Mothers' and new born's health promotion : to reduce the social inequalities of health ; Promotion de la santé des mères et des nouveau-nés : réduire les inégalités sociales de santé

Introduction. It has been shown that the beginning of life is the key period in the genesis of social inequalities in health: support for parenthood is one of the major levers for limiting or even reducing these inequalities. The objective of this dissertation is to develop a conceptual framework establishing the conditions for the success of interventions, policies and organizations to support parenthood in order to limit social inequalities in health for mothers and children in the perinatal period. Methods. The research has two components: a systematic literature review and a realistic evaluation. -Systematic review: this was a systematic review of reviews published between 2009 and 2016 in English or French. 21 reviews meeting the AMSTAR criteria were selected. They were analysed with regard to their consideration of social inequalities in health, according to PRISMA-equity. - Realistic evaluation: The process consisted of three steps: 1) development of a first theory based on the results of the review. 2)multiple case study. Two cases were investigated: the border territories of the steel industry of Longwy in Lorraine and Esch-sur-Alzette in Luxembourg. They were selected for their geographical proximity and the particularly vulnerable and unequal nature of the populations living there. The data collected came from several sources, including a documentary corpus, questionnaires and interviews. The analysis focused on the consideration of social inequalities in health in practices. 3) a synthesis explaining how interventions work based on the mechanisms at play in their real context. Results. The synthesis of the reviews clearly revealed the limitations of current knowledge on health equity in the area of parental support. Parenting education programs, most often offered only to mothers and especially to the most disadvantaged, rarely take into account social gradients in health. In addition, the publications come mainly from Anglo-Saxon cultures; there is little data on the subject in the context of ...