Maternal Health Initiative

Maternal health (defined as the health of a woman during pregnancy, childbirth, or within 42 days of termination of pregnancy) is a leading correlate of a country’s quality of overall reproductive health. More specifically, the maternal mortality ratio (MMR), which is the rate of maternal deaths per 100,000 live births, is a key indicator of a country’s level of development. Each maternal death has a ripple effect through the family and the community, even whole countries. The maternal mortality rate in developed countries is ten times less than that in sub-Saharan Africa, where the probability that a 15 year old woman will eventually die from a maternal cause is 1 in 36 (compared to 1 in 4900 in developed countries). This difference in maternal mortality represents the greatest global disparity of ALL health indicators.

This work aims to address the unmet needs in maternal health research with the aim of developing novel strategies for reducing maternal mortality, morbidity, and stillbirth.

Site: Korle Bu Teaching Hospital (KBTH) in Accra, Ghana is the third largest hospital in continental Africa. Over 11,000 babies are born at KBTH yearly (about 31 babies per day). Our Ghanaian team is world class and consists of 2 OBGYNs, midwives, and a biostatistician.

Our Work

Reducing maternal mortality rates in high-volume resource-limited settings
Study Site: Korle Bu Teaching Hospital, Accra, Ghana

Hypertension and hemorrhage account for 41% of maternal deaths in developing countries, and in Ghana, like many other countries undergoing rapid urbanization, rates of maternal death are especially high in urban areas (~725-1000 deaths per 100,000 live births) where a majority of births occur in high-volume resource-limited hospitals. Data-driven interventions are urgently needed, but there's scarce data regarding maternal mortality in urban hospitals. Most research investigating factors associated with maternal mortality has been aimed at improving rural access to community health centers and hospitals. However, the so-called “urban health advantage”, or assumption that people in urban areas are less vulnerable to morbidity and mortality, is being increasingly questioned. In fact, emerging studies have shown that urban areas often have a disadvantage in terms of maternal mortality. Therefore, there is an urgent need for innovations that can reduce the rates of maternal mortality in these settings. At KBTH, we are conducting the necessary research to inform the implementation of new low-cost, sustainable approaches that will doctors and midwives to more rapidly recognize, respond to, and ultimately avoid obstetric emergencies, thus saving mother and infant lives.

A new approach for the prevention of stillbirth and low-birthweight: the Prenabelt
Study Site: Korle Bu Teaching Hospital, Accra, Ghana; IWK Health Centre, Halifax, Canada; University of South Australia, Adelaide, Australia

There has been little documentation of the effect of lying on one’s back during sleep in pregnancy. However, several studies have suggested that routinely sleeping on the back in late pregnancy may be a risk factor for stillbirth and low birth weight. This is significant given that the majority of pregnant women spend up to 25% of their sleep time on their back in late pregnancy. In 2014, our team won a $100,000 CAD award from Grand Challenges Canada and a $25,000 AUD award from the University of South Australia to investigate a novel approach to mitigate this risk of stillbirth and low birth weight. We have developed a device, called PrenaBelt, to reduce the amount of time a pregnant woman spends on her back while sleeping. We have since completed three trials that investigated the effect of the PrenaBelt on the mother’s sleep and her baby’s birth weight. The results of these trials have been published (Ghana study , Australia study, Canada study). We are now working to optimize the PrenaBelt and evaluate its utility in women who may benefit most (ie. those at high risk of sleep-disorders).