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Maternal, Child and Reproductive Initiative Maternal, Child and Initiative

The Maternal, Child and Reproductive Health (MCRH) Initiative works towards the reduction Every year 289,000 of mortality, and the improvement of maternal health, in developing countries. women die from At the heart of the Initiative’s work model is the concept of knowledge translation: the transfer complications of scientific evidence into concrete action. The three main areas of research are: malaria related to , in pregnancy, causes of maternal mortality and the human papillomavirus (HPV). Through , and its advocacy and educational programmes, the Initiative builds on the evidence generated from postpartum, most of its research projects to influence policy and train health professionals in different countries. them preventable

Despite improvements in women’s and children’s Carrying out Complete Diagnostic Autopsies, health over the last decade, both groups still the gold standard methodology to inform on cause face disproportionateinequalities in access to of death, is not feasible in rural areas of the developing quality . For many women, pregnancy world, not only for the technical expertise required and childbirth are particularly frightening but also because there may be problems with cultural and dangerous times in their lives, when illness and/or religious acceptance, negatively influencing and even death happen all too frequently. consent. Thus, other more practical tools for cause This not only affects women but also their of death ascertainment need to be developed. and communities. However, solely addressing the direct obstetric causes of maternal mortality Cervical is one of the most common causes is not enough. Taken together HIV/AIDS, malaria of death for women in less developed countries. and tuberculosis are among the leading causes The vaccine against HPV is instrumental to reduce of maternal mortality in low- and middle-income the burden of . However, although countries. vaccines are available, their implementation strategy is challenging: it needs to be based on what Moreover, one of the problems which continues is affordable, feasible and culturally acceptable in to hamper progress in the reduction of maternal each country, and the target group — girls between mortality is the lack of reliable data on the levels 9 and 13 years old —, is not included in routine and causes of mortality. schemes that mostly target and pregnant women. Maternal mortality ratio ( per 100,000 live births), 2013

<20 20-99 500-999 Data not available 100-299 1000 Not applicable Source: World Health 300-499 Population <100.000 not included in assessment Organization, 2014

Over 80% of all births Pregnant women occur in countries are twice more where maternal likely to die from causes of death malaria than other data don’t exist or are adults incomplete Research

ISGlobal has a long tradition in the study of malaria. In recognition of the institution’s Cervical cancer is the work and achievements in this field, ISGlobal was officially designated a World Health second most common Organisation (WHO) Collaborating Centre for Malaria Control, Elimination and Eradication, cancer in women in 2013. worldwide Malaria in pregnancy Malaria during pregnancy is one Causes of maternal mortality of the main contributors to both maternal The MCRH Initiative has undertaken the largest and neonatal mortality, mostly through low birth necropsic study of maternal deaths in Africa and is weight and prematurity, and by causing maternal participating in a multi-centre study to design and anaemia or maternal malaria infection (placental assess Minimally Invasive Autopsy (MIA) tools as parasitaemia). As a result, an estimated 10,000 a feasible alternative to complete autopsies. women and 200,000 infants die every year in Africa. Research undertaken by the MCRH Human papillomavirus vaccine Initiative in this area includes: Nearly all cervical cancer cases (99%) are linked to genital infection with human papillomavirus · An evaluation of the safety and efficacy of alter- (HPV). ISGlobal is collaborating with the Manhiça native drugs to sulfadoxine-pyrimethamine Health Research Centre and the Ministry for Intermittent Preventive Treatment during of Health of Mozambique on a pilot pregnancy (IPTp). demonstration project, in preparation for the implementation of a national HPV vaccination · A study of the epidemiological and clinical programme in pre-adolescent girls. features of Plasmodium vivax malaria in pregnancy. Maternal immunization · Studies of the cost-effectiveness of malaria Maternal immunization offers an exceptional control interventions in infants and pregnant opportunity to protect pregnant women and women. their babies from diseases that cause substantial morbidity and mortality. ISGlobal has recently · The development and evaluation of the adopted maternal immunization in its research Intermittent Preventive Treatment in Infants portfolio, and aims to determine the burden (IPTi), a cost-effective strategy to prevent malaria of vaccine-preventable diseases that affect in the first year of life, and whose findings have pregnant women and their infants in preparation led to the recommendation by the WHO to be for the evaluation of vaccines during pregnancy implemented in malaria endemic areas. in resource poor settings. Policy and Global Development

ISGlobal advocates for equity and quality ISGlobal also participates in decision-making care in MCRH, pushes for R&D in the existing forums and helps to raise awareness and inform knowledge gaps and promotes the design the public debate by regularly producing policy of evidence-based programmes and policies, papers and case studies, particularly on the link which are key to improving quality of care for between inequity and maternal and child health. pregnant women with malaria. We use the results of multidisciplinary evidence-based analysis to inform the post 2015 Development Agenda, and to intervene directly on the ground through 99% of maternal international development projects seeking to transfer the results to society and ensure their deaths occur in impact through concrete actions. developing countries The Initiative develops alliances with social and political actors who share common areas and are concentrated of focus in MCRH, such as the UN Secretary General Initiative for Women’s and Children’s in certain regions Health (Every Woman Every Child), The Partnership for Maternal, Newborn and Child (sub-Saharan Africa Health and the Malaria in Pregnancy working group of the Roll Back Malaria Partnership. and South Asia) Training and Education

ISGlobal coordinates various training · A module on Maternal and Reproductive programmes, capacity building workshops Health is included in the Master of , and academic courses on MCRH, with co-organised by ISGlobal and the University the support of the University of Barcelona and of Barcelona. in collaboration with other academic and research centres. Upgrading the technical knowledge · Short courses on “Maternal and Reproductive and leadership skills of key players in the field Health and ” and “Food Security from of MCRH who come from high burden countries the Global Health Perspective”, in collaboration is one of the Initiative’s key priorities. Examples with Médicos Sin Fronteras-Spain. of the Training and Education Programme’s activities include: · Training of health and education professionals in Mozambique, for example, · “Safe Mothers and Newborns. Accelerating in preparation for the future nationwide the Reduction of Maternal and Neonatal implementation of the HPV vaccine supported Mortality: A Leadership Workshop”, organised by “la Caixa” Foundation. by ISGlobal together with the Maternal Health Task Force at the Harvard School of · Training of researchers at PhD level. and the Aga Khan University www.isglobal.org @ISGLobalorg Facebook.com/isglobal

ISGlobal’s mission is to promote through excellence in research and the translation and application of knowledge. Our vision is a world in which all people can enjoy good health.

ISGlobal Initiatives · Antibiotic Resistance Inititative · Chagas Inititiative · Malaria Elimination Initiative · Maternal, Child and Reproductive Health Initiative

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