Boston University/Lata Medical Research Foundation Global Network for Women's Children's Health Research Unit

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PROJECT SUMMARY Although there have been improvements in the under age five mortality rate (U5MR) and neonatal mortality rate (NMR) in Indian children, the burden of death in this population is still one live births to deaths. To achieve the United Nations Sustainable Development Goals for the U5MR and NMR rate, there is still an urgent need for improvement in pre-pregnancy through childhood care in India and globally. The overarching goal of Boston University (BU) and Lata Medical Research Foundation's (LMRF) Global Network (GN) for Women's and Children's Health Research Unit (RU) is to continue to collaborate with other GN RUs on research to improve health outcomes for women and children in low- and lower middle-income countries (LMIC). We have had a GN RU in Nagpur, India continuously since 2008. Our RU is in the eastern part of the State of Maharashtra (center of India) where NMR and infant mortality rates are higher than the overall rates in the state and many other parts of India. Our RU involves a partnership between multiple Schools and Departments (particularly Global Health, Obstetrics, Pediatrics, and Infectious Diseases) at Boston University and the academic medical institutional consortium led by the LMRF in Nagpur, that provides clinical, research expertise and infrastructure support. Since 2008, our RU has been successfully implementing studies, by patient and public involvement and engagement strategy, that exemplify Global Network's goals to conduct high-impact clinical trials and observational studies of sustainable, cost-effective health interventions and their implementation in women and children in LMICs, and building sustainable professional capacity and infrastructure for infectious diseases (maternal and pediatric), obstetric, neonatal and pediatric research. In the current cycle of the GN, we have participated in all common protocols, and have maintained high recruitment and retention rates. We have led 5 research initiatives, including developing a new socioeconomic status index, and studying the risk of maternal, fetal and neonatal adverse outcomes associated with exposure to household air pollution, Caesarian Section delivery and Maternal Depression. We have also had a leadership role in the Azithromycin trial sub-study on risk of acquiring Azithromycin resistance using novel microbiome, metagenomics and whole genome sequencing approaches, which required helping develop lab capacity in several GN sites. We have jointly and successfully mentored 20 junior faculty, fellows and students who have led site specific and GN wide publications. continue growth and development of the Nagpur RU, advance the research network in the region, and sustain the research infrastructure for the design and conduct of public health research in the Nagpur academic institutions; strengthen research focused on the leading causes of morbidity and mortality in pregnancy and early childhood in the GN and in the Nagpur area by public and patient engagement; and continue to identify and address gaps in maternal and child research.