Achieving MDGs 4 and 5: Strategic Research to develop the evidence base for policy for mother and infant care at facility and community level

Aims and Objectives

Eight Millennium Development Goals (MDGs) were identified as targets in meeting the needs of the world's poorest. They provide a blueprint of targets agreed to by all countries and leading development institutions. MDGs 4 and 5 are aimed specifically at improving child and maternal survival. Their targets are to reduce mortality in children under five by two-thirds and maternal mortality ratio by three-quarters by 2015 and from their 1990 levels.

Our research consortium, "Towards 4+5" which is funded by DFID, sets out to help achieve these goals by:

Identifying and testing new approaches to reduce maternal and infant (including neonatal) mortality in poor countries. Reviewing existing cost-effective methods to ensure that services meet the MDGs.

We set out to accomplish these goals by conducting scientific research in the following areas:

1. Maternal, neonatal and post-neonatal interventions
2. Health service and community-based approaches
3. Behavioural, clinical and health systems strategies

Evidence gathered from these three areas will be synthesised, integrating information from all three areas into a cohesive body of knowledge which will be disseminated to policymakers, in different settings.

The activities of our RPC started in April 2005 and will end in March 2010. The key outputs of our research programme will be:

1. Evidence on interventions to improve the survival of women and infants through (i) community interventions and (ii) health services delivery
2. Completion by 2010 of a communication strategy that supports policy and management decision-making on large scale programmes for maternal and infant mortality reduction
3. Increased capacity in partner countries for knowledge generation and policy influence

Partners

The consortium comprises a number of experienced organizations worldwide, and is coordinated by the Institute of Child Health and the London School of Hygiene and Tropical Medicine.

• Institute of Child Health, UK
  Email - ipu@ich.ucl.ac.uk
• London School of Hygiene and Tropical Medicine, UK
  Email - Elizabeth.Anderson@lshtm.ac.uk
• International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B)
  Email - margek@icddrb.org
• Perinatal Care Project (PCP), Diabetic Association of Bangladesh (DAB)
  Email - kishwar@connectbd.com
• Centre MURAZ, Burkina Faso
  Email - nmeda.muraz@fasonet.bf
• Kintampo Health Research Centre (KHRC), Ministry of Health/Ghana Health Services
  Email - Charlotte.tawiah@ghana-khrc.org
• Maimwana project, Lilongwe Central Hospital, Malawi
  Email - cmwansambo@malawi.net
• Mother and Infant Research Activities (MIRA), Nepal
  Email - dsm@healthnet.org.np
• The Florence Nightingale School of Nursing and Midwifery, Kings College London, UK
  Email - Susan_fairley.murray@kcl.ac.uk
• National Perinatal Epidemiology Unit, University of Oxford, UK
  Email - Peter.brocklehurst@perinat.oc.ac.uk
• Aga Khan University, Pakistan
  Email - zulfiqar.bhutta.aku.edu

LSHTM activities within the RPC:

1. Coordinating 5 key papers for the Lancet series on maternal health (funders: DFID and USAID)
2. Establishing the effectiveness of audits, in particular near-miss case review or patient-centered case reviews, in particular in Burkina Faso, Benin and Mali (funder: EU)
3. Establishing the health and psycho-social consequences of long term complications in Benin and Bangladesh (funder: WHO, USAID)
4. Establishing the effectiveness of community interventions on neonatal mortality in Ghana. DFID
5. Developing sustainable community based intervention to improve neonatal care practices in rural Ghana, and evaluating its effectiveness in reducing neonatal mortality. “ Funding decision any day: Have applied for joint funding from WHO/SNL.
6. Conducting a pilot study of the safety and benefits of praziquantal treatment of pregnant women in Burkina Faso and develop further research plans
7. Establishing the efficacy of weekly vitamin A supplementation in reducing maternal mortality in Ghana. DFID
8. Understanding evidence use for international policy-making in maternal health (funder: ESRC)
9. Coordinating a baseline study on all site on priorities of stake holders in relation to safe motherhood and neonatal health
10. Documenting the history of safe motherhood
11. Developing and refining an integration framework which brings together mother and baby, community and facility, behavioural and clinical approaches
12. Conducting a meta-analysis of micronutrient interventions in pregnancy (funder: WHO)

Staff at LSHTM:

Elizabeth Anderson (admin), Rebecca Baggaley, Dominique Behague, Matthias Borchert, Jo Borghi, Oona Campbell, Simon Cousens, Karen Edmond, Veronique Filippi (deputy director), Zelee Hill, Betty Kirkwood, Tom Marshall, Carine Ronsmans, Katerini Storeng

Consortium website