Healthy pregnancies begin long before conception. We take a lifespan approach to strategies for improving maternal outcomes. A child who is undernourished early in life may not fully develop cognitively or physically, with implications of the latter for reproductive health. Clinical undernutrition-related conditions, such as rickets or stunting, place women at higher risk of obstructed labour.  An adolescent who is anemic is at greater risk from mortality related to blood loss than an adult woman. Pregnancies in adolescence may have lifelong consequences for both mother and child and we support the delaying of first pregnancies and birth spacing. We have been involved with the design, monitoring and evaluation of strategies to improve maternal health ranging from community based interventions such as the Baby Friendly Community Initiative, to the assessment of the impact of fortified foods for pregnant women and the design of national nutrition policies including weekly iron folic acid supplements for all women of reproductive age. Conducting program evaluations are again key to decision making by policy makers and programme providers. Examples of our work in this area include:

Weekly iron folic acid for women of reproductive age In Cambodia (Funded by the World Health Organization).

Conducted the baseline/endline evaluation of a programme designed to reduce anaemia among women of reproductive age for the National Nutrition Programme in the Ministry of Health. The programme was initiated to address the nutritional status of schoolgirls age 15 and above as well as adult women in an attempt to ensure they would enter pregnancy with improved iron stores leading to improved birth outcomes. A key issue was that adolescent girls from poorer socio-economic status were less likely to be at school yet more at risk of undernutrition. For programme effectiveness, reach must extend to all adolescent girls.

The efficacy and acceptability of prenatal corn soya blend plus dietary supplementation among women in rural Cambodia (research conducted by Amynah Janmohamed and funded by International Relief and Development (IRD)).  

Our team conducted a baseline survey for IRD’s USAID funded ENRICH project, which was designed to reduce infant, child and maternal mortality through evidence-based interventions.

The objectives were to:
1) reduce the prevalence of child malnutrition;
2) reduce the burden of diarrheal disease;
3) improve maternal nutrition to reduce the incidence of low birth weight, and
4) increase healthy timing and spacing of pregnancies.

With a further focus on how to improve maternal nutrition a trial of corn soya blend was designed to determine if birth outcomes could be improved through the provision and consumption of a supplementary food product fortified with vitamins and minerals.