Our impact on global health
Malaria nets save lives and reduce costs
Malaria still causes the deaths of many persons worldwide, even though insecticide-treated bed nets can virtually prevent malaria. The problem is that less than ten percent of Sub-Saharan African households can afford to own nets.
Frieda Behets, PhD, professor of epidemiology, and team members evaluated the cost-effectiveness of distributing free malaria bed nets to 17,893 pregnant women attending 28 clinics in Kinshasa in the Democratic Republic of Congo. They found that the nets prevented 414 infants from dying and another 587 infants from suffering low birthweight complications. Paying for nets, rather than health treatment for malaria, saved $17.22 per case for disability-adjusted life-years, $15.70 per case for life-year saved, and $411.13 per infant deaths averted. These findings provide guidance for healthcare agencies in Sub-Saharan Africa regarding investments in the prevention versus treatment of malaria. (back to top)
Supporting pregnant women who test positive for HIV
What kinds of support and services are most helpful to pregnant women being tested for HIV infection? Suzanne Maman, PhD, assistant professor of health behavior and health education, is talking with women from one of South Africa’s poorest townships to find out. In the South Africa HIV Antenatal Care Post-test Support Study (SAHAPS), funded by the National Institute of Child Health and Development, Maman and others evaluate whether enhanced post-test support for HIV-positive and HIV-negative pregnant women works better than standard care. Enhancements include additional counseling sessions and access to ongoing support groups and legal services free of charge. Almost one-third of pregnant women in South Africa tested positive for HIV in 2005, so finding interventions that best reduce transmission is critical. Maman and colleagues hope the enhanced intervention will result in m ore women participating in available health services; better health and psychosocial outcomes for women; reduction of transmission risk between partners and fewer instances of mother-to-child HIV/AIDS transmission.
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From the Arctic to the Amazon: linking diet and disease
Nutrition associate professor Sangita Sharma, PhD, travels the world to see what people eat. Looking for associations between diet and health in multiethnic populations, she hopes to find clues that will help reduce the prevalence of chronic disease in vulnerable populations worldwide.
In Arctic Canada, Sharma and her team are linking environmental changes to changes in nutrition, showing that climate change may be affecting the dietary intake of Inuit. In Brazil, Sharma has developed a dietary assessment method to look at total dietary intake, including fruits and vegetables, for Japanese-Brazilian populations to compare their risk of colorectal cancer with Japanese populations living in Tokyo and Honolulu. Using a combination of nutritional science, epidemiology, and dietary assessments, Sharma has also conducted research in Barbados, Cameroon, England, Indonesia, Jamaica, Nepal and the United States, including Alaska. In addition to research, she works with government and non-government organizations to conduct dietary interventions to help improve the public’s diet and reduce the risk of chronic disease. (back to top)
Reaching globally for access to healthcare
Fifty percent of the world’s population consists of the urban poor. Urban populations in Africa and Asia are expected to double between 2000 and 2030. This growth will bring greater need for services that address maternal and infant mortality, family planning and other issues related to living in poverty.
Maternal and child health research associate professor Ilene Speizer, PhD, is leading a six-year, $22 million dollar project funded by the Bill & Melinda Gates Foundation to evaluate programs that provide women and families living in the slums of sub-Saharan Africa and South Asia with choices regarding family planning. Speizer is leading the Measurement, Learning and Evaluation (MLE) for the Urban Reproductive Health Initiative project aimed at improving contraceptive choice in India, Nigeria, Kenya and Senegal. Based at UNC’s Carolina Population Center, her team will identify the most cost-effective ways to improve the quality of and access to family planning and reproductive health services for the urban poor. The project will also: build research and evaluation capacity in the four countries; disseminate findings globally; and encourage the use of data for decision-making with the goal of reducing unintended pregnancies and thus reducing maternal and infant mortality. (back to top)