Harvard Catalyst Profiles

Causes of maternal morbidity and mortality are multifactorial and identifying effective interventions to improve perinatal care in order to reduce avoidable maternal and neonatal morbidity and mortality is challenging. Measurement of the impact of such interventions is equally challenging. Building on the infrastructure of the Tsepamo Birth Outcomes Surveillance Study, the Safe Birth Study was designed to better understand maternal morbidity and mortality in Botswana. The pilot study was launched in November of 2021 with the aim of better understanding baseline maternal morbidity and mortality at Princess Marina Hospital, collecting additional observational data around mode of delivery, delivery complications, perinatal medical complications, and extraordinary interventions. Baseline data and ongoing surveillance will enable the design and evaluation of quality improvement interventions aimed at reducing maternal near-miss and maternal mortality. Students would have the opportunity to participate in on-going data collection, analysis and have the opportunity to develop their own research questions from the data set.

This HPV-based cervical cancer screening study was started in 2018 with the aim of improving cervical cancer screening by evaluating cancer screening algorithms using primary HPV testing followed by standard-of-care and novel triage strategies in women in Botswana. Thus far, the study has evaluated HPV followed by Pap Smear, visual inspection with acetic acid, colposcopy, and automated visual evaluation. Over the past year, there has been on-going recruitment of a cohort of 3000 women in South East District. A total of 2870 women have been enrolled to date. Interval follow-up of the women living with HIV in the cohort is planned at 2 and 3 year intervals, and will begin in March 2023. Data from this study will provide critical effectiveness and implementation data to guide HPV-based screening programs in the region. Students will have the opportunity to develop their own research questions and carry out their project and analysis. Students who travel to Botswana will have the opportunity to participate in day-to-day research activities, understanding considerations for how to implement clinical research in LMICs.