Maternal and perinatal Health Research Collaboration, India (MaatHRI): methodology for establishing a hospital-based research platform in a low and middle income country setting

Abstract

Background: Maternal and perinatal Health Research collaboration, India (MaatHRI) is a research platform that aims to improve evidence-based pregnancy care and outcomes for mothers and babies in India, a country with the second highest burden of maternal and perinatal deaths. The objective of this paper is to describe the methods used to establish and standardise the platform and the results of the process. Methods: MaatHRI is a hospital-based collaborative research platform. It is adapted from the UK Obstetric Surveillance System (UKOSS) and built on a pilot model (IndOSS-Assam), which has been extensively standardised using the following methods: (i) establishing a network of hospitals; (ii) setting up a secure system for data collection, storage and transfer; (iii) developing a standardised laboratory infrastructure; and (iv) developing and implementing regulatory systems. Results: MaatHRI was established in September 2018. Fourteen hospitals participate across four states in India – Assam, Meghalaya, Uttar Pradesh and Maharashtra. The research team includes 20 nurses, a project manager, 16 obstetricians, two pathologists, a public health specialist, a general physician and a paediatrician. MaatHRI has advanced standardisation of data and laboratory parameters, real-time monitoring of data and participant safety, and secure transfer of data. Four observational epidemiological studies are presently being undertaken through the platform. MaatHRI has enabled bi-directional capacity building. It is overseen by a steering committee and a data safety and monitoring board, a process that is not normally used, but was found to be highly effective in ensuring data safety and equitable partnerships in the context of low and middle income countries (LMICs). Conclusion: MaatHRI is the first prototype of UKOSS and other similar platforms in a LMIC setting. The model is built on existing methods but applies new standardisation processes to develop a collaborative research platform that can be replicated in other LMICs.

The complex relationship between iron status and anemia in pregnant and postpartum women in India: Analysis of two Indian study cohorts of uncomplicated pregnancies

“…We conducted a secondary analysis using data from two Indian study cohorts of the Maternal and perinatal Health Research collaboration, India (MaatHRI) 7 . Both data sets were from a population in northern India covered by 10 MaatHRI collaborating hospitals.…”

Relationship between anaemia, coagulation parameters during pregnancy and postpartum haemorrhage at childbirth: a prospective cohort study

“…A hospital-based prospective cohort study undertaken through the Maternal and perinatal Health Research collaboration, India (MaatHRI). 12…”

“…The MaatHRI platform has a laboratory infrastructure through a partnership with a private laboratory in India. 12 Blood collection, processing, storage and analysis were standardised. All blood samples were analysed at the national laboratory.…”

The Mini-Symposium on Global Child Health: Serving the Children of the World

“…The Maternal and perinatal Health Research collaboration (MaatHRI), involving 14 hospitals across 4 states in India, was presented as an example medium for large epidemiological studies. 3 MaatHRI emerged in response to India showing the second highest number of maternal deaths globally and a high number of medical complications during pregnancy, 3 highlighting the need to understand regional drivers of mortality rates.…”