Journal Article

Addressing perinatal health inequities in Dutch municipalities

You may not realise it, but inequity starts at birth, also in the Netherlands – where a baby is born affects its health and well-being later in life. How can these perinatal health inequities be addressed at the municipal level via cross-sectoral collaborations? In this recently published paper, DRIFTers Lisa Barsties, Leonie Daalderop, Frank van Steenbergen, and Derk Loorbach tackle this question and introduce the innovative research design of the Healthy Pregnancy 4 All-3 (HP4All-3) programme.
Substantial health inequities exist between and within Dutch municipalities. These inequities are already present at birth and affect individuals’ health and socioeconomic outcomes throughout their lives. Health inequities at birth (what we call “perinatal health inequities”) are associated with medical risk factors and the accumulation of non-medical risk factors, such as a low educational level, psychosocial problems, lack of social support, a low household income, unemployment, and neighbourhood deprivation.
Due to the variety of factors that influence perinatal health, a comprehensive and cross-sectoral approach before, during, and shortly after pregnancy is needed to address health inequities at birth. To enable this approach, professionals from the entire medical, social, and public health care chain must collaborate. Such a cross-sectoral approach to perinatal health has been labelled ‘social obstetrics’.
The aim of the HP4All-3 programme is to address perinatal health inequities by accelerating the institutional embedding of social obstetrics in Dutch municipalities. We believe that – in the Dutch context – municipal governments can be the main responsible actor to drive social obstetrics, since they are primarily responsible for organising adequate public health.
Within the HP4All-3 programme, we aim to accelerate the institutional embedding of social obstetrics. To do so, we want to stimulate collaboration between professionals with varying backgrounds, motives, and competencies so that they can collectively address the various interconnected medical, social, economic, cultural, and environmental risk factors that underlie perinatal health inequities.
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Barsties, L. S., Daalderop, L. A., Lagendijk, J., van Steenbergen, F., Been, J. V., Bertens, L. C., & Steegers, E. A. (2020). Addressing perinatal health inequities in Dutch municipalities: Protocol for the Healthy Pregnancy 4 All-3 programme. Health Policy.
Pharos, Erasmus MC
Related reading
See also our (Dutch) position paper ‘Integrale geboortezorg als vliegwiel voor de aanpak van gezondheidsongelijkheid’
This research is part of the Healthy Pregnancy 4 All-3 project

January 12, 2021