Zambia OB-GYN and her team receives US$3M from Helmsley Charitable Trust Grant for expansion of antenatal program in the country

ZAMBIA – Dr. Margaret Kasaro, an obstetrician and gynecological doctor (OB-GYN), and her team at the University of North Carolina-Global Project Zambia (UNC-GPZ), have received US$ 3 million from the Leona M. and Harry B. Helmsley Charitable Trust to expand their antenatal care project in Zambia.

The grant from the Helmsley Charitable Trust will help the UNC-GPZ team in their efforts to incorporate portable ultrasounds into antenatal care facilities throughout Zambia.

Dr. Margaret Kasaro said, “What we hope to show is that these portable ultrasound devices, which do not require years of ultrasound training to learn to use, can expand services to areas with limited access.”

The OB-GYN added that her team hoped to produce evidence that will be useful to the Zambian government in a possible future scale-up of the technology, particularly in areas with limited access, where women really need this service.

The grant aims to help prepare for the type of scale-up needed to achieve World Health Organization (WHO) antenatal care guidelines that every pregnant woman undergo at least one ultrasound examination in her antenatal period.

Improving pathways to better maternal and fetal care in Zambia

Each year, around 300,000 women and 3 million babies worldwide die during childbirth or shortly thereafter, according to the World Health Organization.

Understanding its own high maternal mortality rate which stands at 135.00 in 2020, an 4.65% increase from 2019, the Zambia government and its partners are taking decisive action to bring the number down.

For instance, Zambia’s Minister of Health recently made a policy pronouncement that abolished user fees for ultrasound examination in Public Health facilities to promote early antenatal attendance by providing a free ultrasound scan.

The government is committed to closing this gap and portable ultrasound devices may be a solution to this problem.

For obstetricians, ultrasounds are an essential tool, and having an accurate gestational age of the pregnancy informs most decisions that need to be made to provide the best care, and may, for example, reduce the need for unnecessary interventions like labor induction.

Low-cost handheld ultrasound technology and product development over recent years now offer the promise of greatly expanding access to ultrasounds and improving outcomes for mothers and babies worldwide.

Seeing the potential of these low-cost handheld ultrasounds, the UNC Global Women’s Health team has been working over the past five years to develop integrated tools to make them more accessible to nurses and midwives with no sonography training.

The Fetal Age Machine Learning Initiative (FAMLI), led by Jeffrey Stringer, MD, a professor of OB-GYN at the UNC School of Medicine and the director of Global Women’s Health, has developed machine learning algorithms that can determine the gestational age and is developing additional guided assessments.

This new grant from the Helmsley Charitable Trust will extend this work by helping to understand how these tools can be successfully translated from the lab into the type of real-world settings where they are most needed.

A key component of any rollout of newer technologies will be the willingness of both providers and patients to incorporate them into routine antenatal care.

Stephanie Martin, Ph.D., assistant professor of nutrition at the UNC Gillings School of Public Health, will be working with the team to examine the acceptability of these handheld ultrasound devices for both patients and providers.

“We want to understand their satisfaction with the device. Did it feel comfortable for them? Did they enjoy the experience? Were there any aspects of it that made them feel uncomfortable?” queried Dr. Martin.

Dr. Margaret Kasaro and her project to expand antenatal care in Zambia 

Dr. Margaret Phiri Kasaro is the Director of the UNC-GPZ, a research office under the Global Women’s Health Division, at UNC-Chapel Hill.

Dr Kasaro also holds the position of Research Assistant Professor, Global Women’s Health, and participates in teaching at the School of Public Health at the University of Zambia.

She received her medical degree from the University of Zambia and her Master of Science in Public Health from the London School of Hygiene and Tropical Medicine.

Her research interests are in HIV prevention and determinants of outcomes in maternal and child health.

Over the last 15 years, Dr. Kasaro has served in leadership roles in research. Some notable roles include serving as local principal investigator (PI) for several National Institutes of Health-funded HIV clinical trials.

She was the local principal investigator on the Evidence for Contraceptive Options and HIV Outcomes (ECHO) study that investigated the impact of contraceptive methods on HIV acquisition.

The focus of UNC-GPZ is maternal and child health research with a vision of local relevance and global visibility

Working closely with the Zambian government, this team had been instrumental in the rapid scale-up of public health interventions for HIV care, treatment, and prevention and had developed a robust research portfolio focusing on HIV, as well as in women’s cancers, obstetric outcomes, and maternal-child health.

UNC-GPZ has developed strong collaborations with the University of Zambia School of Medicine to further build research and public health infrastructure.

The broad approach to collaboration has expanded to include faculty from Carolina’s Gillings School of Global Public Health and Eshelman School of Pharmacy.

UNC Project-Zambia now supports 20 research grants and employs 104 Zambians.

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