The Global Network for Women's and Children's Health Research supports and conducts clinical trials in resource-limited countries by pairing foreign and U.S. investigators, with the goal of evaluating low-cost, sustainable interventions to improve maternal and child health and simultaneously building local research capacity and infrastructure. These activities are designed to facilitate independent continuation of local research activities that will ultimately lead to improved healthcare systems and personal health.
The Global Network began in 2001 as a public-private partnership between NICHD and the Bill & Melinda Gates Foundation. NICHD provides scientific oversight of the Global Network and all its activities.
The network currently includes a data coordinating center (DCC) and several multidisciplinary research units around the world, each comprising a partnership between a research institution in a developing nation and one in the United States. The network, which was re-competed in 2013, currently includes dyads of investigators in the United States paired with senior foreign investigators in India, Pakistan, Guatemala, Zambia, Kenya, and the Democratic Republic of Congo.
Network studies focus on community-based, common protocols, conducted at three or more sites. These protocols address major maternal and newborn health challenges with the goals of evaluating low-cost, sustainable interventions to improve maternal and child health (MCH), evaluating trends in MCH mortality over time, and simultaneously building local research capacity and infrastructure. This unique approach gives NICHD the ability to identify gaps between science and practice and disseminate the research findings to inform local and national health policy. Each study examines either a novel evidence-based treatment or an innovative use of a proven treatment to improve the health, well-being, and survival of pregnant women and infants. All studies conform to U.S. and international ethical and safety guidelines.
The National Institute of Dental and Craniofacial Research, National Center for Complementary and Integrative Health, Fogarty International Center, National Cancer Institute, and others—in addition to the Bill & Melinda Gates Foundation—have supported projects or parts of projects conducted by the network.
This effort builds partnerships with national, international, and nonprofit organizations, such as the World Health Organization (WHO), the U.S. Agency for International Development, and the American Academy of Pediatrics.
Current activities include:
- Maternal Newborn Health Registry. This prospective, observational study of approximately 60,000 women per year aims to quantify and understand trends in pregnancy services and outcomes over time in defined, low-resource geographic clusters. All pregnant women are registered and their outcomes tracked for 6 weeks following delivery. The registry has been ongoing since 2008.
- Antenatal corticosteroids trial in preterm births to increase neonatal survival in developing countries. In collaboration with WHO, this randomized controlled trial seeks to reduce neonatal mortality by better identifying women at high risk of preterm delivery.
- Helping Babies Breathe (HBB) initiative . HBB, part of the American Academy of Pediatrics’ (AAP) Helping Babies Survive initiative, is a development of the Global Network's FIRST BREATH trial, which was designed to provide skilled birth attendants to babies wherever they are born. HBB was rolled out globally by the Global Network, AAP, U.S. Agency for International Development, and others.
- Women First: Preconception Maternal Nutrition study. The primary hypothesis of this study is that newborns of women in poor communities who receive a comprehensive maternal nutrition intervention starting at least 3 months prior to conception and continuing throughout pregnancy will be significantly longer than those infants whose mothers start to receive the same intervention at 12 weeks of gestation or infants whose mothers do not receive the intervention at all.
- Ultrasound study. This multi-country, cluster-randomized trial will assess the impact of antenatal ultrasound screening performed by community physicians and non-physician healthcare staff in low-resource community settings. The study will be conducted with the support of the Bill & Melinda Gates Foundation, GE Healthcare, and the University of Washington. The study's first hypothesis is that ultrasound will increase the rate of prenatal care utilization and appropriate utilization of delivery facilities for women with complicated pregnancies. The second hypothesis is that antenatal ultrasound screening performed by community physicians and non-physician healthcare staff will decrease a composite outcome of maternal mortality, maternal near-miss mortality, and stillbirth and neonatal mortality.
- Global Network Website (maintained by the Global Network DCC, RTI International)
- NICHD Contact: Marion Koso-Thomas
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