Child Health Programs Research Articles

KNOWLEDGE AND PRACTICE OF MOTHERS REGARDING NEWBORN CARE IN A RURAL COMMUNITY LAHORE, PAKISTAN

Pakistan had an infant mortality rate of 56.88 per 1,000 live births in 2022. According to the World Health Organization, Neonatal mortality is about 45% of all under-five deaths. This study aimed to determine the infant care knowledge and habits of mothers in rural Lahore, Pakistan. A structured questionnaire was used to gather information for a community-based cross-sectional investigation. A straightforward random method was used to determine who each survey respondent was. A grading method was used to determine the mother's level of expertise and actual practice in caring for their newborns. A basic random procedure was used to choose 98 participants. The umbilical cord was reportedly severed by a modern blade in 78% of the cases, while traditional chemicals were reportedly applied to the cord in 12%. While 66 percent of women said that colostrum should be given to their babies, 88 percent of moms knew that breastfeeding should begin within an hour of the baby's birth and that neonates should receive the exclusive feed. Only 5% of moms were unaware that newborns are completely immunized, and 95% had received all their recommended vaccinations. According to the study, it was common practice to apply traditional substances to the umbilical cord, throw away colostrum, delay starting nursing, and feed neonates exclusively. Particularly in rural areas, the Maternal Child Health (MCH) programs and healthcare delivery systems must focus urgently on preventing harmful care behaviors and adopting healthy practices.

Health System Considerations for Community-Based Implementation of Automated Respiratory Counters to Identify Childhood Pneumonia in 5 Regions of Ethiopia: A Qualitative Study.

In Ethiopia, childhood pneumonia is diagnosed in primary healthcare settings by measuring respiratory rate (RR) along with the presence of cough, chest indrawing, difficulty breathing, and fast breathing. Our aim was to identify health system-level lessons from implementing two automated RR counters, Children's Automated Respiration Monitor (ChARM) by Phillips® and Rad-G by Masimo®, to provide considerations for integrating such devices into child health programmes and health systems. This study was part of an initiative called the Acute Respiratory Infection Diagnostic Aids (ARIDA). Key informant interviews (KIIs) were conducted with 57 participants (health workers in communities and facilities, trainers of health workers, district management, and key decision-makers) in five regions of Ethiopia. Data were analyzed in ATLAS.ti using thematic content analysis and themes were categorized using the Tanahashi bottleneck analysis. All participants recommended scaling up the ARIDA initiative nationally as part of Integrated Management of Newborn and Childhood Illness (IMNCI) in primary healthcare. Health workers perceived the devices as: time saving, acceptable by parents and children, and facilitating diagnosis and referrals. Health workers perceived an increased demand for services and reduced numbers of sick children not seeking care. Participants recommended increasing the number of devices distributed and health workers trained. Strengthening drug supply chains, improving oxygen gas availability, and strengthening referral networks would maximize perceived benefits. While training improved knowledge, more supportive supervision, integration with current guidelines and more guidance related to community engagement was recommended. Automatic RR counters for the decentralized diagnosis of childhood pneumonia could have positive impact on improving the quality of diagnosis and management of pneumonia in children. However, the study has shown that a health system approach is required to ensure all steps along the pneumonia pathway are adequate, including drug and oxygen supply, community engagement, health worker training and support, and referral pathways.

Model Promosi Kesehatan Sebagai Upaya Pencegahan Stunting Melalui Program Kesehatan Ibu dan Anak (KIA)

This study aims to identify an effective health promotion model in efforts to prevent stunting through the Maternal and Child Health program at the Tembilahan Health Center, Riau Province. This research is a quantitative research using Quasi Experiments with a pre and post-test control group design approach. The research sample was 102 women of childbearing age, namely 34 people in each group who were taken using the consecutive sampling technique. Data collection using a questionnaire. Univariate and bivariate data analysis using paired t-test statistics. The results showed that there were differences in the increase in knowledge in the treatment group p=0.000 (p<0.05) and there were differences in attitudes in the treatment group and the control group p=0.000 (p<0.05). In conclusion, a health promotion model that is effective in providing increased knowledge is a health promotion model of lectures and leaflet media and a health promotion model that is effective in providing attitude changes is a health promotion model of lectures and video media. 
 
 Keywords: Health Promotion, Maternal and Child Health, Stunting.

Neurodevelopment among children exposed to HIV and uninfected in sub-Saharan Africa.

The population of 16 million children exposed to HIV and uninfected (CHEU) under 15 years of age continues to expand rapidly, and the estimated prevalence of CHEU exceeds 20% in several countries in sub-Saharan Africa with high HIV prevalence. Some evidence suggests that CHEU experience suboptimal neurodevelopmental outcomes compared to children born to women without HIV. In this commentary, we discuss the latest research on biologic and socio-behavioural factors associated with neurodevelopmental outcomes among CHEU. Some but not all studies have noted that CHEU are at risk of poorer neurodevelopment across multiple cognitive domains, most notably in language and motor skills, in diverse settings, ages and using varied assessment tools. Foetal HIV exposure can adversely influence infant immune function, structural brain integrity and growth trajectories. Foetal exposure to antiretrovirals may also influence outcomes. Moreover, general, non-CHEU-specific risk factors for poor neurodevelopment, such as preterm birth, food insecurity, growth faltering and household violence, are amplified among CHEU; addressing these factors will require multi-factorial solutions. There is a need for rigorous harmonised approaches to identify children at the highest risk of delay. In high-burden HIV settings, existing maternal child health programmes serving the general population could adopt structured early child development programmes that educate healthcare workers on CHEU-specific risk factors and train them to conduct rapid neurodevelopmental screening tests. Community-based interventions targeting parent knowledge of optimal caregiving practices have shown to be successful in improving neurodevelopmental outcomes in children and should be adapted for CHEU. CHEU in sub-Saharan Africa have biologic and socio-behavioural factors that may influence their neurodevelopment, brain maturation, immune system and overall health and wellbeing. Multidisciplinary research is needed to disentangle complex interactions between contributing factors. Common environmental and social risk factors for suboptimal neurodevelopment in the general population are disproportionately magnified within the CHEU population, and it is, therefore, important to draw on existing knowledge when considering the socio-behavioural pathways through which HIV exposure could impact CHEU neurodevelopment. Approaches to identify children at greatest risk for poor outcomes and multisectoral interventions are needed to ensure optimal outcomes for CHEU in sub-Saharan Africa.

Tracking progress towards equitable maternal and child health in Yunnan: a systematic assessment for the Health Programme for Poverty Alleviation in China during 2015–2020

ObjectivesTo inform the impacts of health programmes which aimed at preventing women and children from being trapped in or returning to poverty because of illness in Yunnan, the main battlefield...

Recording and Reporting Information System for Maternal Health Monitoring (Literature Review)

The Maternal and Child Health (MCH) program is a health program in Indonesia that aims to improve the health and welfare of mothers and children as stated in Permenkes number 4 of 2019. To support the implementation of the program requires technology in the form of information systems. Information systems are designed to help health workers manage maternal and child health more effectively. Delays in data collection, incomplete filling and long time in presenting data are one of the reasons why a maternal health information system is needed to run optimally. The purpose of this study was to describe the recording and reporting of maternal health monitoring activities. The method used is a literature review based on the PRISMA flow. The results of the health information system research are able to provide the right, accurate and up-to-date quality of information data so as to improve the efficiency and effectiveness of services and facilitate evaluation and help health workers manage maternal health more effectively. The running of an information system will depend heavily on human resources to utilize the information system and produce records and reports to improve the performance of users of the system

Public Health Calls for/with AI: An Ethnographic Perspective

Artificial Intelligence (AI) based technologies are increasingly being integrated into public sector programs to help with decision-support and effective distribution of constrained resources. The field of Computer Supported Cooperative Work (CSCW) has begun to examine how the resultant sociotechnical systems may be designed appropriately when targeting underserved populations. We present an ethnographic study of a large-scale real-world integration of an AI system for resource allocation in a call-based maternal and child health program in India. Our findings uncover complexities around determining who benefits from the intervention, how the human-AI collaboration is managed, when intervention must take place in alignment with various priorities, and why the AI is sought, for what purpose. Our paper offers takeaways for human-centered AI integration in public health, drawing attention to the work done by the AI as actor, the work of configuring the human-AI partnership with multiple diverse stakeholders, and the work of aligning program goals for design and implementation through continual dialogue across stakeholders.

The association between parent-child quality time and children's flourishing level

PurposeFew studies have examined the association between parental quality time and flourishing measures in young children. This study explored the association between parental quality time and children's flourishing in a national sample of USA children 1–5 years of age. Design and methodsA cross sectional study using data from the 2019–2020 National Survey of Children's Health (N = 17,855). Flourishing was measured with a composite score (values 0–4) derived from 4 questions on attachment with parent, resilience, learning, and contentment with life. Having all 4 items was optimal. Parent-child quality time per week was measured with 3 items: singing or storytelling, reading to child, and family meal with child; using a 4-point scale: 0 days, 1–3 days, 4–6 days, and every day/week. Multivariable logistic regression models were conducted to assess the odds of lower flourishing in SAS 9.4. ResultsAfter controlling for confounding, only the lack of singing and storytelling were negatively associated with greater odds of lower levels of flourishing (0–2 items OR = 5.06, 95% CI 2.11–12.14; 3 items OR = 2.92, 95% CI 1.73–4.93). ConclusionsInsufficient parent-child quality time is associated with lower flourishing levels. Fostering parental opportunities to engage in weekly quality time with their children should be a priority of child health programs seeking to improve child flourishing. Practice implicationsNurses should provide guidance to parents on ways to nurture quality family time and promote children's psychosocial, environmental, and physical well-being. Nurses can advocate for programmatic and policy changes to ensure familial work/life balance and licensing/accreditation of all child centers.

Centers for Disease Control and Prevention Harvard Program Evaluation Practicum: 10 Years of Partnership in Public Health Program Evaluation.

The Centers for Disease Control and Prevention (CDC)'s Division of Reproductive Health and Harvard T.H. Chan School of Public Health (HSPH) Program Evaluation Practicum (CDC/HSPH Practicum) is a mutually beneficial workforce development partnership formed to provide state, local, and tribal public health organizations with an evaluation plan for a maternal and child health (MCH) program. State, local, and tribal public health organizations submit an MCH program in need of evaluation for inclusion consideration. Student pairs are matched with the selected programs in a 3-week practical field-based experience. This Practicum provides didactic training for both program staff and students followed by field work at the public health organizations. Students provide organizations with comprehensive evaluation plans, complete with logic model, methodology, and indicators. Since the Practicum's inception in 2013, 104 HSPH graduate students have been trained and 30 states and 1 territory have participated and received evaluation plans for their MCH programs. The utility and importance of the CDC/HSPH Practicum is evidenced by program staff and student feedback. Multiple states have implemented the plans designed by the students, with some evaluations leading to program enhancements. The CDC/HSPH Practicum prepares students for the workforce and adds much needed capacity to public health organizations by providing them with evaluation knowledge and skills, and usable evaluation plans to improve MCH-a win-win for all.

Child health, developmental plasticity, and epigenetic programming

Child health, developmental plasticity, and epigenetic programming

Health facilities preparedness to deliver maternal and newborn health care in Kilifi and Kisii Counties, Kenya

IntroductionHealth facility preparedness is essential for delivering quality maternal and newborn care, minimizing morbidity and mortality by addressing delays in seeking skilled care, reaching appropriate facilities, and receiving emergency care. A rapid assessment of 23 government health facilities in Kilifi and Kisii counties identified poor maternal and newborn indicators in 16 facilities. The Access to Quality Care through Extending and Strengthening Health Systems (AQCESS) project supported these facilities with training, equipment, and referral linkages. This study focuses on facility preparedness of the 16 facilities to deliver maternal and newborn health services, specifically delays two and three at the end of the project implementation.MethodsA descriptive cross-sectional study was carried-out on behalf of AQCESS project team by respective county ministry of health in-charge of reproductive maternal newborn and child health programs and trained nurses and medical doctors from Aga Khan health services in December 2019. The study evaluated the accessibility and reliability of drugs, commodities, equipment, personnel, basic necessities (such as water and electricity), and guidelines using validated World Health Organization service availability and readiness assessment tool. The findings of the assessment are presented through frequency and percentage analysis, along with a comparative analysis between the two counties.ResultsAll the 16 facilities assessed offered routine antenatal care (ANC) and normal delivery, but only two provided comprehensive emergency obstetric and newborn care (CEmONC). Most essential medicines, commodities, and required equipment were available. BEmONC and CEmONC guidelines were present in Kilifi, not in Kisii. One staff member was available 24/7 for cesarean section (CS) in each county, with one anesthetist in Kilifi. Electricity was accessible in all facilities, but only half had secondary power supply. Facilities offering CS had backup generators.ConclusionThe Facilities assessed had necessary drugs, commodities, equipment, and requirements, but staffing and guidelines were limited. Kilifi outperformed Kisii in most indicators. Additional support is needed for infrastructure and human resources to deliver quality maternal and newborn health services. Continuous monitoring will facilitate resource allocation based on facility needs.

The Knowledge, Attitude, and Practice of Lebanese Mothers Toward Their Children's Oral Health: A Cross-Sectional Survey.

This study aims to assess the knowledge, attitude, and practice of Lebanese mothers toward their children's oral health, examine the association between the three variables, and identify their predictors. A cross-sectional online survey was administered to Lebanese mothers residing in Lebanon with children aged six months to 12 years between April and May 2022. The survey was administered to mothers from various geographical areas who presented to academic medical centers, private clinics, and dispensaries. The survey gathered sociodemographic data as well as assessed the knowledge, attitude, and practice of the participating mothers toward their children's oral health. A total of 357 responses were included in the final analysis.The mean age of mothers was 32.67 years +/- 6.35. The majority of mothers had one or two children (35.8% and 37.5%, respectively). More than two-thirds of the mothers were unemployed. Only 13% of the mothers followed best practices for their children's dental health, while 48.6.2% possessed above-average knowledge and 88.9% had great attitudes. Mothers with a university education had higher knowledge, better attitudes, and practice scores than those with school-level education (elementary, high school). Employed mothers had a significantly better knowledge score (p=0.036) and practice score (p=0.043) than unemployed mothers. The decrease in the number of children was associated with an increase in the maternal knowledge score. An increase in the mother's age was associated with a higher knowledge score. The findings of this study suggest the need for targeted oral health education programs for Lebanese mothers to enhance their attitudes and practices toward their children's oral health. It highlights the importance of early oral health interventions and emphasizes the significant role of mothers in promoting good oral health practices for their children. Further research is needed on a larger scale to comprehensively understand these variables and inform the development of appropriate national oral health programs for children in Lebanon.

Predictors and disparities in neonatal and under 5 mortality in rural Pakistan: cross sectional analysis.

Adopted in 2015, the sustainable development goals (SDGs) have set specific targets (SDG 3.2) for countries to reduce their neonatal mortality rate (NMR) to below 12 deaths per 1000 live births and under 5 mortality rate (U5MR) to below 25 deaths per 1000 live births by 2030. For Pakistan to achieve these targets, there is a need to measure these rates and understand the predictors of child mortality at sub-national level. Launched in 2016, the Umeed-e-Nau (UeN) or New Hope project is based on scaling up proven and effective Maternal and Newborn Child Health (MNCH) interventions in 8 of the highest burden districts of the country, using existing public sector platforms in Pakistan at both the community and facility level. The primary aim of the project is to reduce perinatal mortality in these districts by 20% from baseline. We report overall neonatal and post neonatal mortality rates for the two years preceding the UeN baseline household survey. Rates were calculated using the synthetic cohort probability method and predictors of neonatal and post neonatal mortality examined using Cox regression. To investigate spatial variations in the mortality rates, we calculated Moran's I at the district level using predicted probabilities of mortality. Finally, we create district level maps of predicted under 5 child mortality using a stochastic partial differentiation approach. A total of 26,258 children contributed to the analysis of mortality with 838 deaths in the neonatal period and 2236 under-5 deaths during the observation period from March 1, 2015 to March 17, 2017. Overall, we estimated the NMR to be 29.2 per 1000 live births (95% CI: 26.9-31.4) and the U5MR to be 86.1 per 1000 live births (95% CI: 85.5-86.8). We found evidence of within-district geospatial clustering of under 5 mortality (P<0.0001) and that social factors (poverty, illiteracy, multiparity), poor coverage of community health workers and distance from health facilities were strongly associated with child mortality. Important factors associated with neonatal and post-neonatal mortality in our study population included maternal education, parity, household size and gender. Additionally, antenatal care coverage (at least 4 visits) was specifically associated with neonatal mortality only, whereas, LHW coverage and distance to health facility were strongly associated with post-neonatal mortality. These findings emphasise the need for comprehensive, multisectoral strategies to be implemented for future maternal and child health programs and outreach services in rural areas. The study was funded by an unrestricted grant from the Bill & Melinda Gates Foundation to the Aga Khan University (Grant OPP 1148892).

Value profile for respiratory syncytial virus vaccines and monoclonal antibodies

Respiratory syncytial virus (RSV) is the predominant cause of acute lower respiratory infection (ALRI) in young children worldwide, yet no licensed RSV vaccine exists to help prevent the millions of illnesses and hospitalizations and tens of thousands of young lives taken each year. Monoclonal antibody (mAb) prophylaxis exists for prevention of RSV in a small subset of very high-risk infants and young children, but the only currently licensed product is impractical, requiring multiple doses and expensive for the low-income settings where the RSV disease burden is greatest. A robust candidate pipeline exists to one day prevent RSV disease in infant and pediatric populations, and it focuses on two promising passive immunization approaches appropriate for low-income contexts: maternal RSV vaccines and long-acting infant mAbs. Licensure of one or more candidates is feasible over the next one to three years and, depending on final product characteristics, current economic models suggest both approaches are likely to be cost-effective. Strong coordination between maternal and child health programs and the Expanded Program on Immunization will be needed for effective, efficient, and equitable delivery of either intervention.This ‘Vaccine Value Profile’ (VVP) for RSV is intended to provide a high-level, holistic assessment of the information and data that are currently available to inform the potential public health, economic and societal value of pipeline vaccines and vaccine-like products. This VVP was developed by a working group of subject matter experts from academia, non-profit organizations, public private partnerships and multi-lateral organizations, and in collaboration with stakeholders from the WHO headquarters. All contributors have extensive expertise on various elements of the RSV VVP and collectively aimed to identify current research and knowledge gaps. The VVP was developed using only existing and publicly available information.

The Effect of Fresh Moringa Leaf Consumption During Pregnancy on Maternal Hemoglobin Level in Southern Ethiopia: Multilevel Analysis of a Comparative Cross-Sectional Study.

Anemia, especially iron-deficiency anemia during pregnancy, significantly impacts maternal health, fetal growth, and development. Moringa leaf is an iron-rich food that can overcome anemia, but there is a lack of evidence on the association between fresh moringa leaf consumption and maternal hemoglobin level during pregnancy. The aim of this study is to test the effect of fresh moringa leaf consumption during pregnancy on maternal hemoglobin levels in southern Ethiopia. A community-based comparative cross-sectional study was conducted from May to June 2022 among 230 fresh moringa leaf consumers and 230 non-consumers pregnant women. Data were collected using an interviewer-administered structured questionnaire and hemoglobin level was determined by HemoCue Hb 301. Multivariate multilevel linear regression models were fitted using Statistical Software for Data Science (STATA) version 14. The overall mean hemoglobin level among pregnant women was 11.76 g/dl ± 1.47 [12.06 g/dl ± 1.22 among fresh moringa leaf consumers and 11.45 g/dl ± 1.64 among non-consumers] with a significant coefficient of association (β) of 0.90 g/dl [β = 0.90 g/dl, 95% CI: 0.54, 1.27]. A number of under-five children, bleeding during the current pregnancy, male-headed household, and current antenatal care visit were the individual-level factors. Distance from the nearest health facility and urban dweller was identified as the community-level factor associated with maternal hemoglobin level during pregnancy. This study showed that the consumption of fresh moringa leaf during pregnancy increases the level of hemoglobin. So policymakers and maternal and child health program managers need to target moringa tree scale-up and encourage fresh moringa leaf consumption during pregnancy, but its use needs additional rigorous clinical trials. In addition to this, mark the above factors in their efforts to increase maternal hemoglobin levels during pregnancy.

Mortality statistics in a tertiary care teaching hospital in Bagalkot, Karnataka in the year 2022

Background: Mortality statistics is important for epidemiological purposes to find any unusual rise in deaths for investigation of the causes so as to take public health action at an early stage. Cause of death statistics from hospitals are routinely amalgamated along with mortality statistics from other sources to constitute essential statistics on the health of a population. This study was done to understand the mortality pattern in a tertiary care teaching hospital and to undertake preventive action as much as possible. Methods: A retrospective hospital based study was done with all the medical records of patients who died in Hangal Sri Kumareshwar hospital and medical research centre in the year 2022, attached to S. N. Medical College, Bagalkot, Karnataka. After IRB, the medical records were analyzed to study the pattern of disease causing deaths which were classified under ICD 10th revision. Age, sex, month of admission, place of residence and underlying cause of death was used for analysis using chi square test and percentages. Results: Out of 501 deaths, 316 (63.07%) were male and 185 (36.93%) were female. Majority of the deaths 152 (30.34%) occurred between the ages of 41 to 60 years. Non communicable diseases contributed to 71.05% of deaths and communicable diseases to 28.95% of deaths. Conclusions: Continuation of the maternal and child health program and effective implementation of the National health programs to overcome non communicable diseases can reduce avoidable premature mortality in the population.

User Satisfaction Levels about m-Health Application for Growth Monitoring and Children's Development in Yogyakarta, Indonesia

Background: The level of user satisfaction with the m-health application has a significant impact on its long-term viability.&#x0D; Aims: This study aims to determine user satisfaction levels about m-health applications for growth monitoring and children's development in Yogyakarta, Indonesia.&#x0D; Methods: This was a cross-sectional study conducted from May to November 2022 in Yogyakarta, Indonesia. The satisfaction survey was conducted on 100 respondents in Yogyakarta, Indonesia using the RASCH method with a mean rating of 1 2 3 4, from very disagree until very agree.&#x0D; Results: This finding showed that using RASCH method with 14 criteria the mean rate of user satisfaction is 3.5±1.5. The lowest rating is about the app's usage time suits me (3.1±1.4) and the highest rating is about the ease of use and I have many information about children health care (3.5±1.2 and 3.5±1.5 respectively).&#x0D; Conclusion: Based on user satisfaction evaluation tests, overall are good, for ease of use, helpfull time friendly, comfort, and providing information swiftly and properly. Futher this application needs policies to support children's health programs extensively.

DESCRIPTION OF WOMEN'S ORGANIZATIONAL MANAGEMENT IN THE PREVENTION OF MATERNAL AND CHILD DEATH

Backgrounds: The maternal mortality rate (MMR) and the infant and under-five mortality rate (IMR and AKABA) are indicators that show the welfare and health of the people in a country.&#x0D; Objective: This study aims to conduct a study related to the description of the management of women's organizations in preventing maternal and child deaths.&#x0D; Method: The method used is descriptive qualitative, with informants being women's organizations with maternal and child health programs.&#x0D; Result: Women's organizations play a role in reducing maternal and child mortality by conducting active counseling, active assistance, educating the community and carrying out activities that support maternal and child health.&#x0D; Conclusion: The involvement of women's organizations in the planning and implementation of programs to reduce maternal and child mortality needs continuous efforts and assistance so that the programs run effectively and there is an increase in the knowledge and understanding of mass organizations related to gender and women's health and maternal and child health.

Relationship Between Accessibility to Health Services with Exclusive Breastfeeding

Globally, the prevalence of exclusive breastfeeding is still less than 40%. Exclusive breastfeeding is the appropriate recommendation to build quality human resources. The infant mortality rate has not decreased according to the SDGs target. Neonatal death rate is 32/1000 live births. Difficulties in accessing health services can also be seen in Maternal and Child Health (MCH) program, where the MMR and IMR in several areas are still quite high. This study aims to determine the relationship between accessibility to health services related to exclusive breastfeeding. This study is a quantitative study with a cross-sectional analytic design. Primary data collection in the province of DKI Jakarta. Data collected and analyzed using SPSS 25 as univariate and bivariate analysis. The results showed that there was a relationship between the accessibility to health services with exclusive breastfeeding (p=0.040). Accessibility to health services is positively related to exclusive breastfeeding for infants. Ease of access to health services is the fulfillment of all items of access to health services that should be easily accessible to mothers. The item availability of health workers around the house (p=0.042) and health workers who examine mothers during childbirth (p=0.0001) had the greatest influence on access to health services so that it had a positive effect on exclusive breastfeeding. Ease of access to health services motivates and helps a mother to provide exclusive breastfeeding to her baby. We hope that access to health services and facilities can improve performance in providing easy access and the best services for mothers.

Interview With CSCI Joe Doupe Young Investigator Awardee, Dr. Amy Metcalfe.

Dr. Amy Metcalfe is an Associate Professor in the Departments of Obstetrics and Gynecology, Medicine, and Community Health Sciences at the University of Calgary. She is also the Maternal and Child Health Program Director with the Alberta Children's Hospital Research Institute. Dr. Metcalfe's training is a perinatal epidemiologist whose research broadly focuses on the management of chronic illness during pregnancy, and how events in pregnancy impact women's health and wellbeing throughout the life course. Current major projects include co-leading the P3 Cohort study (https://p3cohort.ca), a longitudinal pregnancy cohort study, and the GROWW (Guiding interdisciplinary Research On Women's and girls' health and Wellbeing) Training Program (https://www.growwprogram.com).