Improving women's lifelong health after high-risk pregnancy
Lead Research Organisation:
University of Oxford
Department Name: Women s and Reproductive Health
Abstract
Cardiovascular diseases (CVDs), such as strokes and heart attacks, are the leading causes of death amongst women globally. A particular group of women at high risk of cardiovascular disease are those who experience a pregnancy complicated by gestational diabetes mellitus (GDM) and/or a hypertensive disorder of pregnancy (HDP). Following a pregnancy affected by GDM, within 5 years up to 50% of women will develop T2DM; and following HDP, 30% of women will develop hypertension. Both these conditions greatly increase risk for CVD, however with timely detection and management these risks can be greatly reduced. The importance of breaking this link between high-risk pregnancy and CVD is widely acknowledged, yet to date there have been no trials demonstrating this can be achieved, and importantly whether it can be done affordably and at scale. Three key actions are needed: (i) effective primary prevention; (ii) regular screening, and (iii) evidence-based management when disease is detected.
India is experiencing an epidemic of type 2 diabetes mellitus (T2DM) and hypertension. 73 million people have diabetes, and 207 million hypertension (2017 data). Rates of GDM and HDP are high, affecting 20% and 10% of pregnancies, respectively. There is an urgent need for effective and affordable preventative strategies to reduce the economic, social and health consequences of these conditions for women in India.
In the UK, GDM and HDP are the commonest complications of pregnancy. After a pregnancy with GDM, women should undergo screening with their GP 6 week after birth for persistent high blood glucose. Attendance however is generally poor, with rates between 30-70% across the country. Following HDP, evidence is needed to guide care.
The Fellowship will enable me to lead connected programs of work across two countries: India and the UK, determining the role digital innovations could play to deliver post-partum interventions in women globally. I will conduct two clinical studies, with active engagement with policy makers, clinicians, digital health companies and social enterprises throughout the Fellowship.
SMART Health is a digital platform, developed by the George Institute for Global Health, that has been implemented in India, Indonesia, China, and Myanmar, to improve detection and management of diabetes and hypertension. The platform is aimed at rural community health workers and primary care doctors, enabling task shifting, clinical decision support, automated referral, SMS reminders, and patient tracking. Since 2017, I have been leading the group adapting this platform to improve the detection and management of anaemia, GDM and HDP in pregnant women living in rural India: SMART Health Pregnancy (SHP). Through this Fellowship I will extend SHP to facilitate prevention, screening, and early treatment of hypertension and T2DM in the years after a pregnancy complicated by GDM and/or HDP. The effect of this on achieving target blood pressure and blood glucose control after high risk pregnancy will be assessed in a large clinical trial in rural India, following 960 women for 5 years.
In the UK, I was part of the team of clinicians and researchers in Oxford who developed a remote monitoring system for women with GDM (GDmHealth). We demonstrated in a clinical trial that this approach was safe, convenient and preferred by women and health workers. The technology was licensed to a commercial company (Sensyne) in 2018, and since then thousands of women have benefited from this innovation across the UK. Through this Fellowship I will lead a program of work adapting this approach for women in the year after birth, assessing whether remote monitoring improves screening attendance, deliver effective lifestyle support, offer a potential cost savings to the NHS, whilst being acceptable and more convenient for new mums. Theis approach could improve their health, for future pregnancies and lifelon
India is experiencing an epidemic of type 2 diabetes mellitus (T2DM) and hypertension. 73 million people have diabetes, and 207 million hypertension (2017 data). Rates of GDM and HDP are high, affecting 20% and 10% of pregnancies, respectively. There is an urgent need for effective and affordable preventative strategies to reduce the economic, social and health consequences of these conditions for women in India.
In the UK, GDM and HDP are the commonest complications of pregnancy. After a pregnancy with GDM, women should undergo screening with their GP 6 week after birth for persistent high blood glucose. Attendance however is generally poor, with rates between 30-70% across the country. Following HDP, evidence is needed to guide care.
The Fellowship will enable me to lead connected programs of work across two countries: India and the UK, determining the role digital innovations could play to deliver post-partum interventions in women globally. I will conduct two clinical studies, with active engagement with policy makers, clinicians, digital health companies and social enterprises throughout the Fellowship.
SMART Health is a digital platform, developed by the George Institute for Global Health, that has been implemented in India, Indonesia, China, and Myanmar, to improve detection and management of diabetes and hypertension. The platform is aimed at rural community health workers and primary care doctors, enabling task shifting, clinical decision support, automated referral, SMS reminders, and patient tracking. Since 2017, I have been leading the group adapting this platform to improve the detection and management of anaemia, GDM and HDP in pregnant women living in rural India: SMART Health Pregnancy (SHP). Through this Fellowship I will extend SHP to facilitate prevention, screening, and early treatment of hypertension and T2DM in the years after a pregnancy complicated by GDM and/or HDP. The effect of this on achieving target blood pressure and blood glucose control after high risk pregnancy will be assessed in a large clinical trial in rural India, following 960 women for 5 years.
In the UK, I was part of the team of clinicians and researchers in Oxford who developed a remote monitoring system for women with GDM (GDmHealth). We demonstrated in a clinical trial that this approach was safe, convenient and preferred by women and health workers. The technology was licensed to a commercial company (Sensyne) in 2018, and since then thousands of women have benefited from this innovation across the UK. Through this Fellowship I will lead a program of work adapting this approach for women in the year after birth, assessing whether remote monitoring improves screening attendance, deliver effective lifestyle support, offer a potential cost savings to the NHS, whilst being acceptable and more convenient for new mums. Theis approach could improve their health, for future pregnancies and lifelon
Planned Impact
India impact:
- Short term: Women and their families participating will directly benefit with improvements in their health and wellbeing. A major challenge in the Indian sites is the low status of women in rural communities. Through local public awareness campaigns we hope to promote the status of women, valuing women's health through the life course, and work with communities to create enabling environments for changing attitudes to gender and health.
- Community health workers and primary care doctors will benefit through educational activities, directly impacting patient care during and after the study.
- Short term impact from the policy symposia will be raised awareness within the target groups, with ultimate impact being adoption of a practical and feasible policy for postpartum surveillance and care, to be adopted within 8 years.
- Evidence moving from the pilot study (currently underway) to the larger trial proposed will impact research design and conduct in this setting in the future. I will build research capacity in India, helping team members further their own programs of research in India beyond the Fellowship.
- Longer term: Given in India approximately 25 million babies are born each year and up to 20% of pregnant women will have either GDM or HDP, a 15% improvement in on-target blood glucose or blood pressure in the high-risk group could improve the lives of up to 500 000 women each year, with substantial longer term wider economic and societal benefits as CVD or other complications are averted.
UK impact
- Short term: Women participating in the feasibility study will benefit from the increased preventative health advice and the opportunity to link with other new mums through a social network. This will boost their capacity to make positive lifestyle changes, with immediate and medium-term impacts on their health and wellbeing. If we proceed to the larger, definitive trial, women who receive the intervention will benefit from the above, as well as avoiding the 6-week GP check. This will be cost saving for the NHS if scaled (currently these appointments cost the NHS approx £1M per year).
- The UK roundtable will bring together key groups to discuss what is needed to improve screening rates and women's lives. The impact of this meeting will be formation of a research consortium, to gain competitive funding to conduct the larger definitive trial.
- Longer term: Evidence generated through this research will be used in the formulation of updates to UK clinical guidelines (NICE guidelines 3 and 133), Quality standards in these guidelines are used to benchmark maternity services. If remote monitoring is effective, this could change the way women engage with the health system after birth for other conditions, such as mental health, providing an exemplar of an integrated and evidence-based remote monitoring system.
Global policy impact
- This fellowship will directly provide evidence to update the FIGO initiative on GDM (2015) and the WHO recommendations on postnatal care of the mother and newborn (2013)
Academic impact:
- This will be of interest to academics (outlined in the beneficiaries statement), as well as groups calling on a focus on the specific needs of women for CVD research, prevention and health care delivery, e.g. the Lancet Commission on Women's health and CVD, British Heart Foundation, Women Deliver and the NCD Alliance (see support letters). Longer term, all data will be open access and available to the research community (see data management plan)
Commercial impact
- The UK could become the world leader in digital technologies to support women during and after high-risk pregnancy, challenging current care delivery. GHE have extensive networks across Asia, with a ready market for expansion to the sites already using the SMART Health system. Sensyne work closely with the NHS and partners in the US (Jefferson Health), opening international commercial opportunities.
- Short term: Women and their families participating will directly benefit with improvements in their health and wellbeing. A major challenge in the Indian sites is the low status of women in rural communities. Through local public awareness campaigns we hope to promote the status of women, valuing women's health through the life course, and work with communities to create enabling environments for changing attitudes to gender and health.
- Community health workers and primary care doctors will benefit through educational activities, directly impacting patient care during and after the study.
- Short term impact from the policy symposia will be raised awareness within the target groups, with ultimate impact being adoption of a practical and feasible policy for postpartum surveillance and care, to be adopted within 8 years.
- Evidence moving from the pilot study (currently underway) to the larger trial proposed will impact research design and conduct in this setting in the future. I will build research capacity in India, helping team members further their own programs of research in India beyond the Fellowship.
- Longer term: Given in India approximately 25 million babies are born each year and up to 20% of pregnant women will have either GDM or HDP, a 15% improvement in on-target blood glucose or blood pressure in the high-risk group could improve the lives of up to 500 000 women each year, with substantial longer term wider economic and societal benefits as CVD or other complications are averted.
UK impact
- Short term: Women participating in the feasibility study will benefit from the increased preventative health advice and the opportunity to link with other new mums through a social network. This will boost their capacity to make positive lifestyle changes, with immediate and medium-term impacts on their health and wellbeing. If we proceed to the larger, definitive trial, women who receive the intervention will benefit from the above, as well as avoiding the 6-week GP check. This will be cost saving for the NHS if scaled (currently these appointments cost the NHS approx £1M per year).
- The UK roundtable will bring together key groups to discuss what is needed to improve screening rates and women's lives. The impact of this meeting will be formation of a research consortium, to gain competitive funding to conduct the larger definitive trial.
- Longer term: Evidence generated through this research will be used in the formulation of updates to UK clinical guidelines (NICE guidelines 3 and 133), Quality standards in these guidelines are used to benchmark maternity services. If remote monitoring is effective, this could change the way women engage with the health system after birth for other conditions, such as mental health, providing an exemplar of an integrated and evidence-based remote monitoring system.
Global policy impact
- This fellowship will directly provide evidence to update the FIGO initiative on GDM (2015) and the WHO recommendations on postnatal care of the mother and newborn (2013)
Academic impact:
- This will be of interest to academics (outlined in the beneficiaries statement), as well as groups calling on a focus on the specific needs of women for CVD research, prevention and health care delivery, e.g. the Lancet Commission on Women's health and CVD, British Heart Foundation, Women Deliver and the NCD Alliance (see support letters). Longer term, all data will be open access and available to the research community (see data management plan)
Commercial impact
- The UK could become the world leader in digital technologies to support women during and after high-risk pregnancy, challenging current care delivery. GHE have extensive networks across Asia, with a ready market for expansion to the sites already using the SMART Health system. Sensyne work closely with the NHS and partners in the US (Jefferson Health), opening international commercial opportunities.
Organisations
Publications
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Ayman G
(2021)
The top 10 research priorities in diabetes and pregnancy according to women, support networks and healthcare professionals.
in Diabetic medicine : a journal of the British Diabetic Association
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Bonell A
(2022)
Environmental heat stress on maternal physiology and fetal blood flow in pregnant subsistence farmers in The Gambia, west Africa: an observational cohort study.
in The Lancet. Planetary health
![publication icon](/resources/img/placeholder-60x60.png)
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Bonell A
(2023)
An expert review of environmental heat exposure and stillbirth in the face of climate change: Clinical implications and priority issues
in BJOG: An International Journal of Obstetrics & Gynaecology
![publication icon](/resources/img/placeholder-60x60.png)
Bonell A
(2023)
A feasibility study of the use of UmbiFlow™ to assess the impact of heat stress on fetoplacental blood flow in field studies.
in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
![publication icon](/resources/img/placeholder-60x60.png)
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Cansdale LG
(2022)
Use of mHealth tools to register birth outcomes in low-income and middle-income countries: a scoping review.
in BMJ open
![publication icon](/resources/img/placeholder-60x60.png)
Carcel C
(2024)
A life-course approach to tackling noncommunicable diseases in women.
in Nature medicine
Description | Using an approach called SMART Health Pregnancy, we have developed a new way to deliver guideline-based care for pregnant and recently pregnant women in India. SMART Health Pregnancy supports frontline community health workers (ASHA workers in India) to screen for high blood pressure, anaemia and diabetes in women's homes. Importantly, the system automatically refers and links women with doctors at the primary care centre, who are also supported by a tablet app and can then prescribe guideline-based management. The system was co-designed with users and focusses on the three most common maternal medical conditions in rural India: anaemia, preeclampsia and diabetes. Our team has successfully concluded the SMART Health Pregnancy pilot cluster randomised trial in four rural sites in India. This pilot study, involving 200 pregnant women and 50 frontline health workers, has demonstrated the feasibility and acceptability of the SMART Health Pregnancy approach among women and frontline health workers. Despite the challenging COVID-19 restrictions in India in 2020, the pilot study showcased encouraging results, with high rates of women up to 6 weeks after preg of follow-up. We are now testing whether SMARThealth Pregnancy can improve critical clinical conditions, such as anaemia, in women and whether it can be implemented at scale. To do this, we are conducting a trial in 60 villages across two states in India. We have recruited 3,500 pregnant women and will follow them until one year after birth. We are developing a perinatal mental health intervention for women in rural India (PRAMH) and a large language model chatbot designed to support community health workers. |
Exploitation Route | The findings of this research are of interest to providers of maternal care in many resource-constrained areas around the world. Whilst we are still evaluating the effects on clinical endpoints, we have demonstrated that task shifting of screening during pregnancy is feasible and acceptable, and how digital tools can be used to strengthen quality of care. |
Sectors | Communities and Social Services/Policy Digital/Communication/Information Technologies (including Software) Healthcare |
URL | https://www.wrh.ox.ac.uk/research/smarthealth-pregnancy-improving-women2019s-life-long-health-in-rural-india |
Description | Our approach is a novel approach to integrating non-communicable disease screening into pregnancy and postnatal care. While our main study is ongoing, I have presented the work to colleagues from FIGO, who have developed Pregnancy Passport, which has similar aims but no evidence for implementation. I am supporting two public health students in Rwanda who will be testing a simlar approach. |
First Year Of Impact | 2023 |
Sector | Digital/Communication/Information Technologies (including Software),Healthcare |
Impact Types | Policy & public services |
Description | Expert advisor on NICE Quality Standards Committee for Diabetes in Pregnancy |
Geographic Reach | National |
Policy Influence Type | Participation in a guidance/advisory committee |
URL | https://www.nice.org.uk/guidance/qs109/chapter/Quality-statements |
Description | NICE Diabetes Committee member |
Geographic Reach | National |
Policy Influence Type | Membership of a guideline committee |
Impact | All women in NHS England are now eligible and are given support for CGM during pregnancy. Based on the CONCEPPT trial, this is anticipated to have significant cost savings and benefits with respect to NICU admission and neonatal outcomes. |
URL | https://www.nice.org.uk/guidance/ng3 |
Description | NICE guideline on Maternal and Child nutrition |
Geographic Reach | National |
Policy Influence Type | Participation in a guidance/advisory committee |
Description | RCOG Scientific Impact Statement on Social Determinants of Maternal Health |
Geographic Reach | National |
Policy Influence Type | Membership of a guideline committee |
URL | https://www.rcog.org.uk/en/news/understanding-the-relationship-between-social-determinants-of-health... |
Description | A multidisciplinary roundtable on novel machine learning approaches for complex clinical data with a focus on improving care for women with Gestational Diabetes Mellitus |
Amount | £5,000 (GBP) |
Organisation | University of Southampton |
Department | ESRC National Centre for Research Methods |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 12/2022 |
End | 01/2023 |
Description | Applied Global Health Research Board Networking Award |
Amount | £18,000 (GBP) |
Funding ID | MC_PC_23051 |
Organisation | Medical Research Council (MRC) |
Sector | Public |
Country | United Kingdom |
Start | 12/2023 |
End | 02/2024 |
Description | Effects of extreme heat on maternal, placental and fetal physiology, lactation and newborn health in India |
Amount | £319,301 (GBP) |
Funding ID | 227191/Z/23/Z |
Organisation | Wellcome Trust |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 08/2023 |
End | 09/2028 |
Description | Imperial India Connect Fund |
Amount | £4,995 (GBP) |
Organisation | Imperial College School of Medicine |
Sector | Academic/University |
Country | United Kingdom |
Start | 01/2024 |
End | 07/2024 |
Description | PHIND |
Amount | £199,999 (GBP) |
Organisation | Medical Research Council (MRC) |
Sector | Public |
Country | United Kingdom |
Start | 01/2024 |
End | 12/2024 |
Description | WHo ICFP Scientific Writing, Menotring and Coaching Course |
Amount | $3,000 (USD) |
Organisation | World Health Organization (WHO) |
Sector | Public |
Country | Global |
Start | 11/2022 |
End | 02/2023 |
Description | Digital health in Africa |
Organisation | University College Cork |
Department | Department of Epidemiology and Public Health |
Country | Ireland |
Sector | Academic/University |
PI Contribution | I am a member of the Scientific Advisory Committee for the Ultra project, which is a digital health initiative for maternity care in Tanzania |
Collaborator Contribution | regular convening of meetings, development of the intervention, testing the inervention, reviewing evidence, engaging with policy makers, seeking further funding options |
Impact | Publication: Cansdale et al 2022. |
Start Year | 2021 |
Description | Heat in Pregnancy- India |
Organisation | Translational Health Science And Technology Institute |
Country | India |
Sector | Public |
PI Contribution | 1. Co-developed a successful application to the Wellcome to study the effects of heat in pregnancy 2. Convened a large UK and India group of collaborators to work on this project |
Collaborator Contribution | Supporting the establishment of the HiP-India project, including support with gaining all relevant Indian permissions and ethics |
Impact | Publications: 1. Rehka et al BJOG paper 2023 Multidisciplinary consortia: University of Oxford, Imperial College London, St Georges University London THSTI, The George Institute for Global Health India, IIt Delhi, SRIHER, Podicherry institute of medical sciences, Chhattisgarh Institute of Medical Sciences, Care Mother 2. Media: Interviewed by BBC Global Health Correspondent Tulip Mazumbar, March 2024 |
Start Year | 2023 |
Description | SMARThealth Pregnancy |
Organisation | George Institute for Global Health |
Department | George Institute for Global Health (India) |
Country | India |
Sector | Charity/Non Profit |
PI Contribution | I established the SMART Health Pregnancy program between the University of Oxford and the George Institute for Global Health (TGIGH) in 2021. In 2023, I moved my UKRI FLF to Imperial College London, and I also moved this collaboration. Contributions: 1. Design and leading the SMARThealth Pregnancy cluster trial 2. Supervising the Process and implementation analyses 3. Directly supervising two PhD students and two medical students working as part of this collaboration 4. Supporting the successful application for further funding from BMGF for the Chat GPT add-on for SMARThealth Pregnancy 5. Post doc (N Votruba) leads the perinatal mental health component of SHP (PRAMH) |
Collaborator Contribution | 1. Co-leading from India the SMARThealth Pregnancy cluster trial 2. All aspects of operationalisation of the trial including field work, training, data management, ethics 3. Leading the Chat GPT add-on program 4. Supporting operationalisation of the PRAMH perinatal mental health study |
Impact | 1. Publications: -Main trial protocol -PRAMH protocol -Chat GPT development -Pilot study findings 2. Presentations -DIWAS Diabetes In Pregnancy national Indian conference 2023 -AI and healthcare conference Goa 2022 -Diabetes, Hypertension and Metabolic Syndrome Conference Thessaloniki 2023 -SPHERE conference, Dublin 2024 -CUOGS conference Cambridge 2024 -Imperial College Women's health Network of Excellence, 2023 3. Other -Podcast UK Health Radio 2023 -Webinar C3 Action for Health Network event 2023 -Local media India |
Start Year | 2021 |
Title | SMART Health Pregnancy 2: A Cluster Randomised Trial of a complex intervention to improve women's health in rural India |
Description | Medical and nutritional complications in pregnancy affect the development of the fetus, risks around childbirth, and women's future health and wellbeing. Anaemia affects over 50% of pregnant women in India and reduction is a national priority. Women who develop gestational diabetes mellitus (GDM) or hypertensive disorders of pregnancy (HDP) are at significantly increased risk of pregnancy complications and future type 2 diabetes, hypertension or cardiovascular disease. SMART Health Pregnancy is a tool developed to improve guideline-based screening and management of anaemia, diabetes and hypertension during pregnancy and in the first year after birth. We have completed a 200- woman pilot and feasibility study and are now assessing the intervention across 60 villages (approx 3500 women) in two startes in India. This is a pragmatic, type 2 hybrid effectiveness/implementation cluster randomised controlled trial. The unit of randomisation will be the Primary Health Centre (PHC). The principle source of funding is the UKRI Future Leaders Fellowship. |
Type | Health and Social Care Services |
Current Stage Of Development | Early clinical assessment |
Year Development Stage Completed | 2021 |
Development Status | Under active development/distribution |
Impact | We have conducted national stakeholder workshops on high risk pregnancy conditions in India and are currently developing a perinatal mental health component. |
URL | https://www.georgeinstitute.org/projects/smarthealth-pregnancy-improving-womens-life-long-health-in-... |
Title | SMARThealth Pregnancy GPT |
Description | I am co-leading the development of a Chatbot based on Chat-GPT for community health workers in India. We are developing a technical and clincial validation pipeline |
Type Of Technology | Webtool/Application |
Year Produced | 2024 |
Open Source License? | Yes |
Impact | -Presentation of the development of the tool at Neuro-IPS 2023 |
URL | https://www.medrxiv.org/content/10.1101/2023.12.15.23300009v1.full.pdf |
Description | C3 Webinar |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Webinar organised by the not for profit C3 to promote the idea of pregnancy as an opportunity for lifelong health |
Year(s) Of Engagement Activity | 2023 |
URL | https://www.c3health.org/?s=hirst |
Description | Convening a national workshop on data science and diabetes in pregnancy |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Industry/Business |
Results and Impact | This Innovation Forum brought together a multidisciplinary group of 30 researchers, clinicians, machine learning data scientists, industry partners, NHS Digitial, and others to discuss the opportunities and challenges for improving clinical care using complex clinical data. The workshop focussed on one specific clinical challenge, Gestational Diabetes Mellitus (GDM), with consideration of other data science challenges and solutions in pregnancy care more widely and other clinical conditions. The Forum was an opportunity to learn about specific data challenges researchers had experienced, learn from what has worked, and where further research is needed. We identified several opportunities for GDM data research in the UK, including the commissioning of the first national GDM audit and a need to focus on preventing type 2 diabetes after GDM in young women. The Forum identified six areas for future work and funding: (i) support for infrastructure to enable data science in this field; (ii) the need to map available data sources in the UK for pregnancy research; (iii) streamlined solutions for ethical approvals and regulatory support; (iv) improving data quality, linkage and access for researchers; (v) development of machine learning and statistical approaches; and (vi) the need to collaborate with clinicians, women and their families to make sure data science improves lives. |
Year(s) Of Engagement Activity | 2022 |
Description | India Birth Network |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | I was invited to attend the India Birth Network, an initiative led by the Liverpool School of Tropical Medicine and Christian Medical College, Vellore India. This was a 2-day meeting to network between UK and Indian researchers working in maternity research. Unfortunately due to COVID19, I was only able to attend virtually. |
Year(s) Of Engagement Activity | 2022 |
Description | RCOG Social Determinants of Maternal Health Scientific Impact Statement Launch |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | This was a media release from the RCOG about the new SIP on social determinants of maternal health. It was promoted through RCOG and University social media |
Year(s) Of Engagement Activity | 2022 |
Description | Webinar Bridging the Gaps in Maternal Health Health during pregnancy |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Webinar to present the findings of a scoping review on guidelines and policies for cardiovascualr diseases in pregnancy in low and middle income countries |
Year(s) Of Engagement Activity | 2023,2024 |
URL | https://www.georgeinstitute.org.uk/events/bridging-the-gaps-in-maternal-heart-health-during-pregnanc... |