Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE) Initiative

NIH has published three IMPROVE Maternal Health Centers of Excellence Requests for Applications (RFAs):

The IMPROVE Maternal Health Centers of Excellence Frequently Asked Questions page offers additional information about these RFAs.


An estimated 700 U.S. women die each year from conditions related to or associated with pregnancy or childbirth, the highest rate among developed nations. More than 50,000 women experience severe maternal morbidity (SMM), life-threatening health problems that are present at delivery.

The NIH-wide IMPROVE initiative supports research on how to mitigate preventable maternal mortality, decrease SMM, and promote health equity. Using an integrated approach to understand biological, behavioral, sociocultural, and structural factors contributing to maternal mortality, SMM, and maternal morbidity, including a focus on the ongoing COVID-19 pandemic, IMPROVE will build an evidence base for improved care and outcomes in specific populations and regions of the country.

IMPROVE is a multipronged, innovative research initiative designed to understand and eliminate health disparities among populations disproportionately affected by maternal morbidity and mortality, including African American, American Indian/Alaskan Native, Asian Pacific Islander, Hispanic/Latina, very young women, women of advanced maternal age, and women with disabilities. Many of these populations are also disproportionately affected by the COVID-19 pandemic. The IMPROVE approach also addresses geographic disparities and social determinants of health, including education, racism, and socioeconomic standing.

NICHD co-chairs the NIH Maternal Health Task Force, which leads the IMPROVE initiative. In addition, maternal health is central to NICHD’s research mission and is part of the NICHD Strategic Plan, Scientific Theme 3: Setting the Foundation for Healthy Pregnancies and Lifelong Wellness. Because of the broad nature of maternal mortality and morbidity research, NICHD relies on nearly all of its branches, offices, and labs across all of its divisions and centers to conduct and support these efforts.

Topic Areas

Through the Notice of Special Interest (NOSI): Administrative Supplements and Urgent Competitive Revisions for NIH Grants to Add or Expand Research Focused on Maternal Health, Structural Racism and Discrimination (SRD), and COVID-19 (NOT-OD-21-071), the IMPROVE initiative will support projects to address the following areas of research interest related to the COVID pandemic:

  • Investigate the impact of the COVID-19 pandemic on the health, well-being, and functioning of pregnant persons and up to 1 year postpartum using psychosocial and behavioral research approaches
  • Investigate the impact of SRD in the context of the COVID-19 pandemic on the health and well-being of persons during pregnancy and up to 1 year postpartum
  • Understand how knowledge, attitudes, and beliefs about COVID-19 influence decisions and behaviors related to COVID-19 testing and vaccination during pregnancy and up to 1 year postpartum
  • Develop an integrated understanding of pregnancy-related and pregnancy-associated maternal morbidity and mortality causes, related to COVID-19

NICHD Awardees

The NIH IMPROVE initiative website provides a full listing on grantees.

Fiscal Year 2021 NICHD Awardees:

Fiscal Year 2020 NICHD Awardees:

More Information

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