Maternal and neonatal health
This Board opportunity seeks to address the burden of maternal and neonatal mortality and morbidity in low and middle income countries (LMICs) by funding high-quality proposals across the spectrum of basic to applied research. We particularly encourage proposals focusing on the postnatal period, although pre-conception and pregnancy and birth applications will be considered.
Up to £10m will be ring-fenced to support the maternal and neonatal health (MNH) Board opportunity, jointly funded by the National Institute of Health Research (NIHR). The previous MRC-NIHR maternal and neonatal health call explicitly separated seed-funding from research grant applications. This separation has been removed and applications for small- and large-scale activities will be considered and assessed in the same way.
Every year, worldwide, 2.7 million babies die during the first 28 days of life and 2.6 million babies are stillborn. 98% of this combined total occurs in LMICs along with 99% of maternal deaths. In addition to maternal and neonatal mortality, morbidity also needs to be addressed, moving beyond survival to have a transformative effect on the long-term health of mother, father, and baby. If we are to achieve the targets set out in Sustainable Development Goal 3 more research is needed to improve our knowledge of the scale, cause, prevention, prediction, detection, treatment and management of neonatal and maternal health problems.
Meeting such a wide-ranging challenge requires the involvement of multiple disciplines and an understanding of issues faced pre-conception (including around contraception), during pregnancy and birth, and postnatal where morbidities are not necessarily life-threatening but can have significant impact on quality of life and future reproductive health.
This Board opportunity represents the second activity based on the joint MRC-NIHR Overview of Global Maternal and Neonatal Health Research Priorities (see top-right of page).
The remit is deliberately broad reflecting the range and complexity of the challenges faced and the interdisciplinary efforts required. We emphasise that improvements in maternal and neonatal health rely on both innovation and better implementation of existing interventions. Examples of priority research areas within the pre-conception, pregnancy and birth, and postnatal periods, as well as cross-cutting themes relevant to all areas, can be found in the Overview of Research Priorities. Postnatal applications will be prioritised for funding at this round. Here, postnatal is defined as the period from post-delivery (including live births, stillbirths, and abortion) until 52 weeks.
Briefly, subject areas may comprise (but are not limited to):
- The provision of respectful care following discharge from hospital for families with live or stillborn babies, or following an aborted pregnancy. Effort should be made to move beyond solely keeping in touch with mothers and babies toward providing quality, respectful follow up focused on physical, mental, and social wellbeing.
- Management and treatment of neonatal morbidity and chronic maternal morbidity caused by the birthing process. This includes development of ‘bundles’ of interventions to address multiple risks in the early postnatal period.
- Management of non-communicable disease leading to maternal mortality in the period following discharge from hospital.
- The promotion of breastfeeding through public health practices, which may rely heavily on the social sciences, and arts and humanities.
- Provision of perinatal mental healthcare to mothers and fathers with consideration given to sociocultural factors that may lead to stigma and blame following adverse pregnancy outcomes.
- Postnatal care in humanitarian settings, particularly for those who have endured complicated pregnancies and/or traumatic birth experiences.
- Identification of population-relevant biomarkers and risk factors that allow prediction of complications that may occur during pregnancy, delivery, and beyond.
- Targeted intervention to improve pre-conception health beyond traditional fortification and supplementation (e.g., promoting healthy lifestyle choices, improved health literacy, and better nutrition before and between pregnancies).
- Contraception and sociocultural issues around women’s reproductive rights.