The NICHD Strategic Plan focuses the institute’s research and training efforts to understand human development, improve reproductive health, enhance the lives of children and adolescents, and optimize abilities for all. It presents the institute’s research goals and objectives under five broad research themes:
- Understanding the Molecular, Cellular, and Structural Basis of Development
- Promoting Gynecologic, Andrologic, and Reproductive Health
- Setting the Foundation for Healthy Pregnancies and Lifelong Wellness
- Improving Child and Adolescent Health and the Transition to Adulthood
- Advancing Safe and Effective Therapeutics and Devices for Pregnant and Lactating Women, Children, and People with Disabilities
These five themes will enable NICHD to focus its efforts on the most significant public health challenges and advance science in these areas of priority. The institute will measure progress toward these priorities; analyze the scientific, clinical, and public health impact of its research; and periodically report on metrics to stakeholders.
Several cross-cutting topics emerged during discussions of NICHD’s public health and scientific priorities. It became clear that the institute’s success in advancing its scientific goals and objectives will depend on its ability to integrate the following topics into each scientific research theme.
Pervasive disparities exist in the health of racial/ethnic, rural, low-resource, sexual and gender minority, and other underrepresented populations. Understanding the contribution of social, economic, structural, and regional factors is vital to advancing preventive, diagnostic, and intervention efforts. These factors are particularly important in maternal health and mortality, birth outcomes, infant mortality, child development, and exposure to trauma and injury. Improving approaches in populations that experience specific cultural, social, or access issues will be an emphasis across the research themes.
Disease prevention and health promotion are central to efforts across NICHD. Advancing methods to identify at-risk populations or specific genetic, nutritional, medical, environmental, social, and behavioral risk factors will enhance the ability to target interventions. The institute will concentrate its efforts on prevention in maternal and infant mortality and morbidity, injuries in children, and risk-taking behaviors in adolescents. Promoting research to prevent adverse health outcomes, improve early detection, and understand the optimal timing of prevention efforts will be critical to success in this area.
Infectious agents, such as HIV, continue to pose a significant threat to maternal health and child development. At the same time, pathogens with previously unknown disease-causing properties constantly evolve and emerge. NICHD plans to improve the basic understanding of how infectious pathogens affect pregnant women and young children, address the impact of infections on reproductive and overall health in children and adolescents, and advance safe and effective treatments for pregnant and lactating women, children, and people with disabilities.
Nutrition is critical to growth and development. New technologies and methods allow scientists to characterize the complex biology of nutrition and the effects of nutritional status on health in a more systems-based approach. The recent revolution in ‘omics technologies, including metabolomics, and discoveries related to the interplay among diet, nutritional status, and the microbiome create important scientific opportunities. These new avenues for scientific discovery will allow NICHD to understand the lifetime impact of nutrition on reproductive health, fertility, pregnancy, and fetal, child, and adolescent growth and development. Of unique interest to the institute is a better understanding of the composition and function of human milk, the effect of maternal nutrition and length of gestation on human milk composition and lactation, and the optimal source of nutrition and mode of nutrient delivery to the infant, especially preterm infants.
Disease and disability have no national borders. Because of investments made by NICHD and others, maternal and child survival is improving globally. There is now an opportunity to shift to research aimed at better understanding and addressing long-term health outcomes and chronic conditions of at-risk mothers and children. New interventions to improve pre-pregnancy health will help benefit pregnancy outcomes and prevent prematurity, malnutrition, childhood stunting, disease, and developmental delays. Studying populations globally will also improve domestic capabilities to address disease and risk factors among the culturally diverse U.S. population. Finally, new technologies are emerging to improve assessment and intervention for people worldwide with intellectual, developmental, and physical disabilities, and NICHD will support work in this area.