April Bell, MPH, PhD


Nominated From: University of Michigan

Research Site: Ghana

Research Area: HIV/AIDS; Maternal and Child Health

Primary Mentor: Dr. Cheryl Moyer

Research Project

Understanding maternal and neonatal “near-miss mortality” in Ghana: What happens to women and babies who survive life-threatening complications?

This project will take place at three of the four teaching hospitals in Ghana, representing both rural and urban catchment areas. It is the first project (that we know of) to attempt to quantify neonatal near-misses using a newly developed tool that mirrors the WHO’s maternal near-miss criteria. It is also the first project to address the social and cultural factors associated with near misses and their long-term outcomes. This project will also build upon a FIC-funded Frameworks for Innovation post-doctoral fellowship through the University of Michigan that has focused on interdisciplinary research training for Ghanaian and US post-doctoral researchers.

Specific Aims:
1. Determine the one-year survival rate of women and infants who experienced a “near-miss” event. (“Near-misses” being defined as mothers and babies who experience a life threatening complication but survive, in keeping with WHO markers for maternal near-misses and newly developed neonatal markers.)
2. Identify the clinical, social, and cultural factors that are associated with one-year survival for women and infants who experienced maternal or neonatal near-miss.
3. Determine the merit of using “near-misses” as a classification system for mothers and infants in a developing country setting, understanding that “near-misses” may be seen as a successful alternative to mortality.


Research Significance

This project will: provide a deeper understanding of the sequelae of maternal and neonatal near-miss in southern Ghana; help researchers and programmatic staff understand the social and cultural factors associated with both near-miss mortality and its long-term outcomes; provide heretofore undocumented evidence of the value of a “near-miss” classification system for both mothers and neonates, ideally allowing for triage and additional intervention for those identified as near-misses; directly inform the design of evidence-based, locally relevant, high-impact interventions to improve maternal and neonatal survival in southern Ghana; and further strengthen the partnership between multidisciplinary faculty at University of Ghana, Kwame Nkrumah University of Science and Technology, University of Cape Coast, and University of Michigan, laying the groundwork for future research collaboration.





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