Maternal and perinatal Health Research collaboration, India (MaatHRI) is a UK-India collaboration for maternal and perinatal health research established in September 2018. MaatHRI means 'mother' in Sanskrit. This project is an extension of the pilot initiative called the Indian Obstetric Surveillance and Research System in Assam (IndOSS-Assam) and has expanded the research platform from two government tertiary hospitals in the Indian north-eastern state of Assam to fifteen government and private hospitals in five states in India. This collaboration is led by Dr. Manisha Nair from the National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford.
Why is this research collaboration important?
Globally, 303,000 women died in 2015 from preventable complications during pregnancy and childbirth. India has the highest number of maternal deaths of any country. The maternal mortality rate in India is more than 20 times higher than the UK and every year about 45,000 women die in India compared to only 70 in the UK. In addition, about 5 million pregnant women in India suffer a life-threatening complication. Robust studies are needed to investigate the risk factors, management and outcomes of pregnancy complications to inform guidelines and improve policies. NPEU's work in maternal and perinatal health research has had significant impact in the UK and in other high income countries. The aim of this research collaboration is to translate and adapt this work in India to have a greater impact on improving maternal and perinatal health in the places with the highest burden.
What is this research collaboration doing?
MaatHRI has created a large and diverse platform for academics and scientists to conduct large-scale epidemiological research to improve maternal and perinatal health in a setting with a high burden of mortality and morbidity. Studies that are critical to informing policies and planning to address new and emerging complications in pregnancy can be quickly and efficiently rolled out through MaatHRI. The resultant new and improved scientific evidence will help policy makers and clinicians in India and globally to develop guidance to improve pregnancy care. The collaborative platform is also a training platform for students and early career researchers from the UK and India interested in developing skills in conducting research in maternal and perinatal health in a low and middle income country setting. MaatHRI could form the basis of many studies well in to the future.
MaatHRI aims to:
Routinely collect data on the prevalence of known and emerging life-threatening pregnancy complications.
Conduct large epidemiological studies to generate evidence to develop guidance and interventions to prevent deaths.
Since its establishment in September 2018, the research platform is being used to undertake studies to improve the clinical management and outcomes of pregnant women with anaemia and heart failure, and recently to improve perinatal mental health.
Establishing the MaatHRI platform in 15 public and private hospitals across India
Investigating anaemic heart failure
Examining the safety of induction and augmentation of labour during childbirth in pregnant women with moderate and severe iron deficiency anaemia
Exploring the feasibility of establishing MaatHRI in other states and developing clinical guidance
Scoping follow-up research projects
A laboratory infrastructure has been created through a partnership with a private laboratory in India, Dr Lal PathLabs (https://www.lalpathlabs.com/), which has a pan-India presence with a network of sample collection centres, regional laboratories and a national reference laboratory in New Delhi, India. Their existing service delivery model was adapted to the requirements of the MaatHRI platform. All biological samples are analysed at the National Reference Laboratory. The precision, performance and quality of each laboratory parameter are documented and maintained to a high level.
All MaatHRI research nurses have been trained by experts from Dr Lal PathLabs to collect, centrifuge and pack samples. Centrifuge machines of same make and model have been provided to all MaatHRI collaborating hospitals. The laboratory provides the required blood collection kits with specific written guidance to all study hospitals for collecting, processing and packing the blood samples.
Bi-directional capacity building through mutual learning between the collaborators in India and the UK is an integral component of MaatHRI. Since September 2018, we have conducted training workshops for the MaatHRI collaborating hospitals in India to improve clinical and research skills. The platform is also being used to develop the research capacity of early career researchers (MSc and PhD students and post-doctoral researchers) interested in working in maternal and perinatal health in a low and middle income country settings.
Funding: Medical Research Council Career Development Fellowship for Manisha Nair and Ultromics Limited.