AMANHI Study

A group of investigators from ongoing community-based studies on maternal and newborn health interventions and the WHO have formed the Alliance for Maternal and Newborn Health Improvement (AMANHI) and received funding to conduct additional studies on cohorts of pregnant women and newborns within ongoing study. The study team identified four research objectives as follows:

 

  • To determine the burden, timing, and causes of maternal deaths, stillbirths and neonatal deaths.
  • To determine the burden of severe acute maternal morbidity, care received, and their association with stillbirths, prematurity, intrauterine growth restriction and neonatal mortality.
  • To identify a programmatically feasible method for accurate assessment of gestational age, and use it for (i) quantifying the risk of neonatal mortality by gestational age and birth weight, and (ii) quantifying the risk of various maternal morbidities by gestational age.
  • To test hypothesized biological markers as predictors of important maternal and fetal outcomes, and use this opportunity to establish a repository of biological samples for testing as new hypotheses, methods and technologies become available.

 

Data collection tools for objective 1 and 2 were designed based on the core variables provided by World Health Organization. All data forms were finalized after field testing. Extensive pilot testing was done of the newborn gestational age assessment, data collection tools, and training materials with both physicians and CHWs which contributed to the finalization of the multi-site Objective 3 assessment. 

 

This study plans to use data already being collected in ongoing studies and also collect additional data as per the study design. Thus, many of the study activities are implemented by existing research staff. We have recruited staff members for additional activities for this study. 

 

Verbal autopsy (VA) data collectors and quality control supervisors for objective 1 are trained and are now engaged in data collection activities. The duration of training was 18 days which started on November 03, 2012 and ended on November 20, 2012. Data collection on VA started on December 23, 2012. Training for newly recruited Community Health Workers (CHW) for objective 2 activities were completed in four batches from January 2013 to February 2013. Objective 3 is being implemented by existing project staff and no additional training was needed.

 

Orientation of all existing projects staff on the procedures of AMANHI study and their roles in this study has been completed. We also arranged an orientation session for local Ministry of Health officials on the study. As done in all studies, we organized community advocacy meetings with community leaders including local government representatives and religious leaders. All supervisory staffs were trained on supervision and monitoring system of the project. The training included techniques of supportive supervision; data quality control; data form editing; and reporting for project monitoring purpose.

 

For objective 1, we are performing VA for stillbirths, neonatal deaths and adult female deaths since November 2012. The performance until May 2013 is shown in table 1.

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