Alliance for Maternal and Newborn Health Improvement (AMANHI) Study

Project Description

The Alliance for Maternal and Newborn Health Improvement (AMANHI) multi-centre study aims to harmonize several large ongoing newborn health research studies in sub-Saharan Africa and South Asia. This study hopes to achieve a better understanding of the epidemiology of maternal morbidity and mortality, stillbirths and neonatal deaths, including the associations of maternal morbidity and related care seeking with maternal, fetal and neonatal outcomes. This additional information will be highly relevant for advocacy to increase investment and better planning of maternal and newborn health programs in the participating countries, as well as at sub-regional, regional and global levels. The other studies are evaluating neonatal vitamin A supplementation (Ghana, India-Haryana and Tanzania-Ifakara), chlorhexidine application on the cord (Tanzania-Pemba ), emollient skin care (India-Shivgarh), neonatal sepsis treatment (DRC, Kenya) and neonatal sepsis etiology (Bangladesh, India-Vellore and Odisha, Pakistan-Karachi, Pakistan-Matiari). This will produce one of the largest data sets of reliable epidemiological information on maternal and fetal survival using a multi-country cohort approach in low- and middle-income countries. At the ZamCAT study site in Southern Province, Zambia, CGHD researchers are participating in the following objectives:

  • Determining the burden, timing and causes of maternal deaths and stillbirths.
  • Identifying a programmatically feasible method for accurate assessment of gestational age, and using it to quantify the risk of (i) neonatal mortality by gestational age and birth weight, and (ii) maternal morbidities by gestational age.
  • Generating unique information to guide improvements on interventions to reduce maternal and newborn mortality and morbidity as well as to prevent stillbirths. Specifically,

1. To determine the burden of major maternal morbidity in the study population

2. To document the care received for each morbidity

3. To determine the association of maternal morbidity with stillbirth, preterm birth, intrauterine growth restriction and neonatal mortality

As of December 2013, data collection is well underway. Interviews with pregnant women and mothers to infants in the first six weeks of life have taken place as part of ZamCAT which concluded in the fall of 2013. A new cohort of women is currently being enrolled to study a feasible method for assessing gestational age at the community level. The study team is also conducting verbal autopsies with family members of newborns and mothers who die while enrolled in the study. Through these data collection efforts, the AMANHI study seeks to generate new knowledge to guide improvements on interventions to reduce maternal and newborn mortality as well as prevent stillbirths.

Project Details

Principal Investigator Davidson HamerKatherine Semrau
Boston University Co-Investigators Julie Herlihy, Kojo Yeboah-Antwi
Collaborators Ministry of Health, Zambia; Zambia Center for Applied Health Research  and Development (ZCAHRD)
Country(ies) Zambia
Dates of Research 2012-2014
Donor/Funder WHO LogoWorld Health Organization