Suchergebnisse

This work was supported by the Chief Scientist Office (CSO) of Scotland grant CZH/4/773, the UK Medical Research Council and the University of Dundee work through the provision of a stipend for KL and from the Health Services Research Unit at the University of Aberdeen, which is core funded by the CSO of the Scottish Government Health Directories. We are grateful to all the participants who assisted in this study: F Althabe, A-W Chan, D Altman, D Bratton, E Brass, M Campbell, G Forbes, B Gaglio, R Glasgow, H Hobbelen, S Hopewell, J Krishnan, D Riddle, J Segal, D Steinfort, P Tugwell, SN Van der Veer, VA. Welch, C Witt. ; Peer reviewed ; Postprint

OBJECTIVE: We studied exposure to solid fuel and second-hand tobacco smoke among pregnant women in south Asia, Africa and Latin America. DESIGN: Prospective cross-sectional survey. SETTING: Antenatal clinics in Argentina, Brazil, Ecuador, Guatemala, Uruguay, Democratic Republic of Congo, Zambia, India and Pakistan. SAMPLE: A total of 7,961 pregnant women in ten sites in nine countries were interviewed between October 2004 and September 2005. METHODS: A standardized questionnaire on exposure to indoor air pollution (IAP) and second-hand smoke was administered to pregnant women during antenatal care. MAIN OUTCOME MEASURES: Exposure to IAP and second-hand tobacco smoke. RESULTS: South Asian pregnant women commonly reported use of wood (49.1-89.7%), crop residue and animal dung as cooking and heating fuel. African pregnant women reported higher use of charcoal (85.4-93.5%). Latin American pregnant women had greater use of petroleum gas. Among south Asian women, solid fuel use and cooking on an open flame inside the home were common. There was a significant association between solid fuel use and allowing smoking within the home at the Asian sites and in Zambia (p < 0.05). CONCLUSIONS: Pregnant women from low/middle income countries were commonly exposed to IAP secondary to use of solid fuels. Among these populations, exposure to second-hand tobacco smoke was also common. This combination of exposures likely increases the risk of poor pregnancy outcomes among the most vulnerable women. Our study highlights the importance of further research on the combined impact of IAP and second-hand tobacco smoke exposures on adverse maternal and perinatal outcomes. ; Fil: Kadir, Muhammad Masood. The Aga Khan University; Pakistán ; Fil: McClure, Elizabeth M. Research Triangle Institute; Reino Unido ; Fil: Goudar, Shivaprasad S. Jawaharlal Nehru Medical College Belgaum; India ; Fil: Garces, Ana L. Universidad de San Carlos; Guatemala ; Fil: Moore, Janet. Research Triangle Institute; Reino Unido ; Fil: Onyamboko, Marie. University of Kinshasa; República Democrática del Congo ; Fil: Kaseba, Christine. University Teaching Hospital; Zambia ; Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET.; Argentina ; Fil: Castilla, Eduardo Enrique. Estudio Colaborativo Latinoamericano de Malformaciones Congenitas; Brasil ; Fil: Freire, Salvio. Universidade Federal de Pernambuco; Brasil ; Fil: Parida, Sailajanandan. S.C.B. Medical College; India ; Fil: Saleem, Sarah. The Aga Khan University; Pakistán ; Fil: Wright, Linda L. National Institute of Child Health and Human Development; Estados Unidos ; Fil: Goldenberg, Robert L. Drexel University. College of Medicine; Estados Unidos ; Fil: Global Network Tobacco Study Group. No especifica;

OBJECTIVE: To describe the staffing and availability of medical equipment and medications and the performance of procedures at health facilities providing maternal and neonatal care at African, Asian, and Latin American sites participating in a multicenter trial to improve emergency obstetric/neonatal care in communities with high maternal and perinatal mortality. STUDY DESIGN: In 2009, prior to intervention, we surveyed 136 hospitals and 228 clinics in 7 sites in Africa, Asia, and Latin America regarding staffing, availability of equipment/medications, and procedures including cesarean section. RESULTS: The coverage of physicians and nurses/midwives was poor in Africa and Latin America. In Africa, only 20% of hospitals had full-time physicians. Only 70% of hospitals in Africa and Asia had performed cesarean sections in the last 6 months. Oxygen was unavailable in 40% of African hospitals and 17% of Asian hospitals. Blood was unavailable in 80% of African and Asian hospitals. CONCLUSIONS: Assuming that adequate facility services are necessary to improve pregnancy outcomes, it is not surprising that maternal and perinatal mortality rates in the areas surveyed are high. The data presented emphasize that to reduce mortality in these areas, resources that result in improved staffing and sufficient equipment, supplies, and medication, along with training, are required. ; Fil: Manasyan, Albert. Centre for Infectious Disease Zambia; Zambia. University of Alabama at Birmingahm; Estados Unidos ; Fil: Saleem, Sarah. Aga Khan University; Pakistán ; Fil: Koso Thomas, Marion. Eunice Kennedy Shriver National Institute of Child Health and Human Development; Estados Unidos ; Fil: Althabe, Fernando. Instituto de Efectividad Clínica y Política de Salud. Departamento de Investigación en Salud Madre e Infantil. Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina ; Fil: Pasha, Omrana. Aga Khan University; Pakistán ; Fil: Chomba, Elwyn. Centre for Infectious Disease Zambia; Zambia. University of Alabama at Birmingahm; Estados Unidos. University of Zambia; Zambia ; Fil: Goudar, Shivaprasad S. KLE; India ; Fil: Patel, Archana. Indira Gandhi Government Medical College; India ; Fil: Esamai, Fabian. Moi University; Kenia ; Fil: Garces, Ana. Francisco Marroquin University; Guatemala ; Fil: Kodkany, Bhala. KLE; India ; Fil: Belizan, Jose. Instituto de Efectividad Clínica y Política de Salud. Departamento de Investigación en Salud Madre e Infantil. Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina ; Fil: McClure, Elizabeth M. Research Triangle Institute; Estados Unidos ; Fil: Derman, Richard J. Christiana Health Care; Estados Unidos ; Fil: Hibberd, Patricia. Indiana University; Estados Unidos ; Fil: Liechty, Edward A. Massachusetts General Hospital for Children; Estados Unidos ; Fil: Hambidge, K. Michael. State University of Colorado Boulder; Estados Unidos ; Fil: Carlo, Waldemar A. Centre for Infectious Disease Zambia; Zambia ; Fil: Buekens, Pierre. Tulane School of Public Health and Tropical Medicine; Estados Unidos ; Fil: Moore, janet. Research Triangle Institute; Estados Unidos ; Fil: Wright, Linda L. Eunice Kennedy Shriver National Institute of Child Health and Human Development; Estados Unidos ; Fil: Goldenberg, Robert L. Columbia University; Estados Unidos

BACKGROUND : A prolonged and complicated second stage of labour is associated with serious perinatal complications. The Odon device is an innovation intended to perform instrumental vaginal delivery presently under development. We present an evaluation of the feasibility and safety of delivery with early prototypes of this device from an early terminated clinical study. METHODS : Hospital-based, multi-phased, open-label, pilot clinical study with no control group in tertiary hospitals in Argentina and South Africa. Multiparous and nulliparous women, with uncomplicated singleton pregnancies, were enrolled during the third trimester of pregnancy. Delivery with Odon device was attempted under non-emergency conditions during the second stage of labour. The feasibility outcome was delivery with the Odon device defined as successful expulsion of the fetal head after one-time application of the device. RESULTS : Of the 49 women enrolled, the Odon device was inserted successfully in 46 (93%), and successful Odon device delivery as defined above was achieved in 35 (71%) women. Vaginal, first and second degree perineal tears occurred in 29 (59%) women. Four women had cervical tears. No third or fourth degree perineal tears were observed. All neonates were born alive and vigorous. No adverse maternal or infant outcomes were observed at 6-weeks follow-up for all dyads, and at 1 year for the first 30 dyads. CONCLUSIONS : Delivery using the Odon device is feasible. Observed genital tears could be due to the device or the process of delivery and assessment bias. Evaluating the effectiveness and safety of the further developed prototype of the BD Odon Device™ will require a randomized-controlled trial. TRIAL REGISTRATION : ANZCTR ACTRN12613000141741 Registered 06 February 2013. Retrospectively registered. ; The Saving Lives at Birth partners: the United States Agency for International Development (USAID), the Government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada, the UK Government, and the Korea ...

BACKGROUND:Antenatal corticosteroids (ACS) for women at high risk of preterm birth is an effective intervention to reduce neonatal mortality among preterm babies delivered in hospital settings, but has not been widely used in low-middle resource settings. We sought to assess the rates of ACS use at all levels of health care in low and middle income countries (LMIC).METHODS:We assessed rates of ACS in 7 sites in 6 LMIC participating in the Eunice Kennedy Shriver National Institute of Child Health and Human Development´s Global Network for Women and Children´s Health Research Antenatal Corticosteroids Trial (ACT), a cluster-randomized trial to assess the feasibility, effectiveness, and safety of a multifaceted intervention designed to increase the use of ACS. We conducted this analysis using data from the control clusters, which did not receive any components of the intervention and intended to follow usual care. We included women who delivered an infant with a birth weight <5th percentile, a proxy for preterm birth, and were enrolled in the Maternal Newborn Health (MNH) Registry between October 2011 and March 2014 in all clusters. A survey of the site investigators regarding existing policies on ACS in health facilities and for health workers in the community was part of pre-trial activities.RESULTS:Overall, of 51,523 women delivered in control clusters across all sites, the percentage of <5th percentile babies ranged from 3.5 % in Kenya to 10.7 % in Pakistan. There was variation among the sites in the use of ACS at all hospitals and among those hospitals having cesarean section and neonatal care capabilities (bag and mask and oxygen or mechanical ventilation). Rates of ACS use for <5th percentile babies in all hospitals ranged from 3.8 % in the Kenya sites to 44.5 % in the Argentina site, and in hospitals with cesarean section and neonatal care capabilities from 0 % in Zambia to 43.5 % in Argentina. ACS were rarely used in clinic or home deliveries at any site. Guidelines for ACS use at all levels of the health system were available for most of the sites.CONCLUSION:Our study reports an overall low utilization of ACS among mothers of <5th percentile infants in hospital and clinic deliveries in LMIC. ; Fil: Berrueta, Amanda Mabel. Instituto de Efectividad Clínica y Sanitaria; Argentina ; Fil: Hemingway Foday, Jennifer. University Of Durham; Reino Unido ; Fil: Thorsten, Vanessa R. University Of Durham; Reino Unido ; Fil: Goldenberg, Robert L. Columbia University; Estados Unidos ; Fil: Carlo, Waldemar A. University of Alabama at Birmingahm; Estados Unidos ; Fil: Garces, Ana. Fundación para la Alimentación y Nutrición de Centro América y Panamá; Guatemala ; Fil: Patel, Archana. Lata Medical Research Foundation, Indira Gandhi Government Medical College; India ; Fil: Saleem, Sarah. Aga Khan University. Department of Community Health Sciences, ; Pakistán ; Fil: Pasha, Omrana. Aga Khan University. Department of Community Health Sciences, ; Pakistán ; Fil: Chomba, Elwyn. University Teaching Hospital; Zambia ; Fil: Hibberd, Patricia L. Massachusetts General Hospital; Estados Unidos ; Fil: Krebs, Nancy F. 0University of Colorado School of Medicine; Estados Unidos ; Fil: Goudar, Shivaprasad. KLE University's Jawaharlal Nehru Medical College,; India ; Fil: Derman, Richard J. 2Christiana Health Care; Estados Unidos ; Fil: Esamai, Fabian. Moi University School of Medicine; Kenia ; Fil: Liechty, Edward A. Indiana University; Estados Unidos ; Fil: Moore, Janet L. University Of Durham; Reino Unido ; Fil: McClure, Elizabeth M. University Of Durham; Reino Unido ; Fil: Koso Thomas, Marion. Eunice Kennedy Shriver National Institute of Child Health and Human Development; Estados Unidos ; Fil: Buekens, Pierre. Tulane School of Public Health & Tropical Medicine; Estados Unidos ; Fil: Belizan, Jose. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina ; Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina

BACKGROUND: To describe quantitative data quality monitoring and performance metrics adopted by the Global Network´s (GN) Maternal Newborn Health Registry (MNHR), a maternal and perinatal population-based registry (MPPBR) based in low and middle income countries (LMICs). METHODS: Ongoing prospective, population-based data on all pregnancy outcomes within defined geographical locations participating in the GN have been collected since 2008. Data quality metrics were defined and are implemented at the cluster, site and the central level to ensure data quality. Quantitative performance metrics are described for data collected between 2010 and 2013. RESULTS: Delivery outcome rates over 95% illustrate that all sites are successful in following patients from pregnancy through delivery. Examples of specific performance metric reports illustrate how both the metrics and reporting process are used to identify cluster-level and site-level quality issues and illustrate how those metrics track over time. Other summary reports (e.g. the increasing proportion of measured birth weight compared to estimated and missing birth weight) illustrate how a site has improved quality over time. CONCLUSION: High quality MPPBRs such as the MNHR provide key information on pregnancy outcomes to local and international health officials where civil registration systems are lacking. The MNHR has measures in place to monitor data collection procedures and improve the quality of data collected. Sites have increasingly achieved acceptable values of performance metrics over time, indicating improvements in data quality, but the quality control program must continue to evolve to optimize the use of the MNHR to assess the impact of community interventions in research protocols in pregnancy and perinatal health. ; Fil: Goudar, Shivaprasad S. KLE University. Jawaharlal Nehru Medical College; India ; Fil: Stolka, Kristen B. Research Triangle Institute International; Estados Unidos ; Fil: Koso Thomas, Marion. Eunice Kennedy Shriver National Institute of Child Health and Human Development; Estados Unidos ; Fil: Honnungar, Narayan V. KLE University. Jawaharlal Nehru Medical College; India ; Fil: Mastiholi, Shivanand C. KLE University. Jawaharlal Nehru Medical College; India ; Fil: Ramadurg, Umesh Y. S. Nijalingappa Medical College; India ; Fil: Dhaded, Sangappa M. KLE University. Jawaharlal Nehru Medical College; India ; Fil: Pasha, Omrana. Aga Khan University; Pakistán ; Fil: Patel, Archana. Indira Gandhi Government Medical College and Lata Medical Research Foundation; India ; Fil: Esamai, Fabian. University School of Medicine; Kenia ; Fil: Chomba, Elwyn. University of Zambia; Zambia ; Fil: Garces, Ana. Universidad de San Carlos; Guatemala ; Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina ; Fil: Carlo, Waldemar A. University of Alabama at Birmingahm; Estados Unidos ; Fil: Goldenberg, Robert L. Columbia University; Estados Unidos ; Fil: Hibberd, Patricia L. Massachusetts General Hospital for Children; Estados Unidos ; Fil: Liechty, Edward A. Indiana University; Estados Unidos ; Fil: Krebs, Nancy F. University of Colorado School of Medicine; Estados Unidos ; Fil: Hambidge, Michael K. University of Colorado School of Medicine; Estados Unidos ; Fil: Moore, Janet L. Research Triangle Institute International; Estados Unidos ; Fil: Wallace, Dennis D. Research Triangle Institute International; Estados Unidos ; Fil: Derman, Richard J. Christiana Care Health Services; Estados Unidos ; Fil: Bhalachandra, Kodkany S. KLE University. Jawaharlal Nehru Medical College; India ; Fil: Bose, Carl L. University of North Carolina; Estados Unidos

BACKGROUND: Despite international recommendations, coverage of syphilis testing in pregnant women and treatment of those found seropositive remains limited in sub-Saharan Africa. We assessed whether combining the provision of supplies with a behavioural intervention was more effective than providing supplies only, to improve syphilis screening and treatment during antenatal care. METHODS: In this 18-month, cluster randomised controlled trial, we randomly assigned (1:1) 26 urban antenatal care clinics in Kinshasa, Democratic Republic of the Congo, and Lusaka, Zambia, to receive a behavioural intervention (opinion leader selection, academic detailing visits, reminders, audits and feedback, and supportive supervision) plus supplies for syphilis testing and treatment (intervention group) or to receive supplies only (control group). The primary outcomes were proportion of pregnant women who had syphilis screening out of the total who attended the clinic; and the proportion of women who had treatment with benzathine benzylpenicillin out of those who tested positive for syphilis at their first antenatal care visit. This trial is registered at ClinicalTrials.gov, number NCT02353117. FINDINGS: The 18-month study period was Feb 1, 2016, to July 14, 2017. 18 357 women were enrolled at the 13 intervention clinics and 17 679 women were enrolled at the 13 control clinics at their first antenatal care visit. Syphilis screening was done in a median of 99·9% (IQR 99·0–100·0) of women in the intervention clinics and 93·8% (85·0–98·9) in the control clinics (absolute difference 6·1% [95% CI 1·1–14·1]; p=0·00092). Syphilis treatment at the first visit was done in a median of 100% (IQR 99·7–100·0) of seropositive women in intervention clinics and 43·2% (2·6–83·2) of seropositive women in control clinics (absolute difference 56·8% [12·8–99·0]; p=0·0028). INTERPRETATION: A behavioural intervention, together with the provision of supplies, can lead to more than 95% of women being screened and treated for syphilis. The sole provision of ...

Introduction Neonatal mortality associated with preterm birth can be reduced with antenatal corticosteroids (ACS), yet 36.0 weeks GA. In phase 1, UH measurements were collected prospectively in the Democratic Republic of Congo, India and Pakistan, using distinct tapes to address variation across regions and ethnicities. In phase 2, we tested accuracy in 250 pregnant women with known GA from early ultrasound enrolled at prenatal clinics in Argentina, India, Pakistan and Zambia. Providers masked to the ultrasound GA measured UH. Receiver operating characteristics (ROC) analysis was conducted. Results 1,029 pregnant women were enrolled. In all countries the tapes were most effective identifying pregnancies between 20.0–35.6 weeks, compared to the other GAs. The ROC areas under the curves and 95% confidence intervals were: Argentina 0.69 (0.63, 0.74); Zambia 0.72 (0.66, 0.78), India 0.84 (0.80, 0.89), and Pakistan 0.83 (0.78, 0.87). The sensitivity and specificity (and 95% confidence intervals) for identifying pregnancies between 20.0–35.6 weeks, respectively, were: Argentina 87% (82%–92%) and 51% (42%–61%); Zambia 91% (86%–95%) and 50% (40%–60%); India 78% (71%–85%) and 89% (83%–94%); Pakistan 63% (55%–70%) and 94% (89%–99%). Conclusions We observed moderate-good accuracy identifying pregnancies ≤35.6 weeks gestation, with potential usefulness at the community level in low-middle income countries to facilitate the preterm identification and interventions to reduce preterm neonatal mortality. Further research is needed to validate these findings on a population basis.

Introduction: Neonatal mortality associated with preterm birth can be reduced with antenatal corticosteroids (ACS), yet 36.0 weeks GA. In phase 1, UH measurements were collected prospectively in the Democratic Republic of Congo, India and Pakistan, using distinct tapes to address variation across regions and ethnicities. In phase 2, we tested accuracy in 250 pregnant women with known GA from early ultrasound enrolled at prenatal clinics in Argentina, India, Pakistan and Zambia. Providers masked to the ultrasound GA measured UH. Receiver operating characteristics (ROC) analysis was conducted. Results: 1,029 pregnant women were enrolled. In all countries the tapes were most effective identifying pregnancies between 20.0-35.6 weeks, compared to the other GAs. The ROC areas under the curves and 95% confidence intervals were: Argentina 0.69 (0.63, 0.74); Zambia 0.72 (0.66, 0.78), India 0.84 (0.80, 0.89), and Pakistan 0.83 (0.78, 0.87). The sensitivity and specificity (and 95% confidence intervals) for identifying pregnancies between 20.0-35.6 weeks, respectively, were: Argentina 87% (82%-92%) and 51% (42%-61%); Zambia 91% (86%-95%) and 50% (40%-60%); India 78% (71%-85%) and 89% (83%-94%); Pakistan 63% (55%-70%) and 94% (89% -99%). Conclusions: We observed moderate-good accuracy identifying pregnancies ≤35.6 weeks gestation, with potential usefulness at the community level in low-middle income countries to facilitate the preterm identification and interventions to reduce preterm neonatal mortality. Further research is needed to validate these findings on a population basis. ; Fil: Althabe, Fernando. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina ; Fil: Berrueta, Amanda Mabel. Instituto de Efectividad Clínica y Sanitaria; Argentina ; Fil: Hemingway Foday, Jennifer. Rti International; Estados Unidos ; Fil: Mazzoni, Agustina. Instituto de Efectividad Clínica y Sanitaria; Argentina ; Fil: Bonorino, Carolina Astoul. Instituto de Efectividad Clínica y Sanitaria; Argentina ; Fil: Gowdak, Andrea. Instituto de Efectividad Clínica y Sanitaria; Argentina ; Fil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; Argentina ; Fil: Bellad, M. B. Jawaharlal Nehru Medical College Belgaum; India ; Fil: Metgud, M. C. Jawaharlal Nehru Medical College Belgaum; India ; Fil: Goudar, Shivaprasad. Jawaharlal Nehru Medical College Belgaum; India ; Fil: Kodkany, Bhalchandra S. Jawaharlal Nehru Medical College Belgaum; India ; Fil: Derman, Richard J. Christiana Care Health System; Estados Unidos ; Fil: Saleem, Sarah. The Aga Khan University; Pakistán ; Fil: Iqbal, Samina. Sobhraj Maternity Hospital; Pakistán ; Fil: Ala, Syed Hasan. Sindh Government Qatar Hospital; Pakistán ; Fil: Goldenberg, Robert L. Columbia University; Estados Unidos ; Fil: Chomba, Elwyn. University Teaching Hospital Lusaka; Zambia ; Fil: Manasyan, Albert. University of North Carolina; Estados Unidos. Centre For Infectious Disease Research In Zambia; Zambia ; Fil: Chiwila, Melody. University Teaching Hospital Lusaka; Zambia ; Fil: Imenda, Edna. University Teaching Hospital Lusaka; Zambia ; Fil: Mbewe, Florence. University Teaching Hospital Lusaka; Zambia ; Fil: Tshefu, Antoinette. Kinshasa School Of Public Health; República Democrática del Congo ; Fil: Lokomba, Victor. Kinshasa School Of Public Health; República Democrática del Congo ; Fil: Bose, Carl L. University of North Carolina; Estados Unidos ; Fil: Moore, Janet. Rti International; Estados Unidos ; Fil: Meleth, Sreelatha. Rti International; Estados Unidos ; Fil: McClure, Elizabeth M. Rti International; Estados Unidos ; Fil: Koso Thomas, Marion. Eunice Kennedy Shriver NICHD; Estados Unidos ; Fil: Buekens, Pierre. University of Tulane; Estados Unidos ; Fil: Belizan, Jose. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

International audience ; Background This research prioritization aimed to identify major research gaps in maternal, newborn, child and adolescent health (MNCAH) to help mitigate the direct and indirect effects of the COVID-19 pandemic. Methods We adapted the Child Health and Nutrition Research Initiative methodology. We defined scope, domains, themes and scoring criteria. We approached diverse global experts via email to submit their research ideas in MNCAH and MNCAH-related cross-cutting/ health systems area. We curated the research ideas as research questions (RQs) and sent them to the consenting experts for scoring via the online link. For each RQ, the research priority score (RPS) was calculated as an average of individual criterion scores and ranked based on RPS in each area. Results We identified top-ranked 10 RQs in each maternal, newborn, and child and adolescent health and 5 in the cross-cutting/health systems area. In maternal health, indirect effects on care, measures to improve care, health risks and outcomes, and preventing and managing SARS-CoV-2 infection/COVID-19 disease were priority RQs. In newborn health, clinical characterization and managing SARS-CoV-2 infection/COVID-19 disease, mode of transmission and interventions to prevent transmission were the focus. For child and adolescent health, top-ranked RQs were indirect effects on care, clinical status and outcomes, interventions to protect against SARS-CoV-2 infection/COVID-19 disease, and educational institute-related RQs. The cross-cutting RQs were the effects of the pandemic on availability, access, care-seeking and utilization of MNCAH services and potential solutions. Conclusions We call on partners, including governments, non-governmental organizations, research institutes, and donors, to address this urgent research agenda.

International audience ; Background This research prioritization aimed to identify major research gaps in maternal, newborn, child and adolescent health (MNCAH) to help mitigate the direct and indirect effects of the COVID-19 pandemic. Methods We adapted the Child Health and Nutrition Research Initiative methodology. We defined scope, domains, themes and scoring criteria. We approached diverse global experts via email to submit their research ideas in MNCAH and MNCAH-related cross-cutting/ health systems area. We curated the research ideas as research questions (RQs) and sent them to the consenting experts for scoring via the online link. For each RQ, the research priority score (RPS) was calculated as an average of individual criterion scores and ranked based on RPS in each area. Results We identified top-ranked 10 RQs in each maternal, newborn, and child and adolescent health and 5 in the cross-cutting/health systems area. In maternal health, indirect effects on care, measures to improve care, health risks and outcomes, and preventing and managing SARS-CoV-2 infection/COVID-19 disease were priority RQs. In newborn health, clinical characterization and managing SARS-CoV-2 infection/COVID-19 disease, mode of transmission and interventions to prevent transmission were the focus. For child and adolescent health, top-ranked RQs were indirect effects on care, clinical status and outcomes, interventions to protect against SARS-CoV-2 infection/COVID-19 disease, and educational institute-related RQs. The cross-cutting RQs were the effects of the pandemic on availability, access, care-seeking and utilization of MNCAH services and potential solutions. Conclusions We call on partners, including governments, non-governmental organizations, research institutes, and donors, to address this urgent research agenda.

International audience ; Background This research prioritization aimed to identify major research gaps in maternal, newborn, child and adolescent health (MNCAH) to help mitigate the direct and indirect effects of the COVID-19 pandemic. Methods We adapted the Child Health and Nutrition Research Initiative methodology. We defined scope, domains, themes and scoring criteria. We approached diverse global experts via email to submit their research ideas in MNCAH and MNCAH-related cross-cutting/ health systems area. We curated the research ideas as research questions (RQs) and sent them to the consenting experts for scoring via the online link. For each RQ, the research priority score (RPS) was calculated as an average of individual criterion scores and ranked based on RPS in each area. Results We identified top-ranked 10 RQs in each maternal, newborn, and child and adolescent health and 5 in the cross-cutting/health systems area. In maternal health, indirect effects on care, measures to improve care, health risks and outcomes, and preventing and managing SARS-CoV-2 infection/COVID-19 disease were priority RQs. In newborn health, clinical characterization and managing SARS-CoV-2 infection/COVID-19 disease, mode of transmission and interventions to prevent transmission were the focus. For child and adolescent health, top-ranked RQs were indirect effects on care, clinical status and outcomes, interventions to protect against SARS-CoV-2 infection/COVID-19 disease, and educational institute-related RQs. The cross-cutting RQs were the effects of the pandemic on availability, access, care-seeking and utilization of MNCAH services and potential solutions. Conclusions We call on partners, including governments, non-governmental organizations, research institutes, and donors, to address this urgent research agenda.