Information and relational continuity needs of women can be met using professionally moderated, social media based groups. They may provide an alternative means of facilitating the continuity that is so often lacking in traditional models of care.

Pregnant asylum-seeking and refugee women are a particularly vulnerable group in society, who may be possibly living alone in poverty in inappropriate accommodation (Dunne, 2007) and experiencing hostile attitudes (Hynes and Sale, 2010). They may have poor physical and mental health, placing them at an increased risk of poor pregnancy outcomes (National Institute for Health and Care Excellence (NICE), 2010). Despite this, they are less likely to attend for timely maternity care. This article discusses the evaluation to date of an ongoing befriending project located in Northern England, targeting pregnant asylum-seeking and refugee women and helping to address difficulties that they may face. Volunteer befrienders, who themselves are asylum-seeking and refugee mothers, receive training to provide support and guidance to clients. Preliminary data suggest that befriending has advantages for both client and volunteer: clients appear to develop a trusting relationship with their befriender which facilitates self-confidence and helps overcome social isolation; and the volunteers feel that they are undertaking a worthwhile role and often move onto paid employment. Befriending may be a useful resource for midwives and ultimately improve pregnancy outcomes for asylumseeking and refugee women.

ObjectivesThe COVID-19 pandemic has seen unprecedented restrictions on face-to-face healthcare encounters. This has led to an increase in the use of online healthcare resources by service users. Pregnant women have always been a group particularly motivated to seek out information online. The objective of this study was to explore the experiences of mothers who were using an existing National Health Service social media based antenatal support service during the early stages of the UK COVID-19 lockdown.DesignA short online survey with four closed questions (scale response) and one open-ended free-text question was given to pregnant women who were using the online service 3 weeks after the start of the UK lockdown. Descriptive statistics are used to present the closed question data. Thematic analysis was applied to the free-text responses.Results320 women were sent the survey. 156 completed it (49% response rate). Participants provided information relating to frequency of use, information access, relative level of antenatal care and ease of contact. 105 (66%) participants completed the open-ended free-text question. Key themes to emerge related to: (1) information provision and verification; (2) managing and reducing feelings of isolation; (3) service specific issues, including crisis adaptations; and (4) impact on routine care.ConclusionsThe study suggests that that pregnant mothers found a social media based approach well positioned to provide antenatal care and support during the COVID-19 pandemic.

Ti t l eMi d wif e-m o d e r a t e d s o ci al m e di a g r o u p s a s a v alid a t e d info r m a tio n s o u r c e for w o m e n d u ri n g p r e g n a n cy

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Purpose The improving global health (IGH) programme is a leadership development programme that aims to develop leadership skills and behaviours alongside quality improvement methodology in National Health Service (NHS) employees in a global health setting. Through collaboration, experiential learning and mentorship, the programme aims to produce both vertical and horizontal leadership development in its participants. This paper aims to describe the programme and its impact, in terms of leadership development, in a sample of participants. Design/methodology/approach Open coding and thematic analysis of leadership development summaries (LDS) completed by 39 returned IGH participants were conducted. LDS are written on completion of the overseas placement; participants reflect on their personal leadership development against the nine dimensions of the NHS Healthcare Leadership Model (2013). Findings These IGH programme participants have reported a change in the way they think, behave and see the world. A development in sense of self and experience in developing team members are the two most commonly reported themes. Adaptability, communication, overcoming boundaries, collaborative working, “big picture” thinking and strategic thinking were also identified. Research limitations/implications The study is limited by the relatively low number of completed LDS. More work is needed to understand the long-term effect of this type of leadership development on the NHS. Other leadership development programmes should consider focussing on vertical and horizontal leadership development. Originality/value This more granular understanding of the leadership skills and behaviours developed and how it is the programme’s design that creates it, has not previously been described.

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Background: Despite high levels of prenatal alcohol exposure in the UK, evidence on the prevalence of fetal alcohol spectrum disorders (FASD) is lacking. This paper reports on FASD prevalence in a small sample of children in primary school. Methods:A 2-phase active case ascertainment study was conducted in 3 mainstream primary schools in Greater Manchester, UK. Schools were located in areas that ranged from relatively deprived to relatively affluent. Initial screening of children aged 8-9 years used prespecified criteria for elevated FASD risk (small for age; special educational needs; currently/previously in care; significant social/emotional/mental health symptoms). Screen-positive children were invited for detailed ascertainment of FASD using gold standard measures that included medical history, facial dysmorphology, neurological impairment, executive function, and behavioral difficulties.Results: Of 220 eligible children, 50 (23%) screened positive and 12% (26/220) proceeded to Phase 2 assessment. Twenty had a developmental disorder, of whom 4 had FASD and 4 were assessed as possible FASD. The crude prevalence rate of FASD in these schools was 1.8% (95% CI: 1.0%, 3.4%) and when including possible cases was 3.6% (2.1%, 6.3%). None of these children had previously been identified with a developmental diagnosis.Conclusions: FASD was found to be common in these schools and most of these children's needs had not previously been identified. A larger, more definitive study that uses a random sampling technique stratified by deprivation level to select schools is needed to make inferences regarding the population prevalence of FASD.