Title: GCRF: The PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network: a sub-Saharan network for placental disorders
Funder: Economic and Social Research Council

Abstract: Through our work in West Africa (the Gambia & Senegal; both ODA 'least-developed' countries), East Africa (Kenya; ODA 'Other' low income country) and Southern Africa (Mozambique; ODA 'least developed' country), we have set ourselves the task of fulfilling the following objectives, each of which relates to at least one GCRF thematic area: Objective 1: To increase and disseminate knowledge related to the origins and consequences of the placental disorders of pregnancy in sub-Saharan Africa. This addresses the thematic areas: (i) sustainable health and well-being; (ii) reducing gender and childhood inequalities, as the placental disorders are leading causes of maternal, fetal and infant death and disability; (iii) resilience to short-term environmental shocks (which will advise creating strong infrastructure for sustainable and inclusive development). This requires an understanding of the complex interplay between an individual woman's biology, her burden of acute and chronic infectious disease, her nutritional and societal status, and her existence in place and time throughout a 2-year period. In addition, it requires an understanding of the biology of non-pregnant and physiologically-pregnant reproductive age women in these settings as these foundational data do not exist. Our targets for knowledge dissemination will be women, their communities, local and national decision makers, NGOs and multilaterals. Many of the key relationships already exist and will be strengthened through this shared set of activities. Objective 2: To develop a collaborative team focussed on women's and reproductive health This addresses the thematic areas of: (i) sustainable health and well-being; (ii) strengthening foundations and research infrastructure for inclusive innovation; (iii) reducing inequality within science; and (iv) creating inclusive and equitable education and training for all team members and their trainees. While some members of the proposed PRECISE team have worked together previously, this initiative will create a team through activity in LMICs. We will grow capacity in both LMICs and the UK by developing and strengthening skills around pregnancy research, especially, but not exclusively, focussed on placental disorders. This is especially pertinent for the MRC Gambia unit, which does have a track record of research around the prevention of mother-to-child transmission of HIV, but is otherwise limited in its pregnancy research portfolio. Through the Gates Foundation-funded PRE-EMPT (PRE-eclampsia - Eclampsia Monitoring, Prevention & Treatment) initiative lead by the PRECISE CI, Peter von Dadelszen, the Mozambique team has recently become engaged in pregnancy research related to pregnancy hypertension. Twenty-two (55%) of the 40 named investigators and staff scientists are women, and some are gay. Objective 3: To create an African-controlled resource of a regional biobank that is linked to replete clinical, epidemiological, nutritional, social context, and geographical data. This will address the thematic areas of: (i) reducing inequality through ownership of research resources in Africa by Africans; (ii) inclusive and equitable quality research education and training; and (iii) sustainable health and well-being. This model of local control of data and biological samples in central to our model of global health research and is essential for the development of research strength in Africa. These resources would underpin future hypothesis-driven and -generating projects in these areas and would contribute to the Global Pregnancy Collaboration established by PRE-EMPT. In addition, we believe that the PRECISE project will create a pregnancy cohort that could be followed-up in terms of both maternal and child outcomes related to the origins and consequences of non-communicable diseases


Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS;2.6 RESOURCES AND INFRASTRUCTURE (AETIOLOGY)
Health categories: REPRODUCTIVE HEALTH AND CHILDBIRTH