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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.

Beginning in August 2022, we enrolled approximately 2,400 mothers across 12 health centers- all follow-up was completed in July 2022. In all study health centers, the quality of routine antenatal care was strengthened, including equipping facilities, health provider training, and community mobilization. Health centers were randomized to receive either an enhanced nutrition package, or routine care. The nutrition package included the provision of iron-folate and adequately iodized salt to all women and balanced energy protein supplement to malnourished women. Some mothers received presumptive deworming, screening, and treatment for common pregnancy infections. Our goal was to see how these interventions affect newborn birth weight and length, preterm birth, and other pregnancy and birth outcomes. Data analysis is currently ongoing, and preliminary results are expected in early 2023.

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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