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Introduction

  • Last modified date:
    8 February 2007

About the Mother and Child Health National R&D Programme.

The NHS R&D strategy was launched in 1991 with the aim of creating a research based health service in which reliable and relevant information is used to make decisions on health policy, clinical practice and management of services. In order to identify R&D needs, NHS activity is being reviewed by the Central Research and Development Committee (CRDC) from six overlapping perspectives: disease related problems; management and organisational issues; problems related to specific client groups; consumer issues; health technologies; and research methodologies. Within these perspectives, time-limited expert advisory groups are convened to consider key areas in detail.

  • Within the perspective of client groups, people with physical and complex disability had been the subject of a CRDC review in 1993. Mother and child health was the second review identified by the CRDC within this perspective.

Context of Mother and Child Health

  • This is an important area for the NHS. As a population, mothers and children comprise about a third of the total population. In addition, interventions in early life have a significant impact on the later health of adults. Research and development to improve maternal and child health will therefore be of benefit to the general population.
  • The health and health care needs of this client group are broad, ranging from the promotion and maintenance of health for the well mother and child to different aspects of acute and chronic disease. Issues related to mothers and children are a major component of the national public health agenda and thus the health needs of women, infants and children were highlighted in the Health of the Nation report. Key areas directly relevant to this client group include injury, sexual health and mental health.
  • Maternal and child health has been the subject of recent reports, including the report of the Expert Maternity Group in 1993, 'Changing Childbirth' which followed the 1992 report by the House of Commons Health Committee. These have major implications for the provision of maternity services. The report 'Changing Childbirth' placed emphasis on giving choice to women and this approach is also highlighted in recent legislation affecting children. The Children Act of 1989 and the Education Act of 1993 as well as recent reports by the Audit Commission on services for children, highlight the importance of a child-centred service and the need to involve parents and children in decisions about care. Some of these policy initiatives have themselves generated research questions relevant to this exercise.
  • Previous reviews within the NHS R&D Programme have identified priorities relevant to mother and child health from different perspectives. These include work in relation to mental health (for example, the treatment of childhood hyperactivity), cancer (for instance, ways of effecting, maintaining and evaluating behaviour changes leading to reduction of smoking, particularly in children), physical and complex disabilities (such as the effectiveness of current therapies) and health technology assessment (for example, evaluation of methods of screening for Down's syndrome). The Advisory Group was mindful of relevant work taken forward by previous programmes but was not inhibited by possible overlap when considering the broad needs of the NHS for R&D relating to mother and child health. Any unhelpful duplication would be prevented at the stage of commissioning work.
  • Different kinds of research will benefit the NHS, including work to identify disease mechanisms and health needs; identifying health behaviours and social and environmental influences on the healthy development of mother and child; identifying health care interventions which may affect health outcome; and evaluating the delivery of care.
  • Any research agenda will need to build on existing evidence. In the field of mother and child health, the UK Cochrane Centre has compiled a database on effective care on pregnancy and childbirth. A pilot module was produced and released in 1993 of systematic reviews in pregnancy and childbirth and this is regularly updated and is widely available. Those working in the field of mother and child health are able to draw on an invaluable resource to support evidence-based care.

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