Researchers Awarded Grant to Improve Maternal Health Outcomes and Population Surveillance in Western Myanmar

Dr. Ruth Masterson Creber, associate professor of population health sciences at Weill Cornell Medicine (WCM), has received a R21 grant to improve maternal health outcomes and support population surveillance in western Myanmar through the use of mobile health (mHealth) technology. This research is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Fogarty International Center.

Dr. Natalie Benda, instructor in population health sciences at WCM, is a key collaborator on this project. A recipient of the NIH K99/R00 award, Dr. Benda is the principal investigator on “Maternal Outcome Monitoring and Support (MOMS) - A mHealth symptom self-monitoring and decision support system to reduce racial and ethnic disparities in postpartum outcomes,” which leverages mHealth to monitor symptoms for early recognition of complications in African American and Latina women during the postpartum period. “It’s really exciting that we can partner together on a study that focuses on the same theme of vulnerable pregnant women but in an international context,” noted Dr. Masterson Creber, the study’s principal investigator.

For the first two years of the five-year project, investigators will 1) continue developing an infrastructure for tracking population health outcomes using mobile phones, and 2) introduce and assess feasibility collecting and interpreting ultrasound images by health professionals.

Myanmar is divided into seven states representing seven main ethnic races. Over 500,000 individuals reside in the mountainous Chin and Rakhine states where there is a regular struggle to meet basic food, healthcare, and education needs. Maternal mortality is an especially prevalent issue in this area. Due to rugged terrains, limited transportation infrastructure, and a scattered population, less than 6% of women give birth in a health facility, usually located a three-to-four days walk from their homes.

“The goal of the larger study is to provide support for pregnant women to have attended birth and improve their access to care,” said Dr. Masterson Creber. The project, however, has since pivoted substantially as a response to a growing refugee crisis.

In February 2021, a military coup took place in Myanmar that led to the displacement of hundreds of thousands of people. As a result, there has been a tremendous need to track and support the health of this vulnerable population. Partnering with a local nonprofit healthcare organization, the research team has been able to use consumer health informatics tools to support refugee population health. “What’s different about this project is that the tool we develop is really focused on the needs of this specific population,” explained Dr. Masterson Creber. “It’s going to be done in seven different languages. In addition, because there’s such a rich linguistic environment with so many different local dialects, we are also using icons and images that are culturally contextualized to support people with low literacy.”

This new project builds on Dr. Masterson Creber’s previous research, funded by the Kellen Junior Faculty Fellowship, which provided the preliminary data on the impact of mHealth technology on maternal mortality.

“Many births occur in the women’s homes and are not attended by anyone trained,” said Dr. Masterson Creber. “The previous system of data collection was to have someone come around to the villages every few months and write down on paper how many births and deaths there have been.” The new population surveillance tools will allow information to be collected electronically, painting a more accurate picture of what is happening in the community and ultimately providing real-time support for pregnant women, including mobile ultrasound.

This new research is laying the groundwork for an unprecedented feat in population health. Currently, no official records track the maternal health of the individuals living in western Myanmar or the recently displaced population. By developing a robust surveillance infrastructure, Dr. Masterson Creber and her team are enabling local providers to ask clinical questions in a systematic way and address the health priorities of the community.

The Department of Population Health Sciences addresses the intersection of health and practice. Serving as a collaborative and interdisciplinary hub for clinical research, the Department aims to improve the health of populations and reduce inequities through applied research, technological innovations, and novel education programs.

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