A Co-Produced Health Literacy Programme for Pregnant Women Whose First Language Is Not English: A Qualitative Study of Women's Experiences.

introductionHealth literacy, the ability to access, understand and use health information to make informed decisions, is a key determinant of maternal and infant health. In the United Kingdom, approximately one-third of the 600,000 babies born annually are to mothers born overseas, many of whom have limited English proficiency. This language barrier contributes significantly to health disparities. To address this, we co-produced a 6-week health literacy course for pregnant women with limited English proficiency in East London. Designed to empower participants, the course aimed to improve their ability to navigate health information and services. Multidisciplinary facilitators co-designed and delivered sessions covering topics such as anatomy, pregnancy, childbirth, postnatal care and medical decision-making, using illustrated materials to enhance understanding. This study aimed to explore the experiences of women who participated in the programme.

methodsSixteen participants took part in qualitative, semi-structured interviews conducted by a qualitative researcher and an interpreter. Data were analysed using reflexive thematic analysis.

resultsAnalysis resulted in three themes: (1) Reflections on programme content and delivery, (2) enhanced confidence in multiple areas of life and (3) wider social and personal benefits. DISCUSSION: This programme represents the first UK-based, co-produced health literacy initiative tailored specifically for pregnant women with limited English proficiency. Participants reported improved understanding of pregnancy and increased confidence in communicating with healthcare professionals. Importantly, the programme also fostered peer support networks, which contributed to sustained well-being. These findings underscore the potential of health literacy interventions to reduce health inequalities and improve maternal outcomes, particularly when language and community engagement are central to programme design. PATIENT OR PUBLIC CONTRIBUTION: This research was co-created with Katie's Team, a Patient and Public Involvement (PPI) Advisory Group in women's health. The project emerged from concerns raised by pregnant women, families, birthing companions and translators about the challenges faced by non-English speaking pregnant women in accessing and understanding healthcare. A working group including four PPI members, a health professional and two medical students helped shape the study. PPI contributors co-designed and facilitated focus groups with 20 recently pregnant women, informing programme content and delivery. PPI members were actively involved in co-developing the course content and lesson planning alongside a multidisciplinary team. Three PPI members received English for Speakers of Other Languages (ESOL) qualifications, two of whom co-delivered the programmeas teachers. PPI members supported participant recruitment, helped contextualise the interpretation of results and co-authored this paper. Findings were shared with PPI contributors for review and reflection. PPI members also took part in two community events to share findings.