BIRMINGHAM, Ala. - University of Alabama at Birmingham (UAB) Professor of Obstetrics and Gynecology Jeffrey S.A. Stringer, M.D., has been awarded a five-year, $11.2 million grant from the Doris Duke Charitable Foundation African Health Initiative to design and implement a large-scale primary health care program to reduce child mortality in the sub-Saharan African nation of Zambia.
The project, "Clinical Mentoring and Community Engagement to Improve Health Outcomes," will train health workers in three rural health districts in standard management protocols for common conditions and assure that each health center has the resources it needs to deliver quality care. Community health workers also will be engaged to ensure that patients remain in care and return for follow-up visits. Additionally, an electronic medical record will be developed to help measure how well service delivery meets standards of care and to identify areas that need improvement.
"We will focus on the major causes of child mortality, including pneumonia, diarrhea, malaria and malnutrition, plus improved adult HIV/AIDS care and pregnancy care, but our major emphasis will be on kids," Stringer said. "We also will use these community health workers to distribute insecticide-treated bed nets for mosquitoes, to ensure all homes are sprayed for mosquitoes and to follow up on folks who don't come for their appointments."
The districts in Zambia where Stringer and his colleagues will be working are extremely poor and have generally poor health outcomes. The ultimate goal, Stringer said, is saving lives.
"Our primary aim is to reduce child mortality from its current rate of around 140 in 1,000 live births to less than 100 in 1,000," Stringer said.
One of the keys to making this project successful is the cooperation from local governments. The close collaboration between the research teams and government health systems is a unique feature, Stringer said. The researchers both will ensure the delivery of health services and rigorously measure the impact of these services on people's lives. Government involvement will ensure that the programs are aligned with national plans and policies, which should improve their sustainability when funding ends. Stringer directs the UAB-affiliated Center for Infectious Disease Research in Zambia (CIDRZ), which has collaborated on a number of health care and research programs with the government of Zambia since 2001.
The Doris Duke Charitable Foundation African Health Initiative was launched in 2007 after a review of the factors underlying sub-Saharan Africa's high rates of maternal and child death. Mortality rates from many common and easily treatable diseases remain unacceptably high, and life expectancy at birth is below 40 years in many countries. The goal of the initiative is to fund partnerships between teams of researchers, practitioners and local governments that will strengthen fragile health systems and address inefficiencies that prevent health agencies from providing higher quality integrated healthcare.
"What makes these partnerships so potentially powerful is that they are designed to save lives by strengthening the very systems that are needed to support the growing number of vertical programs for particular diseases like AIDS and malaria," said Peter Ndumbe, M.D., M.Sc., Ph.D., DLSHTM, dean of the faculty of health sciences at the University of Buea, Cameroon, and co-chair of the expert panel that reviewed the partnership proposals.
About UAB
Known for its innovative and interdisciplinary approach to education at both the graduate and undergraduate levels, UAB is an internationally renowned research university and academic medical center. The UAB Department of Obstetrics and Gynecologyprovides the most up-to-date and effective care to patients, advances scientific understanding of women's health, and translates science into improved diagnosis, treatment, and prevention of diseases and disorders of the female reproductive system. It comprises six divisions - Maternal-Fetal Medicine, Gynecologic Oncology, Women's Reproductive Health, Women's Pelvic Medicine and Reconstructive Surgery, Reproductive Endocrinology and Infertility, and International Women's Health - and provides the highest level of comprehensive services for women of all ages.