We propose to develop a Global Network for Women's and Children's Health Research site in Eldoret, Kenya. This East African site will be a joint partnership between Indiana University and Moi University School of Medicine, one of two medical schools in Kenya. The 17 year partnership of Moi University and Indiana University will bring unique strengths to the Global Network. These include an established administrative, scientific, and collegial relationship between the institutions, an extensive research infrastructure that includes an established network of rural health centers from which to draw subjects, a well functioning Kenyan Institutional Review Board with a OHRP Assurance number, and an established expanding coverage of subjects by an electronic medical record. The Senior Foreign Investigator is Dean of the Medical School, and has well established relationships with high level Ministry of Health personnel. A large number of other Moi University investigators with expertise in Obstetrics, Public Health, Nutrition, Epidemiology, and Behavioral Sciences are also eager to join the Global Network. US based expertise is also present in Obstetrics, Biostatistics, and Bioethics. We propose to the Network a cluster randomized protocol evaluating the efficacy of both Community Mobilization for the use of a Safe Water System (SWS) and for zinc supplementation in partially weaned infants less than 6 months of age. The SWS includes specially designed narrow neck water storage containers and point of use home chlorination using dilute sodium hypochlorite. Hypotheses to be tested are that 1.) Community Mobilization will result in sustained, consistent use of point of use water treatment 2.) This will lead to a decreased incidence of diarrhea in less than 6 month old infants. 3.) Zinc supplementation beginning at partial weaning will lead to a further decrease in the incidence of diarrhea in these infants. 4.) Growth will be improved and failure to thrive decreased in experimental groups. 5.) All cause mortality in >6 month old infants will be decreased in experimental groups. If efficacy is shown, these are highly sustainable interventions that will improve the health and well being of vulnerable infants.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Research Project--Cooperative Agreements (U01)
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Special Emphasis Panel (ZHD1-DSR-K (16))
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Koso-Thomas, Marion
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Indiana University-Purdue University at Indianapolis
Schools of Medicine
United States
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Pasha, O; McClure, E M; Saleem, S et al. (2018) A prospective cause of death classification system for maternal deaths in low and middle-income countries: results from the Global Network Maternal Newborn Health Registry. BJOG 125:1137-1143
McClure, E M; Garces, A; Saleem, S et al. (2018) Global Network for Women's and Children's Health Research: probable causes of stillbirth in low- and middle-income countries using a prospectively defined classification system. BJOG 125:131-138
Garces, Ana L; McClure, Elizabeth M; PĂ©rez, Wilton et al. (2017) The Global Network Neonatal Cause of Death algorithm for low-resource settings. Acta Paediatr 106:904-911
Goldenberg, Robert L; Saleem, Sarah; Ali, Sumera et al. (2017) Maternal near miss in low-resource areas. Int J Gynaecol Obstet 138:347-355
Swanson, David; Lokangaka, Adrien; Bauserman, Melissa et al. (2017) Challenges of Implementing Antenatal Ultrasound Screening in a Rural Study Site: A Case Study From the Democratic Republic of the Congo. Glob Health Sci Pract 5:315-324
Bang, Akash; Patel, Archana; Bellad, Roopa et al. (2016) Helping Babies Breathe (HBB) training: What happens to knowledge and skills over time? BMC Pregnancy Childbirth 16:364
Bellad, Roopa M; Bang, Akash; Carlo, Waldemar A et al. (2016) A pre-post study of a multi-country scale up of resuscitation training of facility birth attendants: does Helping Babies Breathe training save lives? BMC Pregnancy Childbirth 16:222
McClure, Elizabeth M; Goldenberg, Robert L; Jobe, Alan H et al. (2016) Reducing neonatal mortality associated with preterm birth: gaps in knowledge of the impact of antenatal corticosteroids on preterm birth outcomes in low-middle income countries. Reprod Health 13:61
Garces, Ana; McClure, Elizabeth M; Figueroa, Lester et al. (2016) A multi-faceted intervention including antenatal corticosteroids to reduce neonatal mortality associated with preterm birth: a case study from the Guatemalan Western Highlands. Reprod Health 13:63
Berrueta, Mabel; Hemingway-Foday, Jennifer; Thorsten, Vanessa R et al. (2016) Use of antenatal corticosteroids at health facilities and communities in low-and-middle income countries. Reprod Health 13:66

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