R21HD103053

Mhealth and Mobile Ultrasound for Mothers in Myanmar (MMUMM) - Project Summary

1 Women in the ethnic minority, Chin State of Western Myanmar have one of the highest maternal mortality rates in Asia (357 per 100,000 live births). Currently, less than 10% of births take place in a healthcare facility because most women have to travel two or more days on foot through mountainous regions to reach one.

2 Lack of prenatal care and obstetric ultrasound means that high-risk conditions, including breech position and multiple births, are often not identified prior to the woman presenting in labor. The dual objectives of our proposed "Mhealth and Mobile Ultrasound for Mothers in Myanmar" (MMUMM) stepped-wedge cluster randomized trial are to evaluate: (1) the utility of using a mobile health (Mhealth) application to collect population surveillance data, and (2) the effectiveness of using a portable ultrasound device to improve the rates of attended births and successful transfers for high-risk pregnancies to a hospital.

3 The MMUMM trial responds directly to the priorities of Health and Hope Myanmar (HHM), the only nonprofit organization providing healthcare in the Chin State. Over the last 10 years, HHM has built comprehensive health, agriculture, and education programs in Western Myanmar, including the training of 834 CHWs and 166 traditional birth attendants.

4 HHM is currently expanding its focus to Mhealth-based population health surveillance data collection following millions of dollars of investment in telecommunications infrastructure across Myanmar, including the Chin State, by the government and international agencies.

5 In the R21 phase, we will 1) evaluate the quality of data collected using a Mhealth population health surveillance application (Survey123), refine to optimize quality, and 2) assess data quality and the feasibility of collecting and interpreting ultrasound images by local midwives.

6 In the R33 phase, we will randomize 55 villages, evaluate the effectiveness of Mhealth population surveillance and Mhealth population surveillance plus ultrasound on rates of attended or transferred births. Our central hypothesis is that the combination of both Mhealth surveillance and ultrasound will increase the composite outcome of prevalence of attended births and successful transfers for high-risk pregnancies to a hospital.

7 Through earlier recognition, midwives can plan to attend low-risk births in the villages and transfer women with high-risk presentations to a hospital (far in advance of the birth) that can conduct surgical procedures, including a cesarean section.

8 The long-term goals of this program of research are to improve the quality and timeliness of population health surveillance, and improve maternal and child outcomes in this remote, low-resource region of Western Myanmar.

The Trustees Of Columbia University In The City Of New York

TO CONDUCT AND SUPPORT LABORATORY RESEARCH, CLINICAL TRIALS, AND STUDIES WITH PEOPLE THAT EXPLORE HEALTH PROCESSES. NICHD RESEARCHERS EXAMINE GROWTH AND DEVELOPMENT, BIOLOGIC AND REPRODUCTIVE FUNCTIONS, BEHAVIOR PATTERNS, AND POPULATION DYNAMICS TO PROTECT AND MAINTAIN THE HEALTH OF ALL PEOPLE. TO EXAMINE THE IMPACT OF DISABILITIES, DISEASES, AND DEFECTS ON THE LIVES OF INDIVIDUALS. WITH THIS INFORMATION, THE NICHD HOPES TO RESTORE, INCREASE, AND MAXIMIZE THE CAPABILITIES OF PEOPLE AFFECTED BY DISEASE AND INJURY. TO SPONSOR TRAINING PROGRAMS FOR SCIENTISTS, DOCTORS, AND RESEARCHERS TO ENSURE THAT NICHD RESEARCH CAN CONTINUE. BY TRAINING THESE PROFESSIONALS IN THE LATEST RESEARCH METHODS AND TECHNOLOGIES, THE NICHD WILL BE ABLE TO CONDUCT ITS RESEARCH AND MAKE HEALTH RESEARCH PROGRESS UNTIL ALL CHILDREN, ADULTS, FAMILIES, AND POPULATIONS ENJOY GOOD HEALTH. THE MISSION OF THE NICHD IS TO ENSURE THAT EVERY PERSON IS BORN HEALTHY AND WANTED, THAT WOMEN SUFFER NO HARMFUL EFFECTS FROM REPRODUCTIVE PROCESSES, AND THAT ALL CHILDREN HAVE THE CHANCE TO ACHIEVE THEIR FULL POTENTIAL FOR HEALTHY AND PRODUCTIVE LIVES, FREE FROM DISEASE OR DISABILITY, AND TO ENSURE THE HEALTH, PRODUCTIVITY, INDEPENDENCE, AND WELL-BEING OF ALL PEOPLE THROUGH OPTIMAL REHABILITATION.

93.865 - Child Health and Human Development Extramural Research

National Institute of Child Health and Human Development (NICHD) [HHS - NIH]

New York United States

State-Wide

Change of Recipient Organization (Type 7 Parent Clinical Trial Optional) (PA-21-268)

Amendment Since initial award the End Date has been extended from 08/31/23 to 02/28/26 and the total obligations have increased 95% from $191,644 to $373,238.