Healthy Mothers, Healthy Babies (HMHB)

Healthy Mothers, Healthy Babies (HMHB) is a collaborative research program aimed at providing life-saving health care for women and children in Papua New Guinea (PNG). It's one of Burnet's flagship initiatives.

HMHB aims to define the major causes of poor maternal, newborn, and child health, and to identify feasible, acceptable and effective interventions and service delivery strategies to improve reproductive, maternal, neonatal and child health (RMNCH) outcomes in PNG.

There are 5 program objectives:

• identify and quantify major causes of illness in mothers, newborns and infants attending health care facilities, and the impact of illnesses in pregnancy on poor pregnancy outcomes for mother and infant
• identify key determinants of current maternal, newborn and child health (MNCH) care utilisation, patterns (such as timeliness and completeness) of utilisation through pregnancy and the first year of life, and the predictors of optimal utilisation of health services for MNCH
• evaluate RMNCH services and identify strategies to improve services aimed at reducing sickness and death
• examine sexual and reproductive health knowledge, attitudes, practices and outcomes among young people, and use this knowledge to develop strategies and inform policy development to improve sexual and reproductive health
• identify strategies to improve RMNCH care, and strengthen disease control and develop new interventions to improve maternal and child health, targeted to populations in PNG with varying levels of access to health services.

HMHB includes 5 separate but complementary studies to provide a complete overview of the issues being faced. The emphasis is on the generation of evidence that has immediate use in East New Britain to improve services, and that can inform future health policy in PNG and similar settings.

The program addresses 3 major needs:

• developing and testing better ways to provide interventions of proven effectiveness to communities that currently lack access
• defining the major disease burdens that contribute to maternal and infant mortality, such as anaemia, malaria, tuberculosis (TB), sexually transmissible infections (STIs), malnutrition, and maternal complications of childbirth
• developing new and more effective interventions to improve maternal and child health.

Understanding the causes of poor health among pregnant women and infants

In resource-poor regions globally, pregnant women experience high rates of malaria, anemia, under-nutrition, reproductive tract infections, and other viral and bacterial infections.

These issues can lead to morbidity and mortality in women. In infants, these factors can cause low birth weight (LBW) and premature delivery resulting in a significant number of infant deaths each year. 

Being born too small is the biggest risk factor for neonatal death, and also puts infants at risk of poor growth and development.

Poor growth and development in young children, often referred to as stunting, is a major problem in many regions and is associated with 40% of deaths in young children as well and many chronic health problems.

However, the roles of nutrition, anemia, malaria, and other infections on birth outcomes and child growth and development are not well understood which limits the development and implementation of effective strategies and interventions.

Through the HMHB initiative, we have undertaken a longitudinal study of 700 pregnant women attending antenatal care and followed them through to delivery and followed the mothers and their infants for 12 months after delivery.

Among these women, we are evaluating nutrition, including evaluating specific micronutrient deficiencies, metabolic status, anemia, and a range of infections including malaria.