Improving maternal and child health and social inequalities for migrants with no recourse to public funds and irregular status
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7 February 2024 — November 2023 to October 2028
Improving maternal and child health and social inequalities for migrants with no recourse to public funds and irregular status
The term ‘irregular or undocumented migrant’ refers to people who are in the UK without a legal right to be. There were approximately 674,000 irregular migrants (including 215,000 children) living in the UK in 2017.
irregular migrants in UK (2017)
migrants with NRPF conditions
of those with NRPF are women and children
Approximately 1.4 million migrants in the UK have leave to remain subject to the condition of No Recourse to Public Funds (NRPF), meaning they have no entitlement to most state welfare support.
These migrant groups are liable to pay secondary NHS charges, including hospital treatment and maternity care. These costs and lack of welfare support can result in financial hardship, unstable housing, isolation and a lack of access to services, posing serious public health risks.
The associated harms fall disproportionately on women, children, low-income, minoritised and disabled groups, and there is wide national variation in support offered.
Despite approximately 25% of those with NRPF and/or irregular immigration status being women and children, little is known about their long-term health and social outcomes. Research into maternity services has found a lack of professional knowledge and guidance, and consistent errors in the assessment of immigration status, resulting in women wrongly being charged. Many women do not access essential antenatal care for fear of being charged for care they cannot afford.
Project aim
This project aims to explore the long-term health and social outcomes of pregnant women and young children with NRPF, and to develop and evaluate multidisciplinary guidance to reduce inequalities.
Two leading charities guide the direction and scope of the research, co-produce multidisciplinary guidance, and disseminate findings through their networks:
The project advisory group also includes: Birthrights, Happy Baby Community, Project 17, maternity care professionals and academic experts.
How this project will be carried out
This novel research will address significant knowledge gaps through four workstreams:
A systematic review of international literature to identify long-term health and social outcomes of pregnant migrant women and children up to age 5, the impact of high-income countries’ integration policies, and an accurate proxy to measure women likely to have NRPF. A national mapping exercise will identify variation in local authority support available and how this aligns with the UK’s legal framework.
Analysis of two well-established UK-based cohorts to explore differences in access, experiences and long-term health and social outcomes between women and children with NRPF/irregular immigration status, other migrants, and UK-born residents.
Co-production of guidance for multi-disciplinary professionals using realist methodology. Women with NRPF who have given birth within one year, and stakeholders at six NHS trusts serving diverse populations, will be interviewed to identify how access to services, experiences, and health and social care outcomes might be improved.
Implementation and realist evaluation of the guidance at six pilot sites.
How patients and the public are involved
A group of approximately 6–10 women with lived experience of pregnancy whilst having NRPF will be recruited for the entirety of the project, although membership to the PPIE and engagement group will evolve over the five years. Formal meetings will be held tri-annually throughout the research project with both the PPIE and project advisory groups.
“This sensitive project has brought together a team of experts by experience who are all passionate about exploring the link between the no recourse to public funds policy and migrant women’s maternal experience. By continuing to build a trusting rapport with all participants, my role (and aim) is to support the latter through training and mentorship, to enable them to confidently lead the development and dissemination of outputs. As a team, we have opted for a flexible and informal collaborative approach, with a special focus on trust-building and meaningful co-production.”
Zenab Barry — PPIE advocate, experienced peer researcher and former Director of National Maternity Voices
Zenab will work with the project lead to ensure that the PPI group’s voice is embedded in all aspects of the research. She will also act as a PPIE mentor for PPI members, enhancing research that involves strong, meaningful, and diverse patient and public involvement, and will provide reverse mentoring to the project lead.
After the first year, other members of the PPI group will be given the opportunity to co-chair PPI and project advisory group meetings on a yearly membership to ensure varied and up-to-date involvement.
“We aim to develop an enhanced evidence-base of the impact of the NRPF policy and NHS charging programme on women and children’s health and social outcomes, including guidance on what works to improve inequalities. We will share our findings with local communities, key stakeholders, policy makers and the scientific community.”
Dr Hannah Rayment-Jones — Project lead, midwife and NIHR research fellow, King’s College London
Related content
- →
Maternity, migration and policy: a collaborative roundtable — June 2025 - →
A better start for migrant mothers and babies — migrants’ maternal health conference (November 2024) - →
Maternity and perinatal mental health research at ARC South London - →
Maternity Action: NHS charges for maternity care — guidance for migrants
Original source: arc-sl.nihr.ac.uk — NIHR ARC South London legacy content archived May 2026.