Learning from system-wide organisational change to the provision of maternity care and early years services in Northern Ireland

Research output: Contribution to conferencePosterpeer-review


Background: Antenatal care and education are recognised as mechanisms to impact on maternal and infant outcomes in the short and long term. Important links between maternity care and early childhood services have encouraged interventions to lessen social disadvantage and give every child the best start in life. In Northern Ireland (NI) universal change was introduced through implementation of a group antenatal care and education model for pregnant women without complications. Change was also implemented within early years’ services by introducing a named health visitor and an integrated 3+ year child-health review within pre-school settings.
Methods: A mixed methods evaluation of group-based antenatal care and education across five Health and Social Care Trusts in NI included a comparison of self-report and clinically observed outcomes for women receiving group antenatal care and education (intervention) with women receiving routine care, alongside a cost comparison. Focus groups and interviews were conducted with health and education professionals who implemented changes to universal services and parents who participated in integrated child health reviews. A retrospective case study approach was used to analyse the implementation of change across the project timeline and identify key features for sustaining change. Kotter’s organisational theory of change model was used to underpin the analysis of system wide change and identify key drivers for facilitating change.
Findings: The study findings resonated with key themes identified in the literature and were comparable across maternity care and pre-school settings. Utilising a retrospective case study approach provided valuable insight into key themes which directly or indirectly influenced the context of implementation in both education and health settings. Themes identified included leadership with a strategic vision, organisational factors such as culture and resistance to change, identifying allies to support change, engagement with changes being implemented and strategy to ensure change is sustained.
Original languageEnglish
Publication statusPublished - 12 Sept 2022
Event21st International Normal Labour and Birth Research Conference - Aarhus University , Aarhus, Denmark
Duration: 12 Sept 202214 Sept 2022


Conference21st International Normal Labour and Birth Research Conference
Internet address


  • pregnancy; leadership; public health; qualitative; communication


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