MEVo is a method for champions (Healthcare Professionals within the Local Maternity System) to facilitate dialogue among South Asian mothers to record, collect and embed the local voices of mothers in their transformation process, using a stage-based guided set of tools supported by the MEVo platform.
Women from Asian backgrounds experience two-fold differences in maternal mortality and almost 64% higher numbers of stillbirths and neonatal deaths, when compared to white women. This emphasises the need to address these disparities. Antenatal education offered by the NHS directly and indirectly affects outcomes as it helps mothers prepare emotionally, mentally and physically for childbirth. South Asian women typically have lower rates of access to antenatal education which leads to missed opportunities in preparation, lower rates of care satisfaction and unplanned births, which in turn increases trauma, complications and in worse case scenarios mortality for mothers or babies. We mapped the barriers to access into individual capacities, interpersonal relationships, community, service delivery ecosystems and socio-political contexts. Placing South Asian women in a cultural context, we defined a point of entry in the service delivery ecosystem with an aim to improve care by designing and delivering services that are accessible and relevant to the local context and lived realities of mothers.
Within the Local Maternity Systems, which are responsible for the design and delivery of maternity services to the wider population, we identified key stakeholders who play a vital role in embedding our service user needs. We see them as Champions. Let's now meet the Champions and understand the barriers that they experienced in embedding the voices of our service users.Meera, Cultural Liaison Midwife at Alperton, feels overwhelmed and doesn’t know where to start. She is also frustrated with service user voices being an afterthought and not fully integrated from the start. Jessica, Head of Midwifery in Alperton, aims to complete the department’s strategic goals and improve the maternal outcomes. She feels that the higher management is often inhibited from involving the service users. Fiona, local MVP Chair and does not have the skills and tools to conduct a co-production session with users while also being scared of cultural insensitivity when engaging with the users.
MEVo’s 7 stages include :Stage 1. The objective is to introduce the method to champions through a website leveraging live examples and e-modules.Stage 2. The objective is to build capabilities, planning, approvals and creating the network of HCP and South Asian mothers.Stage 3. Provides tools to create dialogue between HCP and South Asian mothers to understand both sides of the story, record evidence and create ideas for plausible solutions. Stage 4. Provides tools for self-reflection by the HCP to collate qualitative data and plan the changes that can deliver better care. Stage 5. Focuses on addressing the changes using the recorded evidence to embed the voice of the users.Stage 6. This is about sharing the changes with the HCP and mothers to build trust, responsibility and relations.Stage 7. Focuses on creating a library of good practices that can inspire other champions across the UK.
In collaboration with Benash Nazmeen, Cultural Liaison Midwife at Bolton, we have tested MEVo and run virtual workshops with her and other South Asian mothers to understand the usability of tools for initiating dialogue, collecting evidence and analysing the data. Through the multiple sessions we were able to build and test the tools to fit within the seven stages of MEVo. Over the next few months we wish to run the pilot at Bolton BL3 hub, set up meetings with RCM and NMV for collaboration and reach out to more champions to endorse MEVo. Simultaneously, we will work on expanding the tools to cover more communities by adding relevant images, languages and scenarios. Finally, the aim is to build a library of good practices, which is the most important outcome for MEVo as it highlights what’s working and inspires more people.
Through MEVo, South Asian mothers can access a safe space to express their needs and opinions and in turn get the opportunity to access services that help them prepare better for their maternal journeys. Through tools of MEVo, Meera (our Champion) is able to understand the needs of the mothers and build a qualitative data set that can inform plans for the department. Over time MEVo enables building capacities to deliver user-centred care at a local level aided by evidence along the different timelines of the pregnancy journey. MEVo indirectly informs personal practice, cultural competency and highlights good practices within the department, giving insight into how to leverage that further.The NHS will be able to increase access to responsive care along with an increase in antenatal education attendance. In the long run MEVo aims to reduce insurance costs in maternity.
A special thanks to Benash Nazmeen and her colleagues who have supported us through the project. We are also indebted to all the women who have supported us, from the streets of Alperton, Church Street and virtually who have poured their heart out to us and shared their emotional maternity journey for our project. Our project is an ode to women from Ethnic Minorities who go through the troubles of life and bring a newborn child to this world. From women, for women and by women. Thank you!
