AM Advisory group 22.11.23

Exploring the prevention of modern slavery and human trafficking among women and girls with maternal health needs

Liz Such Anne McLaren Research Fellow

Agenda

1. Introductions and welcome (5 minutes)2. Overview of the Fellowship’s goals (10 minutes) +comments from AG (10 minutes)3. Work so far (20 minutes) Annex 14. Feedback and discussion (30-40 minutes)Next steps and close (5-10 minutes)

Introductions and welcome

Overview of the Fellowship

Modern slavery and public health, gov.uk Public Health England 2017

A public health approach to modern slavery South West England proof of concept study NHS England and Improvement SW, Unseen, OHID 2021

Modern slavery: a global public health concern, BMJ 2019

Modern slavery in the UK: how should the health sector be responding? J of Public Health 2020

Refining a public health approach to modern slavery 2021 PHE, IASC, Sheffield

Prevention of labour and sexual exploitation in the UK: What does or could work? MS-PEC with BASNET, WMASN and Sheffield 2022

Modern slavery and public health: a rapid evidence assessment and an emergent public health approach, Public Health 2020

Exploring a public health approach to modern slavery: potential, problems and translating principles into practice, IASC & PHE J of Poverty and Social Justice 2022

The Fellowship

Starting in September 2022 at the School of Health Sciences and partnered with the Rights LabLinked to the Maternal Health and Wellbeing Research Group

Prevention focus

3 year programme

Building on previous work

Proposed schedule of work with some flexibility

Inclusive

Building a CoI

Partnering and building equitable collaborations

Ambition of a 'Prevention Hub'

Aims and objectives

To build a more complete picture of how maternal health and wellbeing relate to systems of exploitation, trafficking and harm and what we can do to prevent it

OBJ1 Examine relationships between maternity and modern slavery - risks, protection, outcomesOBJ2 Examine (effective) 'whole systems' of prevention of exploitation of women and girls with maternal health needsOBJ3 Identify health, wellbeing and healthcare service economic costs OBJ4 Mobilise across maternal health systems

Theory/Method/work packages

Theory/approachSystems approach Critical realist theory Feminist and critical race influences

Systems-informed methods Consultation, participation, case studies, consensus, knowledge mobilisation

Originally 3 Work Packages1. Evidence synthesis 2. Consultation and participation3. (Coproduction and ) Mobilisation

Work so far

Consultation with survivors

3.

2.

1.

Discussion with survivors

Desk work - CLD

Workshop with survivors

Generation of the CLD from workshops Notes, queries and questions retained. Sub-system diagrams

Presentation of CLD, explanation, discussion, opinion, experience Expansion of the 'what happens' questions

May 2023 1.5 hour workshop Risks, protective factors Narratives of challenges, feelings, dangers, hope

Outputs and insights

Substantive and about the method

• Re-iteration of the CLD
• Creation of a dependency model - IF, THEN, OR, AND, ELSE
• Discussion of 'likelihoods' of events happening - variety of views/experiences
• Methods - of value, CLD rightly represents complexity, few 'places to turn' to find pathways positive outcomes, prevention outside of maternal healthcare system
• Of interest - role of stigma and shame in pathways

Let's take a look at the analysis

Miro board

What next?

• Do we need to go further with the modelling?
• Do we use evidence synthesis to support model building?
• Do we look at points in the model that offers promising ways to build a preventative system?
• (How) do we write this up? (How) do we involve survivors?
• Do we engage in primary reseach to elucidate causal relationships?
• Do we do something else?

Thanks!

elizabeth.such@nottingham.ac.uk