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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 will 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.

We will enroll approximately 2,000 mothers across 12 health centers, beginning in August, 2020. In all study health centers, the quality of routine antenatal care will be strengthened, which includes equipping facilities, health provider training, and community mobilization. Health centers have been randomized to receive either an enhanced nutrition package, or routine care. The nutrition package will include the provision of iron-folate and adequately iodized salt to all women and balanced energy protein supplement to malnourished women. Some mothers will receive presumptive deworming, screening, and treatment for common pregnancy infections. Our goal is to see how these interventions affect newborn birth weight and length, preterm birth, and other pregnancy and birth outcomes. 

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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