Project finds gaps in clinical research

The most pressing research questions around mother and baby healthcare relate to improving outcomes for Māori and Pacific whanau, according to a piece of ground-breaking research.

A team of researchers led by the University of Auckland’s Liggins Institute and on behalf of national clinical trials network ON TRACK, surveyed clinicians, patients, healthcare providers and fellow researchers across Aotearoa New Zealand about gaps in current knowledge in the area of pregnancy and newborn care.

“The top 20 priorities emerging from this study all related directly to Māori and Pacific health,” says lead researcher Associate Professor Katie Groom.

“What really surprised me was that it wasn’t about specific interventions, it was actually about our healthcare systems.”

Surveys and interviews were offered to thousands of people, of which 367 responded, representing a broad spectrum of patients, clinicians, professional bodies and administrators, as well as a good geographic spread.

An expert representative group analysed the surveys and used a framework, adapted from a method used overseas, to prioritise the research topics, with the resulting paper published in the New Zealand Medical Journal (14 April).

The research topics needed to be suitable for clinical trials or large observational studies.

Current healthcare system reforms will support new ways of working together nationally to conduct these types of trials and studies, Groom says.

“An example of future research will be to explore how Māori models of pregnancy care support better health for mothers and babies,” she says.

“At the moment, we have a cookie-cutter model of pregnancy care, where everyone gets a similar approach. But, for Māori, care that includes their whanau and iwi may well deliver better pregnancy outcomes.”

To achieve better health for Māori mothers and babies, we also need research to understand the enablers and barriers to training Māori doctors and midwives, and whether current training models work for Māori.

The process of identifying and prioritising research topics aims to ensure the right research is being done to improve future healthcare in this country and that healthcare is based on high-quality evidence.

The study was analysed using a method that factored in equity, because Aotearoa New Zealand doesn’t currently have equitable outcomes for mothers and babies, Groom says.

“Depending on where you live, what ethnic group you identify with, what socioeconomic group you belong to, you don't have the same chance of a good pregnancy outcome,” she says.

The ON TRACK Network is a national clinical trials network (CTN) that aims to improve the health and wellbeing of New Zealand mothers and babies.

This is the first prioritisation project of its type in this country and the network has already had enquiries from other clinical fields wishing to run similar projects.

If you are interested in finding out more about this Liggins-led project and the ON TRACK Network visit the website or Facebook page.

• Read The priorities for future clinical trials and large cohort studies addressing health and healthcare for mothers and babies in Aotearoa New Zealand (NZMJ 2022;135(1553):43061).