March of Dimes Global Network for Maternal and Infant Health

Since the establishment of its Global Programs in 2008, March of Dimes has worked hard to improve birth outcomes in low- and middle-income countries. To date, Global Programs has overseen projects in 33 countries through a partnership mechanism that it calls the "mission alliance." The ideal mission alliance partner is one which has an established presence in the target country, including legal status, the support of and connection to its Ministries of Health and Finance and a local infrastructure; shares our mission to improve the health of newborns; and demonstrates financial health and stability. Together with our international and U.S. partners, March of Dimes has conducted interventions over the past decade that have been well-planned and executed, product-intensive, of short turn-around and measurable. In doing so, March of Dimes has respected the individual cultural differences of our partner organizations. We also have offered our technical partners technical expertise and the extensive resources of the March of Dimes, including professional and public health education materials and tools for establishing data collection systems, which have been easily adapted by our mission alliance partners to local conditions and needs. Working in this manner, March of Dimes has become a highly-visible, trusted and respected ally in the eyes of our developing country colleagues and a source of scientifically-robust data, curricula and other informational materials for use both in lower-income countries and in resource-poor settings in industrialized countries.

In 2008, March of Dimes combined its four strongest mission alliance partners in China (Peking University), Lebanon (American University of Beirut), Philippines (National Institute of Health) and Brazil (Hospital de Clinicas de Porto Alegre), creating the March of Dimes Global Network on Maternal and Infant Health (GNMIH). These four countries were selected, not just because of the strengths of our principal investigators and their institutions, but also because all have levels of health system and professional capacity that allow for implementation and evaluation of the kinds of programs at which the March of Dimes and its U.S. and international partners excel. In addition, each partner has links to and the support of their respective ministries of health and finance. This collaboration with government is another reason why March of Dimes mission alliances with the GNMIH and our other mission alliance partners have been successful and sustainable to date.

The goal of the GNMIH is to allow developing country experts to share their knowledge, experience, skills and materials in ways that improve birth outcomes. The core philosophy of the network is communication and collaboration from the earliest stages of proposal development through the conduct and evaluation of network projects. The objectives of the GNMIH are to establish surveillance systems to capture data on adverse birth outcomes; train primary care providers in best practices in care and prevention; partner on education and intervention at the community and family level; and strengthen parent-patient groups and other national networks.

The benefits of the GNMIH include the fact that it provides a platform for developing and industrialized country experts to exchange knowledge and lessons learned; promotes both a common and complementary portfolio of research and program activities across network centers; and encourages a consistent methodological approach to data collection, evaluation and analysis, thus enhancing the opportunity to contrast or even pool project findings across centers. Importantly, each of the GNMIH centers has close links, not only with their respective government ministries, but also with the broader community of health professionals, public health workers, laboratories, hospitals and the public in their respective countries and regions. Thus, each member of the GNMIH has the potential to become a hub of a regional network with common goals, approaches and programs.

An additional strength of the GNMIH is its heterogeneity. The four middle-income countries participating in the network represent four different regions of the world: Latin America, the eastern Mediterranean, western Pacific and China. The target populations in these countries are uniquely varied with respect to geography; the racial, ethnic and social makeup of its populations; and the predominant risk factors and gaps in health services delivery contributing to the high toll of birth defects and preterm birth in their populations. These differences present unique opportunities for evaluating interventions, professional and public education and other programs in a variety of target populations.