Attachments
Executive summary
In only its first two decades, the twentyfirst century witnessed a wave of infectious disease epidemics that spread on a significant scale. In the wake of escalating disease epidemics, the world has been profoundly challenged by the health, social, and economic ramifications of these crises.
Pregnant and recently pregnant women are often at increased susceptibility to severe illness, as seen in both the COVID-19 and 2009 influenza pandemics. The heightened risk extends to their offspring, as exemplified by associations between maternal Zika infection and congenital malformations. In addition, these populations often have reduced access to high-quality maternity and child health services during epidemics.
Substantial knowledge gaps exist in relation to the scale of the impact of epidemic-prone diseases on maternal and perinatal outcomes. Insufficient data impedes informed clinical and policy decision-making, which in turn hampers access to prevention and treatment strategies during health emergencies. A comprehensive research response will help us better understand how epidemics affect women’s and children’s health, their access to health care, and the related social and economic burden.
This Roadmap represents a significant milestone in the global pursuit of enhanced maternal and perinatal health during epidemics and pandemics. It describes collaborative means to address the most pressing challenges that hinder the generation of high-quality evidence on the direct and indirect effects of epidemics on maternal and perinatal health. The Roadmap is relevant to multiple types of stakeholders working in the areas of maternal and perinatal health, global health security and surveillance, and medical products development.
The development of the Roadmap followed a rigorous and systematic process, starting with a comprehensive landscape and gaps analysis that described the current research infrastructure, and identified gaps and challenges in research on maternal and perinatal health in the context of epidemic threats. Two consultative meetings, held in June 2022 and May 2023, were designed to build the vision for the Roadmap, develop an initial framework for improved research on maternal and perinatal health, define guiding principles, identify needs, and agree on strategic areas and activities.
The Roadmap offers a path to attaining the vision shared among stakeholders that every pregnant woman and her offspring, irrespective of geographical location, socioeconomic status, or other demographic factors enjoy equal access to evidence-based preventive care, diagnosis and management. in the context of epidemic threats. Guided by the principles of equity and inclusivity, human-centeredness, and sustainability, the Roadmap outlines four strategic areas within which conducting relevant research should be promoted. These are:
Strategic area 1: Foster coordination and collaboration for maternal and perinatal research and surveillance in the context of epidemics threats. This area aims to expedite the research response by streamlining activities and the use of human and financial resources to support studies, capacity building, knowledge dissemination, and monitoring and evaluation, and by leveraging knowledge and technical expertise across the other three strategic areas.
Strategic area 2: Bolster advocacy efforts to prioritize the health and wellbeing of pregnant women and their offspring in the context of epidemic threats. This area aims to bridge gaps among stakeholders for securing funding and generating evidence to inform policy, clinical care guidance, and decision-making. A comprehensive advocacy strategy will help create the conducive environment needed for ethical, equitable and inclusive research on, and surveillance of, maternal and perinatal health across all phases of epidemics.
Strategic area 3: Strengthen research and surveillance capacity in maternal and perinatal health in the context of epidemic threats. This area aims to improve the relevance and quality of research and surveillance on maternal and perinatal health undertaken in the context of epidemics. While strongly relying on the coordination and collaboration mechanisms described in Strategic area 1, this area specifically supports improving knowledge, competencies and skills on maternal and perinatal health research and surveillance.
Strategic area 4: Optimize the timely use of evidence in maternal and perinatal health in the context of epidemic threats by disseminating and encouraging wide accessibility and use of scientific knowledge. A dynamic, user-friendly knowledge hub would allow findings to be shared, would facilitate easy access to and exchange of essential information among stakeholders, and would ultimately ensure comprehensive guidance on maternal and perinatal care in the context of epidemics
These four strategic areas are interrelated. As such, they require concerted efforts on the part of all stakeholders across the continuum of preparedness, response, and recovery, spanning the period of the next five years or more. Implementation will be phased, and will consider both the nature of the epidemic threat and the level at which it should be tackled. This Roadmap is complementary to wider research conducted in the context of disease outbreaks, as well as to maternal and perinatal and health research efforts outside this context. A monitoring and evaluation framework will be proposed to track progress in implementing the Roadmap and to assess the level of stakeholders’ engagement. The pace of of implementing the activities stated in this document will inform the need and scope of any future updates that may be required.