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）：女性在怀孕期间营养不良，尤其是在分娩和分娩期间，缺乏铁、锌、叶酸和维生素 B12 等关键矿物质和微量营养素 (M&M)，容易出现严重并发症。此外，这些母亲的孩子可能会出现中线出生缺陷、大脑发育改变和感染倾向。尽管发布了新的方法和指南，通过简单的医疗保健服务调整来优化孕产妇和婴儿的营养，但发展中国家的临床实践往往仍然根深蒂固地采用非最先进的护理模式。我们认为，要解决资源匮乏地区妇女及其子女优化营养的迫切需要，需要一个论坛，让当地多学科专家临床医生研究人员小组能够聚在一起反思这些临床进展；自由交流这些数据与其实践的相关性；找出文献中可以通过研究解决的空白；然后制定短期研究项目，为优化母婴营养的更大预防策略奠定基础。 肯尼亚埃尔多雷特的 AMPATH（提供医疗保健的学术模型；http://www.iukenya.org/）有一个新颖的基础设施，这是一个已有 20 年历史的组织结构，由莫伊教学和转诊医院、莫伊大学、以及一个由北美大学组成的联盟，其教师拥有行为与社会科学、儿科、生殖健康、成人医学和营养学等学科研究的专业知识和跟踪记录。 AMPATH 有兴趣加强跨学科研究的交叉方面，重点是优化资源匮乏环境中妇女和儿童的护理。因此，R13 提案的具体目标是让 AMPATH 教员聚集在一起参加两次会议，挑战他们跳出学科内的界限进行思考，并与其他学科的成员合作，实施适合具体情况的“低技术”干预措施，从而产生积极影响资源匮乏地区妇女、婴儿和儿童的营养。对于第一次会议，在反思了母婴营养方面的最新进展后，并根据小组对 R21 提案中应解决的关键具体目标的共识，我们将制定有针对性的计划，以就以下方面产生必要的初步信息年。我们还将利用焦点小组和健康论坛（肯尼亚社区集会的习惯形式）发起妇女、老年人和思想领袖之间的对话，以加深社区对孕产妇健康和营养相关社会文化问题的理解。在第二次会议上，我们将讨论这些初步结果，并完善 NIH R21 提案草案，该提案重点关注一项创新临床试验，旨在评估出生时 M&M 干预对婴儿血液学特征、感染易感性、行为和行为的益处。智力开发 一年后。此类研究是通过 NIH R01 格式开展更大的基于社区的纵向项目的必要前奏。 1