Implementation research for maternal and child health

Topic description

Specific Challenge:

Each year, an estimated 213^[1] million women become pregnant and 140 million newborn babies are delivered. However, many of the women and infants receive no appropriate care or care that is below evidence-based standards; others suffer from over-medicalisation. Access to quality care, during and after pregnancy, is essential to ensure good maternal health and the favourable early development of the child.

The gap between countries with the lowest and highest maternal mortality rates has doubled between 1990 and 2013 and huge differences exist within countries in Europe and globally. The burden of maternal mortality in both contexts falls disproportionately on the most vulnerable groups of women and girls: Every day approximately 830 women die from preventable causes related to pregnancy and childbirth; 99% of maternal deaths occur in developing countries^[2]

Although there is a consolidated evidence base of what works in improving maternal and newborn health, the "knowledge-do" gap has not been bridged and evidence based guidelines are insufficiently implemented or integrated in routine training and service provision. Therefore, more and better targeted implementation research is needed.

Proposals should focus on implementation research^[3] for improving maternal and child health with a focus on the first '1000 days' from pregnancy until two years of age.^[4] This research can take place in either high income countries or low and middle income countries, or in a combination thereof.

The implementation research in the first 1000 days may cover:

• new or improved health service delivery interventions that strengthen maternal and child health; and/or
• the scaling up and/or adapting of existing evidence-based interventions to new contexts.

Neither pre-clinical research nor clinical trials in the context of product development are within the scope of this call.

The research should take into account the specificities of different contexts and situations. The research should be integrated from different perspectives, e.g. recognising the interdependent relationship between mother and child; addressing prevention, health promotion and treatment; allowing for the specific needs of vulnerable groups (e.g. preterm infants, adolescents, migrants); addressing different concurrent pathologies; avoiding the creation of parallel or vertical programmes, etc;. Research may cover physical and/or mental health, as well as communicable and non-communicable diseases. The integration of social sciences including gender analysis and the use of mixed methods research^[5] is strongly encouraged. In addition, particular attention should be given to equity issues.

The interventions should build on but may go beyond existing state-of-the art knowledge on biological, psychological and social determinants of maternal and child health. Research is expected to be carried out in continuous partnership, in particular with the end-users, i.e. the concerned women, the fathers, and their community, in addition to policy makers, politicians, and the media, to ensure that evidence can be translated into policy and practice.

The Commission considers that proposals requesting an EU contribution between EUR 2 to 4 million would allow this specific challenge to be addressed appropriately. Nonetheless, this does not preclude submission and selection of proposals requesting other amounts.

• Research-supported solutions to maternal and child health challenges.
• Providing evidence of successful and/or innovative approaches for bridging the ''knowledge-do'' gap in improving maternal and child health.
• Better understanding of scaling-up processes with regard to different contexts and resource requirements.
• Contribution to the achievement of SDGs 2 on improved nutrition (target 2), Goal 3 on health (targets 1 and 2 on maternal and child health) and Goal 5 on gender equality (targets 1 and 6) and Goal 10 (on reducing inequality within and between countries).

Applicants may be interested in a separate but connected call topic on "Food systems Africa" under Societal Challenge 2.

Gender
International cooperation
Socio-economic science and humanities

[1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4727534/

[2]WHO, Maternal mortality fact sheet (n. 348), Nov 2015 - http://www.who.int/mediacentre/factsheets/fs348/en/ Lancet Series on Maternal Health (2016).

[3]'Implementation Research is the scientific study of methods to promote the systematic uptake of clinical research findings and other evidence-based practices into routine practice, and hence to improve the quality (effectiveness, reliability, safety, appropriateness, equity, efficiency) of health care. It includes the study of influences on healthcare professional and organisational behaviour

[4]Lancet Series on Maternal and Child Nutrition (2013).

[5]broadly defined as research in which the investigator collects and analyzes data, integrates the findings, and draws inferences using both qualitative and quantitative approaches or methods in a single study or a program of inquiry http://journals.sagepub.com/doi/pdf/10.1177/2345678906293042