About this trial
Access to quality antenatal care (ANC) and postnatal care (PNC), including maternal, newborn, and infant services, is integral to reducing adverse pregnancy-related health outcomes and promoting positive birth experiences. The World Health Organization (WHO) recommends a total of eight ANC visits for pregnant women. However, the ANC coverage rate remains considerably lower among more vulnerable populations, and the quality of care that women receive is inconsistent, often poor, and frequently fails to detect risks in a timely fashion or adequately prepare women for the birth process. While rates of facility-based delivery are on the rise worldwide, disparities persist and the quality of care across facilities remains uneven. Even less information is available on PNC, where services beyond routine immunizations may not be widely available, especially in resource-poor regions.
Additionally, limited evidence exists on innovative service delivery approaches and how to effectively scale tested maternal and newborn health (MNH) interventions. This coupled with the fragmented datasets from smaller studies limit our ability to advocate for policy change.
The Pregnancy Risk Stratification Innovation and Measurement Alliance (PRiSMA) is implementing a harmonized open cohort study that seeks to evaluate pregnancy risk factors and their associations with adverse pregnancy outcomes, including stillbirth, neonatal mortality and morbidity, and maternal mortality and severe morbidity. The goals are to develop a harmonized data set to improve understanding of pregnancy risk factors, vulnerabilities, and morbidity and mortality and to estimate the burden of these risk factors and outcomes in LMICs. Ultimately, these data will inform development of innovative strategies to optimize pregnancy outcomes for mothers and their newborns.
Eligibility criteria
Qualifiers
Lives within the study catchment area;
Ghana: 15 years of age;
Kenya: 18 years of age or those who meet the criteria of emancipated minors;
Pakistan: 15 years of age or those who meet the criteria of emancipated minors;
Disqualifiers
Nonviable (e.g. ectopic or molar) pregnancy;
Plans to relocate outside of the study catchment area during pregnancy and/or postpartum.
Trial design
Treatments tested in this trial
- Not listed
Trial groups
Sponsors and collaborators
George Washington University
Lead sponsor
Kenya Medical Research Institute
Collaborator
University of North Carolina, Chapel Hill
Collaborator
Kintampo Health Research Centre, Ghana
Collaborator
Aga Khan University
Collaborator
Christian Medical College, Vellore, India
Collaborator
Centres for Disease Control and Prevention, Kenya.
Collaborator
Vital Pakistan Trust
Collaborator