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Exploring stillbirth associated co-morbidities (GCRF)

Project Description

Described as a ‘double tragedy’, women are left incontinent (urine &/or faeces), and without a baby, resulting in community stigmatisation, hardship and emotional dysfunction. Stillbirth risk is 99 times greater when women develop OF than if they have a normal birth. Peer support is proposed as a way of supporting these women, based on its use in other fields e.g. HIV. Further study is needed to identify transferable elements of peer support, to explore the contextual relevance of individual components.

We aim to develop a sustainable peer support package to provide women with psycho-social support to be integrated into current health systems. The project will provide the groundwork for an RCT of a multicomponent package to support women with a OF and stillbirth. The key questions include:

1. What is the most acceptable peer support intervention for women experiencing a fistula following stillbirth.
2. What health system factors are required to implement an effective peer-support programme for these women?
3. How can this exploratory work inform a future study of the impact of peer-support on delivery of services for women, and their subsequent outcomes?

This research is made up of three phases.

Phase 1: Realist review
We will conduct a realist literature review to determine the intervention components with the greatest potential to improve women’s social, psychological and physical well-being. This approach enables one to not only determine what works (or does not work) but also for whom it may work and in what context. This phase will also inform the interview schedules for phase 2.

Phase 2: Intervention development
The study will take place in Kisi, Kenya, having a high prevalence of obstetric fistula and stillbirth. Building on earlier work and using a multi-morbidity lens, we will co-develop a peer support intervention. Underpinned by empowerment theory we will gain stakeholder consensus on a peer support intervention, using participatory action research (PAR). This approach encourages community collaboration, enabling activities and outcomes to be grounded in experience and cultural context. Our CEI group will ensure local and cultural appropriateness. Women, partners, community members, health workers/managers and policy makers will be invited to participate in affirmative interviews and focus groups to review current evidence (ours & others) to gain consensus on the peer support package.

Phase 3: Protocol development
All evidence will be synthesized, to inform a protocol for a feasibility study of a peer-support intervention. This will be carried out with key informants and Community Engagement and Involvement Groups, to ensure consensus.

Research outcomes include:

- Acceptable peer support package ready for further evaluation in a feasibility study
- Skills in multiple research methodologies.

Entry Requirements
Candidates are expected to hold (or be about to obtain) an Upper Second class Honours degree (or equivalent) in a related area / subject.

If you are interested in this project, please make direct contact with the Principal Supervisor to arrange to discuss the project further as soon as possible. You MUST also submit an online application form - choose PhD Midwifery. Full details on how to apply can be found on the GCRF website

Funding Notes

The GCRF PhD studentship programme is a 4 year programme with integrated teaching certificate. There are up to 12 studentships available. Applicants can apply to one project which will start in either April or September 2020.

Funding for the programme will include tuition fees, an annual stipend at the minimum Research Councils UK rate (around £15,000 for 2019/20), a research training grant, training allowance and travel allowance.

As an equal opportunities institution we welcome applicants from all sections of the community regardless of gender, ethnicity, disability, sexual orientation and transgender status. All appointments are made on merit.

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