Optimizing Maternal-Child Health in Kenya

优化肯尼亚的母婴健康

• 批准号: 8529589
• 负责人: Asok Antony
• 金额: $ 0.6万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-15 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8529589
• 关键词: 20 year old; Address; Adult; American; Behavioral; Birth; Brain; Caring; Child; Child Nutrition; Clinical; Clinical Trials Design; Communities; Congenital Abnormality; Consensus; Data; Developing Countries; Development; Discipline; Educational process of instructing; Elderly; Faculty; Fertilization; Focus Groups; Folate; Foundations; Guidelines; Health; Health Services Accessibility; Hospital Referrals; Infant; Infection; Intervention; Iron; Kenya; Learning; Literature; Maternal and Child Health; Medicine; Methods; Micronutrients; Minerals; Modeling; Modification; Mothers; Patterns of Care; Pediatrics; Predisposition; Pregnancy; Prevention strategy; Publications; Reproductive Health; Research; Research Infrastructure; Research Personnel; Research Project Grants; Resources; Testing; United States National Institutes of Health; Universities; Vitamin B 12; Woman; Women Status; Zinc; base; behavioral/social science; health care delivery; improved; infant nutrition; innovation; interest; meetings; member; micronutrient deficiency; mother nutrition; novel; nutrition; prevent; symposium

DESCRIPTION (provided by applicant): Undernourishment with key mineral and micronutrient (M&M) deficiencies of iron, zinc, folate, and vitamin-B12 among women during pregnancy predisposes to serious complications, especially during labor and delivery. In addition, children of such mothers can develop midline birth defects, altered brain development, and a predisposition to infections. Despite the publication of new methods and guidelines to optimize maternal and infant nutrition through simple modifications in healthcare delivery, clinical practic in developing countries often remains entrenched in patterns of care that are not state-of-the-art. We believe that addressing the urgent imperative to optimize nutrition among women and their children in resource-poor settings requires a forum where a local multi-disciplinary faculty group of expert clinician-researchers can meet to reflect on these clinical advances; freely communicate on the relevance of these data to their practice; identify gaps in the literature that can be addressed through research; and then develop short-term research projects that can then lay the foundation for a larger preventive strategy to optimize maternal-child nutrition. There is a novel infrastructure in Eldoret, Kenya, at AMPATH (Academic Model Providing Access To Healthcare; http://www.iukenya.org/)-a 20-year old organizational construct consisting of Moi Teaching and Referral Hospital, Moi University, and a consortium of North American Universities-with faculty who have expertise and a track record of disciplinary research involving Behavioral & Social Sciences, Pediatrics, Reproductive Health, Adult Medicine, and Nutrition. AMPATH is interested to strengthen the cross-fertilization aspects of inter-disciplinary research that focuses on the optimization of care for women and children in resource-poor settings. So the Specific Aim of this R13 proposal is to bring AMPATH faculty together for two conferences to challenge them to think outside of their intra-disciplinary silos and collaborate with members of other disciplines to implement contextually appropriate 'low-tech' interventions that can positively impact the nutrition of women, infants, and children in resource-poor settings. For the first conference, after reflecting on recent advances in maternal-child nutrition, and based on the group's consensus on the key specific aims that should be addressed in an R21 proposal, we will develop focused plans to generate the necessary preliminary information over the following year. We will also use focus groups and health barazas-the customary form of community assembly in Kenya-to initiate a dialogue among women, elders and thought leaders to attain a deeper community understanding of socio-cultural issues surrounding maternal-child health and nutrition. At the second conference, we will discuss these preliminary results and refine the draft of a NIH R21 proposal that focuses on an innovative clinical trial designed to assess the benefit of a M&M intervention at birth on the infant's hematologic profile, susceptibility to infections, behavioral and intellectual development a year later. Such studies are a necessary prelude to a larger community-based longitudinal project via a NIH R01 format. 1

描述（由申请人提供）：营养不足，其关键的矿物质和微量营养素（M＆M）缺乏铁，锌，叶酸和维生素-B12在妊娠期间女性中的妇女中的含量不足，易患严重的并发症，尤其是在劳动和分娩过程中。此外，这样的母亲的孩子可以发展中线出生缺陷，大脑发育改变以及感染的倾向。尽管出版了新方法和准则，可以通过简单的医疗保健提供来优化孕产妇和婴儿营养，但发展中国家的临床实践往往仍然根深蒂固，这并不是最先进的护理模式。我们认为，应对在资源贫乏的环境中优化妇女及其子女营养的紧急情况需要一个论坛，在该论坛上，当地的多学科教职员工团体组成的专家临床医生研究员可以开会以反思这些临床进步；自由就这些数据与实践的相关性进行沟通；确定可以通过研究解决的文献中的差距；然后开发短期研究项目，然后可以为更大的预防策略奠定基础，以优化产妇营养。 肯尼亚的埃尔多雷特（Eldoret）在Ampath上有一个新颖的基础架构（提供医疗保健的学术模型； http://www.iukenya.org/)-A）20岁的组织结构，包括MOI教学和推荐医院，MOI大学，MOI大学，MOI大学，以及北美学院的社交和社会研究，并录制了专业的研究，并涉及专业的研究，并涉及专业知识，并涉及专业知识，生殖健康，成人医学和营养。 Ampath有兴趣加强跨学科研究的交叉利用方面，该研究重点是在资源贫乏的环境中对妇女和儿童的护理优化。因此，这项R13提案的具体目的是将Ampath教师聚集在一起，以挑战他们在其内部学科的孤岛之外思考，并与其他学科的成员合作，以实施上下文适当的“低技术”干预措施，从而积极影响妇女，婴儿，婴儿，资源poor poor setings in n n n in saters intsings intsings intersings intersing nestings netry nation。在第一次会议上，在反思了母婴营养的最新进展之后，并基于该集团对R21提案中应解决的主要特定目标的共识，我们将制定重点计划，以在接下来的一年中生成必要的初步信息。我们还将使用焦点小组和卫生巴萨斯 - 肯尼亚社区议会的习惯形式形式，以在妇女，长者和思想领袖之间进行对话，以使社区对围绕孕产妇健康和营养的社会文化问题有更深入的了解。在第二次会议上，我们将讨论这些初步结果，并完善NIH R21提案的草稿，该提案的重点是一项创新的临床试验，旨在评估M＆M出生时对婴儿血液学特征的好处，对感染，行为和智力发展的易感性 一年后。此类研究是通过NIH R01格式进行大型基于社区的纵向项目的必要前奏。 1