 2007.
Reducing infant mortality in hackney (2007)PDF (PDF 440 Kb)
Reducing infant mortality in hackney. This article outlines a range of new initiatives in Hackney to reduce infant mortality. New Digest article, October 2007.