Improving maternal health is one of the eight Millennium Development Goals identified by the United Nations. Although Rwanda has decreased its maternal mortality rate from the previous World Health Organization estimate of 1,300 maternal deaths per 100,000 live births, the Ministry of Health currently estimates that 750 Rwandan women die for every 100,000 live births, compared to 11 maternal deaths per 100,000 live births in the United States.
The Fulbright grant of up to $36,000 will allow Dr. Nathan to determine the effectiveness of mobile reproductive health care teams versus community-level birthing services in rural areas of Rwanda. Encompassing 50 villages in the Kibogora area, her research will impact a population of 29,000 people and is being conducted in conjunction with the National University of Rwanda, the local health leadership and Women's Equity in Access to Care and Treatment (WE-ACTx). Dr. Nathan's research is modeled after WE-ACTx's successful delivery of HIV counseling and testing through highly efficient mobile teams.
"It has been a goal of our team to bring these much-needed services to the region and provide a study that will lay the groundwork for improving health outcomes," said Dr. Nathan, who also is the Rwanda project director for the Global Women's Health and Primary Care Program of the department of obstetrics & gynecology and women's health at Einstein and Montefiore Medical Center. "The fact is that many Rwandan women are dying through childbirth and, in many cases, these tragic deaths are preventable."
Dr. Nathan and her research team will be evaluating and comparing the effectiveness of two interventions based at the most basic level of the Rwandan health system: health posts or ambulatory care centers. Her team will create a birthing center at one post, provide mobile birthing services at a second post, and monitor a third post, operating under conventional methods. At the end of the evaluation period the team hopes to determine which of the two interventions reduces maternal morbidity and mortality most significantly.
"Lisa is driven to serve," stated Irwin R. Merkatz M.D., the Chella and Moise Safra Chair in Obstetrics & Gynecology and Women's Health. "There is no obstacle too high or too difficult to dissuade her from her goal."
"Lisa has already made remarkable progress in a very short period of time," said Kathryn Anastos, M.D., professor of medicine and of epidemiology & population health at Einstein, and co-founder and director of scientific capacity building for WE-ACTx. "She will have the mobile teams and the maternity center operating before the end of the year, allowing for a real assessment of the impact of these two relatively low-cost interventions on maternal deaths. Her work with us may lead to models of service delivery that are replicable in other countries identified by the U.N. in the Millennium Development Goals."
Dr. Nathan is one of approximately 1,100 U.S. faculty and professionals who will travel abroad through the Fulbright U.S. Scholar Program in 2009-2010. Dr. Nathan completed her residency at Einstein and earned her medical degree from Rush Medical College in Chicago, Illinois. She holds a master's in public health from Northern Illinois University in DeKalb, Illinois, and a bachelor of science in biology from Bradley University in Peoria, Illinois.
Source: Albert Einstein College of Medicine
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