CHAMNHA Climate, heat and maternal and neonatal health in Africa

CHAMNHA 非洲的气候、高温与孕产妇和新生儿健康

• 批准号: NE/T01363X/1
• 负责人: John Marsham
• 金额: $ 10.29万
• 依托单位: University of Leeds
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=NE%2FT01363X%2F1
• 关键词: CHAMNHA; Climate; heat; maternal; neonatal; CHAMNHA; Climate; heat; maternal; neonatal

The frequency and intensity of heat waves have increased in sub-Saharan Africa (SSA) and are set to escalate in the coming decades. Heatwaves present major health threats, especially for vulnerable population groups, such as those with limited socio-economic resources or compromised physiological ability to respond to heat stress. Pregnant women and neonates (<28 days after birth) have a unique set of health vulnerabilities, particularly in low- and lower-middle income countries (LLMICs), where pregnancy and childbirth are often highly precarious. Heat exposure complicates Maternal and Neonatal Health (MNH), increasing risks for maternal hemorrhage and sepsis, prematurity, low birth weight and neonatal dehydration. Few studies have assessed these impacts in sub-Saharan Africa, where maternal and neonatal deaths are frequent, facilities experience high indoor temperatures, health systems have low adaptive capacity and access to services is increasingly disrupted by climate events. The proposed study (CHAMNHA) is led by a transdisciplinary team from 3 continents, spanning the natural, health and social sciences, and will address key knowledge gaps around heat and MNH in SSA in collaboration with stakeholders, employing qualitative and quantitative methods, implementation and evaluation science, and climate impact methods. The project is divided into three workpackages (WP). WP1 will quantify impacts of heat exposure on MNH outcomes, using trial data, birth cohorts and other data sources from SSA, Norway and Sweden. We will characterize these impacts and identify sub-groups at high-risk. In WP2, qualitative research will document perceptions and local practices relating to heat exposure in pregnant women and neonates in Burkina Faso and Kenya. Then, in conjunction with pregnant women, male partners and health workers, we will co-design community- and facility-based interventions, such as improving preparedness for heat, e.g. through warning systems; changing behaviors and health worker practices to reduce heat impacts on MNH; training birth companions and traditional birth attendants on heat reduction during childbirth; and promoting breastfeeding and optimised hydration for women and neonates. WP3 will test the acceptability, feasibility and effectiveness of selected interventions using a randomized design (Kenya) and pre-post study design (Burkina Faso). In WP4, building on established collaborations with stakeholders, ministries of health and WHO, we will translate research findings into recommendations for improved MNH practice in the health sector, and national adaptation planning to reduce the current and future impacts of climate change.

在撒哈拉以南非洲（SSA）中，热浪的频率和强度有所增加，并将在未来几十年中升级。热浪构成了主要的健康威胁，尤其是对于弱势群体群体，例如具有有限的社会经济资源或对热压力做出反应的生理能力损害的人群。孕妇和新生儿（出生后<28天）具有独特的健康脆弱性，尤其是中低收入的收入国家（LLMICS），那里的怀孕和分娩通常非常不稳定。热量暴露使产妇和新生儿健康（MNH）复杂化，增加了母体出血和败血症，早产，低出生体重和新生儿脱水的风险。很少有研究评估了撒哈拉以南非洲的这些影响，在撒哈拉以南非洲，孕产妇和新生儿死亡经常发生，设施经历较高的室内温度，卫生系统的适应能力较低，气候事件越来越多地破坏服务。拟议的研究（CHAMNHA）由来自3大洲的跨学科团队领导，跨越了自然，健康和社会科学，并将与利益相关者合作解决SSA中热和MNH的关键知识差距，采用定性和定量方法，实施和评估科学，以及气候影响方法。该项目分为三个工作包（WP）。 WP1将使用来自SSA，挪威和瑞典的试验数据，出生队列和其他数据源来量化热量暴露对MNH结果的影响。我们将表征这些影响，并在高风险处识别子组。在WP2中，定性研究将记录与布基纳法索和肯尼亚孕妇和新生儿的热暴露有关的观念和当地实践。然后，与孕妇，男性伴侣和卫生工作者一起，我们将共同设计基于社区和设施的干预措施，例如改善热量的准备，例如通过警告系统；改变行为和卫生工作者实践，以减少对MNH的热量影响；培训出生伴侣和传统的亲生服务员在分娩期间减少降温；并促进妇女和新生儿的母乳喂养和优化的水合。 WP3将使用随机设计（肯尼亚）和验证前研究设计（Burkina Faso）测试选定干预措施的可接受性，可行性和有效性。在WP4中，建立在与利益相关者，卫生部的既定合作基础上，以及谁将研究结果转化为改善卫生部门MNH实践的建议，以及国家适应计划，以减少气候变化的当前和未来影响。