Preterm Birth Initiative

Investigator: Dilys Walker, MD
Sponsor: Bill & Melinda Gates Foundation

Location(s): Kenya; Rwanda; Uganda


Working in selected sites in Kenya, Uganda, and Rwanda, PTBi-East Africa aims to reduce morbidity and mortality from preterm birth by strengthening facility-based care from pregnancy through labor, delivery, and immediate postnatal period.

We use evidence-informed interventions where they exist and test novel approaches that are carefully adapted to the local context, and planned and implemented with local stakeholders. Rigorous measurement and evaluation enables us to understand what works and why. Our approach is grounded in a commitment to capacity building and long-term sustainability.

While our primary focus is improving implementation to save lives immediately, we also conduct research to gain new knowledge about preterm birth in order to develop new solutions.

PTBi-East Africa has four aims:

Aim 1: Improve measurement and data use

We aim to strengthen existing data collection processes in health care facilities; improve data collection practices to identify women at risk; and provide tools to better assess gestational age. We are creating digital tools to collect data that local providers, health officials, and national policy makers can use to aid decision making. This will be the compass for our work in the next four years and beyond.

Aim 2: Implement a labor, delivery, and postnatal care package

We aim to Implement and test packages of proven interventions to address facility-based labor, delivery and immediate post-natal care to improve mother and infant survival and to determine which interventions are optimal.

Aim 3: Design and implement a group model for prenatal care

Research in Rwanda will focus on preventing preterm birth and better managing fragile babies. We will focus on designing and implementing and evaluating a group care model that includes prenatal and immediate postnatal period.

Aim 4: Conduct research to inform preterm birth intervention development.

We are conducting research that improves our knowledge of preterm birth and the development of tools to identify and manage at-risk women and preterm infants. We will also fund projects that are directly relevant to our measurement and implementation efforts, including studies to better understand preterm birth phenotypes, risk factors, and the use of ultrasound during triage We will focus specifically on research led by East African principle investigators in partnership with UCSF researchers.