Swaziland Health Research - Research Topics #4

Research Agenda

Research Areas: Reproductive Health and Child Health

Despite considerable efforts, the neonatal, child and maternal mortality rates relatively high, and the country is not on track to achieve MDG4 and MDG5. Therefore, research is needed to guide improvement of existing interventions and development new capacities to curb the morbidity and mortality.

1. Research Priorities in Neonates
Assessment of burden and determinants:
  • Assess death rates of neonates and determinants.

Research to Improve Existing Interventions:
  • Identify health system interventions that will increase population coverage of key newborn health interventions – (i) two post-natal care contacts in the first week of life (ii) exclusive breast feeding for the first six months of life (iii) immunization.

Research to Improve Effectiveness and Cost-Effectiveness:
  • Assess effectiveness of approaches to achieve early initiation of breastfeeding.
  • Assess effectiveness of approaches to identify and care of low birth weight infants within 24 hours of birth.
  • Assess effectiveness of Kangaroo mother care and alternative methods of providing thermal care to low birth weight infants.
  • Assess effectiveness and cost-effectiveness of different newborn care methods.
  • Assess effectiveness of community participation to improve recognition and prompt acting on simplified danger signs for mothers in labour to reduce birth asphyxia.
  • Develop and evaluate methods for early detection of specific maternal complications with higher risks of unfavourable asphyxia related outcomes.
  • Assess feasibility, effectiveness and cost of different approaches to promote home care practices such as early initiation and exclusive breastfeeding, hygiene cord and skin care, prompt care seeking for illness, and hand washing of caregivers.


2. Research Priorities in Childhood
Assessment of burden and determinants:
  • Monitor the burden of malaria, diarrhoea and pneumonia.
  • Assess key risk factors predisposing children to malaria, diarrhoea and pneumonia.

Research to Improve Existing Interventions:
  • Identify health system interventions that will increase population coverage of key child health interventions – (i) immunization (ii) care seeking for pneumonia and other febrile illnesses (iii) Oral Rehydration Therapy (ORT) for diarrhoea.

Research to Improve Effectiveness and Cost-Effectiveness:
  • Identify the optimal balance between health facility and community treatment to improve coverage and / quality of treatment for malaria, diarrhoea and pneumonia.
  • Assess the effectiveness of community treatment of malaria, pneumonia and diarrhoea on childhood morbidity and mortality.
  • Identify optimal packaging and delivery of different MNCH and nutrition services in terms of increasing coverage, efficiency, client satisfaction, etc.
  • Assess effectiveness and cost of implementing IMCI guidelines in health facilities.


3. Research Priorities in Adolescence and adults
Assessment of burden and determinants:
  • Assess factors (including barriers and facilitators) associated with the utilization of maternal health services (antenatal, intrapartum, postpartum) by adolescents and adult women.
  • Assess pregnancy outcomes (maternal and neonatal) among adolescents related to mode of delivery, presence of a skilled birth attendant at delivery and care of infants up to 6 months of age.

Research to Improve Existing Interventions:
  • Develop strategies to improve the use of antenatal care, skilled birth attendants, PMTCT and postnatal care by adolescents and adult women
  • Develop strategies to promote postnatal family planning to reduce subsequent unwanted pregnancies.
  • Identify factors determining adolescent girls and adult women choice of sources of antenatal, delivery and postnatal care.
  • Identify contraceptive strategies that can delay first births among married adolescents.
  • Identify mechanisms for financing or subsidizing the provision of regular and emergency contraceptives to adolescents and adults.
  • Develop strategies for increasing consistent and effective condom use among both male and female adolescents and adults.
  • Identify barriers faced by health-care providers when offering contraception services to unmarried adolescents.
  • Identify factors that protect adolescents from unwanted and/or unsafe pregnancy.
  • Determine knowledge of adolescents on prevention of unwanted pregnancy, abortion law, and less invasive procedures for pregnancy termination.
  • Identify health system interventions that will increase population coverage of key maternal health interventions – (i) at 4 antenatal care visits (ii) skilled care at birth (iii) two post-natal care contacts in the first week of life.

Research to Improve Effectiveness and Cost-Effectiveness:
  • Assessimpact of comprehensive sex education at school on:
    •      reduction of adolescent pregnancies,
    •      increase in health-care seeking behaviour among adolescents, and
    •      reduction of the incidence of STIs, including HIV infection.
  • Identify most effective and affordable models for delivering integrated family planning and HIV services and information

Development of new capacities (tools and products):
  • Develop and test female-controlled methods for preventing both STIs and pregnancy.

Contacts

Physical Address: Christian University Building, Office #, Mbabane, Swaziland

Postal Address: P.O Box 5 Mbabane, Swaziland

Phone: 2404 4905

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