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The ENAT Study

Enhancing Nutrition and Antenatal infection Treatment for maternal and child health

Maternal undernutrition and infections in pregnancy are important causes of poor birth outcomes, including low birthweight (<2500 grams at birth) and preterm birth (<37 weeks gestation). In Ethiopia, one in three mothers are malnourished and reproductive tract infections in pregnancy are common, but screening and treatment are limited. An estimated 635,000 (20%) babies are born with a low birth weight, and 320,000 (10%) are born premature each year.   

Map of Amhara Region, Ethiopia and health centers participating in the ENAT Study.

The ENAT (meaning “Mother” in Amharic) Study, is a pragmatic effectiveness study (ISRCTN15116516) that aims to test the impact of packages of antenatal interventions to optimize maternal nutritional status and infection management in pregnancy, on maternal and infant health outcomes in West Gojjam and South Gondar Zones of Amhara regional state, Ethiopia.

From 2021-2022, we enrolled 2,400 pregnant women across 12 rural health centers. In all study health centers, the quality of routine antenatal care was strengthened, including equipping facilities, health provider training, and community mobilization. Women were randomized to receive routine care, an enhanced nutrition package (a monthly supply of adequately iodized salt and a micronutrient fortified balanced energy protein supplement for undernourished mothers), enhanced infection management package (genito-urinary infection screening and treatment and intensive deworming), or borth packages. Our goal was to see how these interventions affect newborn birth weight and length, preterm birth, and other birth outcomes. Results from this study are forthcoming.

ETHIOPIA CHILD DEVELOPMENT STUDIES
Longitudinal Infant Development & Growth (LIDG) Study

The LIDG (pronounced ልጅ”, meaning “child” in Amharic) Study aims to determine the effects of the prenatal ENAT interventions on long-term growth, health, and development of children up to 24 months of age. using a range of modalities to assess the development of the child. These new studies are funded by NICHD and the Bill and Melinda Gates Foundation and will use a range of modalities to assess the development of the child. 

The Bahir Dar Child Development (BCD) Study

The aim of the BCD study is to (1) characterize typical neurodevelopment and (2) identify factors influencing child growth and development in a cross-sequential cohort of children ages 0 to 5 years old in Bahir Dar, Ethiopia, a peri-urban area in Amhara region.

We are working in partnership with the Addis Continental Institute of Public Health (ACIPH), Ethiopian Federal Ministry of Health, Johns Hopkins Bloomberg School of Public Health, Jhpiego, and several Harvard-affiliated hospitals.

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