A-
A+
Mary Fadairo, Population Health Programme Officer, explains her role and her work in City and Hackney’s Neighbourhoods
Interview conducted by Veryan Wilkie-Jones, Programmes Manager (VCS Neighbourhoods).
Health equity and improving outcomes for communities, especially for marginalized individuals and groups as this really resonates with me. When I saw the opportunity advertised, I thought it would be the perfect role for me. I’ve always lived in Hackney – this is my community and I’ve seen all the changes that have taken place. I felt I could use my own lived experience to help make improvements.
I’ve really enjoyed talking to different communities – listening to and learning from them – and I’ve used the information in our different workstreams. It’s been really eye-opening and also heartwarming to see that people want to make changes, and now we’re actually ‘en route’ to making those changes happen.
It’s been a privilege to work alongside Anna Garner, Kyia Omoshebi (Equity and Inclusion Specialist Midwife), Vicky Beckwith (Equality Diversity and Inclusion Lead) at Homerton hospital, and the whole maternity department.
We also work with a whole range of organisations depending on the work we’re doing – Volunteer Centre Hackney, Healthwatch Hackney, NEL Integrated Care Board, and the Maternity Neo Natal Voice Partnership, Bump Buddies at the Shoreditch Trust, and others. There are so many moving parts of the system it’s important that we look outwards. It’s also really important for us to talk with community members and residents to get a well-rounded perspective of what’s happening in and out of the system.
This research on maternity outcomes for global majority women was part of our MATCH programme (eMbedding heAlth equiTy in City and Hackney) – set up to establish a rigorous and systematic approach to embedding proportionate universalism in City and Hackney in order to support people to improve outcomes proportionate to their level of need. The MATCH programme supports programme areas (e.g. maternity) to bring wider stakeholders together with residents, to review what we know about equity in the area (including any available data, along with insight from staff and residents) and identify change ideas to improve equity. And then to support with implementing and monitoring these change ideas.
We wanted to make sure we supported people to improve their health outcomes, so we brought different stakeholders together with residents, using what we know already, to come up with suggestions to improve outcomes as a piece of co-production work. We’re hoping to better support women who use maternity services with the ‘change ideas’ that came out of these discussions.
This research is vital because it shines a spotlight on the inequities faced by Global majority communities in accessing quality maternal healthcare. We looked at what we knew already – high stillbirth rates, premature delivery of babies, and low birth weight for women from GM backgrounds.
We know that, for example, on average more than half of women are admitted to hospital during pregnancy with rates higher among Black and Asian women compared with White women (65% and 58% versus 50%). In addition Black and Asian women are much more likely to be admitted to hospital within 6 weeks of delivery (18% and 18% compared with 11%). Babies born to Black women are twice as likely to be admitted to neonatal care than those to White women (20% versus 9%) and the proportion of babies with low birth weight born to Black and Asian women is nearly three times as high as for White women (14% and 15% versus 5%). Sadly, Hackney is one of the 3 boroughs in which stillbirths to Black and Asian women are concentrated – 3 per 1000 births.
With these concerning clinical outcomes, it’s imperative to make sure women get more individualised support, since having a blanket ‘one fits all’ approach is part of the cause of these issues. We desperately need a more well-rounded outlook and proactive initiatives. It is also important that we encourage women and give them a ‘brave space’ to stand up and advocate for themselves especially when they feel vulnerable. Every individual is an expert of their own experience.
What’s causing these inequalities?
Inequalities stem from various factors, including lack of cultural awareness and ‘automatic bias’. The existing system amplifies these inequalities by failing to address the unique challenges faced by women from global majority backgrounds, such as low levels of health literacy, barriers to accessing information and limited access to economic opportunities. What is needed is a fairer, more nuanced system.
What’s the next step?
We now have the ‘change ideas’ including:
Next there will be an application process to determine which of the 5 change ideas will be funded, but those who don’t make the shortlist may still be possible to address. It’s really exciting work and the residents involved have been very engaged and proactive in the discussion. We have learned that it’s important to engage with communities to get their insights as it’s so important.
We were prompted to contact the Neighbourhood Forums because we recognise and understand that Neighbourhoods have invaluable insights in terms of what’s needed in their own communities. Because of the amazing work that’s been done, there are trusted relationships. It’s a great opportunity to get more residents involved in our work. It will be more of a cyclic journey than a one way street in terms of trying to engage communities and their residents in the work we are doing. I think it will strengthen the trust and collaboration between both the neighbourhood and individual to build a relationship with us, rather than people feeling they are being left out. We are hoping that our close work with Neighbourhoods will lead to more equitable health outcomes and strong bonds within the community. This is a new way of doing things but I feel it’s the right way to go!
We have such a diverse and vibrant community that has a strong sense of community. This is demonstrated by the amazing work that groups/organisations have come up with and done the work by themselves. It’s so impressive and inspiring for me to see that this is already happening – people are not waiting for the system to step in. It’s for us to say “ok we see the amazing work you’re doing and how can we help, how can we make it more sustainable?” I love being part of this work and knowing I am making an impact – it’s really rewarding. We’re all part of the jigsaw puzzle and the roles we play all come together to improve health and wellbeing in City & Hackney. Remembering even the smallest actions and changes have the potential to make great impact over time – ‘ripples can make a current!’
We have ongoing work that we are doing, improving health literacy for example. Health literacy is vital, especially in City and Hackney, where socio-economic differences can worsen health disparities. Many in our communities face obstacles like limited healthcare access, language barriers, and cultural differences, hindering their ability to access, understand and use health information effectively. Improving health literacy empowers people to make informed decisions about their health, reducing healthcare disparities and promoting better outcomes. It’s more than just knowing the basics; it’s about empowering individuals and communities to take charge of their well-being and overcome barriers, whether linguistic, cultural, or socio-economic, ensuring everyone can make informed health choices.
The Population Health Hub in City and Hackney focuses on small-scale projects to measure, understand, and enhance health literacy. Split into System, Organisation, and Community/Individual levels, our approach includes developing a communication toolkit for partners to improve health literacy awareness, integrating health literacy into training programs like Making Every Contact Count (MECC), and collaborating with community organisations to embed health literacy across the area. Health literacy is vital beyond healthcare settings, promoting overall well-being. Our vision is for a thriving, healthy, vibrant, and resilient community in City and Hackney.
Other areas we are working on include women’s health – exploring how to support young women to manage their periods (to tackle inequalities in wellbeing, self-management and adverse outcomes from these), prevention of poor outcomes from cardiovascular disease using an anti-racist and health equity approach, and food poverty – supporting people to find a way out of food poverty, as well as supporting their health and wellbeing needs
I’m excited about the continuous improvement in creating a strong community-led work, making sure no one is left behind because of their background. Due to the current climate there is a need to build strong connections as people are lonely and in many instances have been separated from family – the need for an equitable system is more important than ever before.
We want to support people along their journey by ensuring they have access to the right information, allowing them to understand and make the right decisions about their issues or issues within their communities.
