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A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting

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Published on: January 12, 2018

Accelerating birth equity using collaborative systems mapping.

Sharita R Thomas¹, Hiba Fatima², Jessica Simon³

¹Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America. sharita.thomas@unc.edu.

Health Research Policy and Systems

|October 14, 2025

Summary

This summary is machine-generated.

Systems thinking and the Remove, Repair, Remediate, Restructure, and Provide (R4P) framework were used to create tools that identify and address systemic barriers to birth equity. These tools help advocates advance birth equity by outlining actionable steps and responsible actors.

Keywords:

Birth equity Complex systems Infant health Maternal health Methods Public health R4P framework Strategic investment Systems thinking Tools

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Area of Science:

Public Health
Systems Science
Health Equity

Background:

Achieving birth equity requires innovative, cross-sector collaboration to address complex systemic barriers.
This project utilized systems thinking and the Remove, Repair, Remediate, Restructure, and Provide (R4P) framework to understand and dismantle these barriers.
The study focused on identifying key actors within the system and the critical actions necessary to promote birth equity.

Purpose of the Study:

To apply systems thinking and the R4P framework to identify systemic barriers to birth equity.
To develop actionable tools for diverse stakeholders to advance birth equity.
To foster a holistic approach to understanding and addressing the root causes of birth inequity.

Main Methods:

Employed systems thinking tools within the R4P framework through collaborative, iterative activities.
Conducted an environmental scan and synthesized existing reports on birth equity recommendations.
Engaged diverse birth equity stakeholders in systems mapping workshops to co-create tools.

Main Results:

Developed an innovative Birth Equity Ecosystem Map, Birth Equity Iceberg, and interactive Birth Equity Action Map.
The Birth Equity Ecosystem Map synthesizes recommendations for an equitable system.
The Birth Equity Action Map identifies systemic barriers, critical actions, and responsible actors, organized by the R4P framework dimensions.

Conclusions:

Systems thinking and the R4P framework provide a holistic and effective approach to achieving birth equity.
The developed tools offer actionable insights for public health initiatives.
Birth equity advocates can use these tools to assess resources, identify priorities, and collectively advance equity.