142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Strengthening Research Collaborations and Developing a Centralized Registry in an Urban, Low-Resource Hospital to Explore Predictors of Maternal Mortality and Identify Health Services Research Priorities

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Nessa Ryan, mph , Department of Obstetrics and Gynecology, NYU School of Medicine, new york, NY

Korle Bu Teaching Hospital (KBTH) in Accra, Ghana conducts approximately 10,000 deliveries per year with a morbidity/mortality rate (MMR) of 1,063 deaths in 100,000 live births. One-quarter (28%) of maternal deaths are attributable to hypertensive complications.  Effective clinical interventions for prevention and treatment of these complications exist; however, implementation barriers (like service delay) impede positive clinical outcomes. Creating an onsite registry of obstetrical events and service delivery indicators can facilitate monitoring and addressing of preventable morbidity/mortality.


Through a twinning partnership with two teaching institutions, we conducted multivariate analyses on 20,331 deliveries at KBTH to explore the relationship between maternal mortality and predictor variables of appropriate care before reaching the facility (timely administration of magnesium) and appropriate care provided at the facility (indicators related to screening and treatment) for women with hypertensive complications of pregnancy.


The regression model regenerated will inform subsequent prospective data collection, as well as contribute to the implementation of targeted interventions to improve service delivery. New data will be integrated every 6 months and leadership will meet to plan, monitor and evaluate evidence-based interventions in real-time.  Lessons learned in creating these collaborative research relationships include establishing a shared work plan as a working document that can redirect research focus as necessary. Establishing regular communication schedules will hold both partners responsible for assigned tasks.


This implementation science research may ultimately strengthen human and resource capacity onsite and provide a model to other academic institutions focusing on sustainably improving health outcomes in low-resource facilities.


Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Program planning
Public health or related research

Learning Objectives:
Identify 2 lessons learned from building a collaborative research partnership in a low-resource setting. Evaluate how this model design could be generalizable to their own research.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a co-investigator of a global health research initiative within the division of global women's health in the NYU obstetrics and gynecology department. We are partnering with Korle Bu Teaching Hospital in Accra, Ghana to build sustainable education and collaborative research programs. Among my scientific interests has been the development of data capture systems in low-resource settings for health services research and quality improvement interventions in women's health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.