Past Seed Grant Recipients

GHI Seed Grants support UW-Madison efforts to launch new global research projects and make them competitive for sustained external funding. Seed grants allow researchers to reach across disciplines for collaborators and make many projects possible.

2022 Seed Grant Recipients

Real world efficacy of school-based HPV vaccination campaigns and bivalent HPV vaccination in rural Zimbabwe

PI: Megan Fitzpatrick, M.D., Department of Pathology, SMPH 

Abstract: The primary objective of this study is to investigate the effectiveness of the school-based HPV vaccination campaign in rural Zimbabwe, and to measure HPV infection rates in a cohort of Zimbabwean girls that received the HPV vaccine. This study is part of a CHW led cluster-randomized effectiveness trial targeting mother-daughter pairs in rural Zimbabwe for cervical cancer screening and HPV vaccination. Secondary objectives are the correlation of breakthrough infections with HIV status, treatment, and control (HIV viral load) and the participation rates in HPV vaccination in this rural site at baseline and after CHW led mobilization.

We will explore the critical gaps in existing knowledge about the real-world effectiveness of the HPV vaccination and school-based delivery in rural Zimbabwe among HIV infected and HIV negative girls. As such, this study advances the Global Health Institute’s mission of fostering the understanding of the complex determinants of health and disease, such as studying the interplay between HIV infection, unique HPV genotypes and vaccine efficacy by applying research across disciplines and continents, thus bringing to life the GHI’s vision of equitable and sustainable health globally.

Key personnel: Racheal Dube, Moffit/University of Zimbabwe; Bothwell Guzha, University of Zimbabwe; Oscar Tapera, UNICEF-Zimbabwe 

Food insecurity and child health in India’s urban slums

P.I.: Priya Mukherjee, Ph.D., M.A., M.Sc., Agricultural and Applied Economics, CALS 

The COVID-19 pandemic has been an unprecedented global challenge that has affected the health and livelihood of billions globally. Low-income households in developing countries such as India, are have been especially vulnerable and both infections and fatalities have been vastly underestimated (Cai et al., 2021). The lack of schooling and school meals, worse nutrition and increased stress at home due to income losses of parents, and, in some cases, losing a parent or other family members, have impacted the health and wellbeing of children severely. However, detailed information about nutritional intake and health outcomes of children within households is severely lacking. Without clear, quantitative evidence, it remains unclear where limited resources for child health must be targeted first, and in what form. I propose to conduct an exploratory data collection effort that will significantly contribute towards preparing for a large, multi-year study of the health and socio-economics effects of the pandemic on children in vulnerable households in urban India. The seed funding will allow the implementation of one round of phone surveys of low-income families with school-age children in Delhi’s slums in 2022, with the aim of understanding the evolving challenges that households face.  

Participatory systems modeling to improve food and nutrition security under climate change  

P.I. Charles Nicholson, Ph.D., M.S., Agricultural and Applied Economics, CALS 

The potential is high for negative impacts of climate change on food and nutrition security (FNS) for populations in low-income countries.  However, the pathways linking climate change to FNS outcomes are complex and dynamic and thus necessitate an interdisciplinary systems approach to improve understanding of underlying causes and the effects of potential interventions.  This project will document the opportunities and potential challenges for Participatory Systems Modeling (PSM) to improve understanding of these complex pathways and facilitate the identification of effective interventions.  We propose a structured invitational workshop involving researchers and practitioners from multiple relevant disciplines to assess critically the potential for PSM to contribute insights about appropriate responses to the impacts of climate change on FNS.  The project will produce four key outputs, including a review of previous applications of PSM to public health nutrition, a journal article submission to the American Journal of Public Health, a written action plan to develop financial support for additional implementations of PSM in priority contexts and familiarity among researchers with relevant expertise and interests that could facilitate collaboration on future project proposals.  

Improving perioperative anesthesia care and training (IPACT) in Lusaka, Zambia

P.I. Deborah Rusy, M.S., MBA, FASA, Anesthesiology, SMPH 

Provision of scientific education, research and clinical application in the field of anesthesiology in Low-and-Middle-Income Countries (LMICs) has been shown to have an improved long-term impact on patient surgical care.  

The Department of Anesthesiology (DOA) at the University of Wisconsin (UW) is committed to providing education, training and research support with the goal of improving access to surgery, anesthesia, and patient safety in low and middle-income countries where a sustainable partnership is possible.   

Our DOA Global Initiative plans to organize, develop, and collaborate with other U.S. academic anesthesia departments to create a Global Academic Anesthesia consortium (GAAC) which will take an innovative approach to both live and virtual anesthesia education programs, research, and perioperative clinical training, partnering with anesthesia providers at the University Teaching Hospital (UTH)-University of Zambia with planned expansion to other countries.    

Research will focus on the anesthetic perioperative care, education, and QI projects.  

Our intent is to assist in the advancement of self-sustainable anesthetic care in the Lusaka Zambia and other LMICs we partner with.  We will also provide our U.W. Anesthesia Residents with advanced knowledge of global health issues and mentoring during clinical training and  partnered research projects while on global educational missions abroad. 

Key personnel: Kelly McQueen, SMPH 

2021 Seed Grant Recipients

Combating antimicrobial resistance: A complex systems approach

PI: Jessica L. Hite, Ph.D., Department of Pathobiological Sciences, School of Veterinary Medicine, with Dorte Dopfer, Food Animal Production; Jingyi Huang, Soil Sciences; Johanna Elfenbein, Pathobiological Sciences at UW-Madison; and Eric Fevre, University of Liverpool

Antibiotic resistance is an increasingly urgent global health crisis that disproportionately affects developing nations and poor livestock farmers, approximately 67 percent of whom are women. Globally, the majority (73 percent) of all antibiotics are used in animals raised for food. This common practice is strongly linked with the rise of drug-resistant infections, both in animals and humans. Non-pharmacological solutions designed for developing countries are urgently needed to sustainably limit antibiotic resistance—without reducing livestock production. While we have a sophisticated understanding of how to combine livestock nutrition and antibiotics to maximize animal growth and protein production, we rarely consider how to harness these management practices to limit the spread of antibiotic resistance among the herd, farmers or the surrounding community. Our interdisciplinary project combines the skills of quantitative epidemiologists, computer programmers and soil scientists from UW and the International Livestock Research Institute (hosted by Kenya and Ethiopia). Using existing databases, we will, for the first time, apply machine learning and AI to identify: 1) antibiotic resistance hotspots and 2) geographic areas of high/low nutritional stress. By revealing how specific drugs, certain types of fodder or specific farming practices increase/decrease rates of antibiotic resistance, this project represents an essential step in developing non-pharmacological options to limit antimicrobial resistance.

Health, climate, and agriculture: A case study of Brazil’s Amazon and Cerrado biomes

PI: Holly Gibbs, Ph.D., Nelson Institute for Environmental Studies, with Marin Skidmore, Nelson Institute, and Kaitlyn Sims, Department of Agricultural and Applied Economics at UW-Madison

Agricultural production in the Brazilian Cerrado and Amazon has skyrocketed, launching Brazil as the world’s leading soybean producer and beef exporter. The environmental impacts of this agricultural revolution are well documented, but here we will explore the health impacts of land-use and climate change. We propose to develop a database of health outcomes to combine with existing agricultural data and leverage it to assess the impacts of the adoption of soy, a high-input crop, on cancer mortality rates. This database can further be used to explore respiratory health, interpersonal violence and child mortality driven by agriculture, deforestation and climate shocks.

Traditional health knowledge and COVID-19: Health narratives of a migrant Salasaka Indigenous community in the Galapagos

PI: Diego Román, Ph.D., M.A., M.S., Department of Curriculum and Instruction, School of Education, with Gioconda Coello, Department of Curriculum and Instruction; Luiz Gonzalez, School of Medicine and Public Health; and Gabriella Gaus-Hinoja, Department of Counseling Psychology

It is clear by now that the COVID-19 pandemic has amplified the historical inequities suffered by migrant and ethnic minoritized communities across the world. What has not been well documented is how these communities have responded to the pandemic. In particular, little is known on how minoritized Indigenous communities are using, producing and communicating their traditional health knowledge as they actively confront with COVID-19. This study addresses this gap in the literature by examining the collective narratives of a migrant Salasaka Indigenous community from the Andes living in Galapagos as they discuss whether and how this global pandemic has impacted (1) their ancestral health knowledge; (2) their reliance on host-land (Galapagos) and homeland (the Andes) networks of support to continue and maintain Indigenous health knowledge-flows and practices; and (3) the ways they educate younger Indigenous generations on their ancestral health knowledge. Using asset-based, community-centered, and critical historical approaches, we will conduct archival work, interviews, surveys, focus groups and on-site observations with members of this Salasaka community. This project answers urgent calls to investigate the creation and communication of Indigenous health-disease-treatment-healing knowledge as well the practices Indigenous communities have developed to address the effects the COVID-19 pandemic.

2020 Seed Grant Recipients

Community-based chronic disease screening and management in low-resource settings

P.I. Justin Boutilier, Ph.D., Department of Industrial and Systems Engineering, College of Engineering with Sarang Deo, Indian School of Business

We will develop a framework that can be used to optimize the daily visitation schedule for a network of community health workers (CHW) delivering a diabetes screening and management program to low income populations. Our models will leverage techniques from Statistics and Operations Research to provide patient-centered visitation schedules that prioritize patients by accounting for differences in disease progression and visit effectiveness. For example, patients with slower disease progression (or patients that see large improvements after each visit) may require more infrequent visits than patients with fast disease progression (or limited visit effectiveness). The objective of the model is to improve overall health outcomes and given our focus on diabetes, we use random blood glucose as a proxy for health improvement (i.e., the model aims to reduce blood glucose). Our hypothesis is that an optimized CHW program will improve health outcomes, cost-effectiveness, and overall efficiency. To obtain data and conduct our research, we will work with a local CHW organization that is focused on (among other things) screening and managing diabetes in the urban slums of Hyderabad, India. Through this partnership, we have the means to investigate this problem on a large-scale and implement our solutions.

Sustainable Partnership for Cervical Cancer Screening in San Lucas Tolimán, Guatemala

P.I.: Sean Duffy, M.D., MPH, Department of Family Medicine and Public Health with Kevin Wyne and Taryn Valley, UW-Madison, Dana Benden, Gundersen Health System, and Alli Foreman, San Lucas

Cervical cancer, a preventable and treatable illness, nonetheless kills hundreds of thousands of women per year. Over 80 percent of cervical cancer morbidity and mortality occurs in low- and middle-income countries. Guatemala, a middle-income country in Central America with significant healthcare inequity, struggles with high rates of cervical cancer diagnosis and death. In San Lucas Tolimán (SLT), Guatemala, a municipality with a highly indigenous rural population, UW-Madison providers and students have long-standing relationships with local health care workers and promoters. Preliminary research in SLT shows that women are eager to learn more about cervical cancer prevention but cannot access affordable screening or reliable follow-up. Our team would leverage our collective experience in SLT and with community-centered programmatic design to scale up HPV self-swab cervical cancer screening, which is both biotechnologically advanced and culturally appropriate. Our proposal centers on local health care workers and community outreach to assure equity and sustainability in program design and implementation. Our innovative approach will provide state of the art technology and overdue cervical cancer care to underserved women. This will furnish an open access toolkit for scaling cervical cancer screening and follow-up geared towards teams working in similar areas around the world.

Living Well: Indigenous Philosophies for Global Resilient Food Systems

P.I. Mariaelena Huambachano, Ph.D., Department of Civil Society and Community Studies, School of Human Ecology

While much progress has been made to address the global food crisis, people do not have enough food to eat and no region of the world is safe from malnutrition and obesity. While the United Nations Sustainable Development Goals (SDGs) are working to address these global concerns, we argue that sustainability and equity, two of the pillars of the SDGs, require further exploration. To address this, we propose the first base-line study on the contribution of Indigenous peoples’ knowledge of food systems and well-being. We will examine the Indigenous good-living philosophies of Mauri Ora  in Aotearoa, New Zealand, and Maehnaw Pewatesanony Yahpeh  of the Menominee peoples in North America. The aim is to provide a base-line analysis report on the knowledge contribution of Indigenous well-being philosophies to achieving the SDGs. The Khipu Model, an Indigenous research framework developed by Huambachano (2017), is adopted to investigate how Indigenous philosophies frame sustainability practices and processes that drive the restoration of Indigenous peoples’ food systems, cultural knowledge, and environmental health today.

Valuing Life and Limb: An Intellectual History of Discord Within Environmental Economics

P.I.: James Kelleher, Ph.D., Department of Medical History and Bioethics, School of Medicine and Public Health

Economic appraisals of the policy importance of global climate change hinge on answers given to two ethical questions.

  • Should deaths in poor nations be treated as less bad than deaths in rich nations, as indeed they were in IPCC’s Second Assessment Report?
  • Should harms to future health be discounted simply because it exists in the future, as is standard in welfare economics?

Economists disagree vehemently among themselves on these questions, and to date, the intellectual history literature has been silent on why. This project will use semi-structured interviews with key figures in these debates to analyze their roots and prospects for resolution in the future.

Tick-borne disease in South America: casting light on neglected vector-borne diseases

P.I.: Susan Paskewitz, Ph.D., Department of Entomology, College of Agriculture and Life Sciences with Gebbiena Bron and Jorge Osorio, UW_Madison; Maria del Pilar Fernandex, Columbia University, Brian Leydet, SUNY ESF, Yamila Romer, Emory University, and Rachel Sippy, University of Florida/ SUNY Upstate Medical University

Most emerging zoonotic vector-borne diseases (dominated by Rickettsiaceae bacteria and RNA viruses) are transmitted by ticks and mosquitoes. However, human tick-borne diseases have been understudied in South America. Sporadic human case reports of Spotted Fever group illnesses are available, but detection of Rickettsia spp. in cattle, dogs and their associated ticks have been the primary focus of tick research. Therefore, we aim to investigate the occurrence and ecological and social determinants of tick-borne diseases in South America to improve disease surveillance and prevention. As a first step, the GHI Seed funds will support the identification of at-risk human population for Spotted Fever Group Rickettsia exposure by screening banked serum collections in well-defined areas in Argentina, Colombia and Ecuador. This data will help guide targeted eco-epidemiological studies of tick-borne diseases in these areas, and build a collaborative North-South network of collaborators to guide future research efforts.

A global estimate of the numbers of children with incarcerated parents and their well-being

P.I.: Julie Poehlmann-Tynan, Ph.D., Department of Human Development and Family Studies, School of Human Ecology

Many countries are in a period of mass incarceration, leading to high levels of racial, economic, and health disparities. Estimates in countries that have published such statistics indicate that the majority of incarcerated individuals are parents of minor children, and scholars have increasingly found that incarceration of parents actually increases health inequities for the next generation. With the exception of a few countries such as the United States and Australia, globally there is no systematic collection of data regarding the number of children left behind when a parent is incarcerated. This is despite the requirement in Rule 7 of the United Nations Standard Minimum Rules for the Treatment of Prisoners 2015 to collect such information. With incarceration of a household member recognized as a potent adverse childhood experience, known to increase long-term risk for health and compromised well-being, the lack of information about these children is a major oversight in the support and prevention of harm for children internationally. The goal of the proposed project is to develop international estimates of the intergenerational implications of mass incarceration that could prompt international action for more equitable and sustainable well-being for vulnerable children and their families throughout the world.

Improving risk assessment of emerging tick-borne diseases in North America by considering tick population biology

P.I.: Sean Schoville, Ph.D., Department of Entomology, College of Agriculture and Life Sciences with Susan Paskewitz, UW-Madison, and Jean Tsao, Michigan State University

Understanding factors that influence the spread of tick-borne disease is a critical problem for public health globally, as ticks expand in distribution and disease incidence increases. How readily ticks move and perform across different environmental gradients will influence future transmission of tick-borne pathogens. Blacklegged ticks are a useful model, as populations in North America are exposed to substantial variation in climate and host species, and vary in behavior, host species use, and pathogen burden. We propose to develop foundational data to infer gene flow and genomic adaptation to local environments across tick populations, ultimately to improve disease risk assessment models.

Vitamin A status of children dying from multiple causes

P.I.: Sherry Tanumihardjo, Ph.D., Department of Nutritional Sciences, College of Agricultural and Life Sciences with Parminder Suchdev, Emory University

In this project, vitamin A status assessment will be applied to the Child Health and Mortality Prevention Surveillance (CHAMPS) initiative using the gold standard approach for assessing vitamin A status, i.e., total liver vitamin A reserves obtained from post-mortem minimally invasive tissue sampling (MITS) of liver. This project will validate the use of circulating retinyl ester concentrations as an approach to assess elevations in vitamin A status in larger, population-based studies. In addition, we will further define the utility of serum retinol concentration to diagnose severe vitamin A deficiency in children by comparison with total liver vitamin A reserves with correction for inflammation measured by C-reactive protein and alpha-1-acid glycoprotein. The World Health Organization (WHO) recommends the use of serum retinol concentrations for determining the prevalence of vitamin A deficiency in populations, but does not specify how to account for the effects of inflammation on retinol concentrations. Universal high dose vitamin A supplementation to children 6-59 months is recommended by the WHO in areas where vitamin A deficiency is considered a public health problem, and 80 countries have on-going programs. However, controversy exists on whether vitamin A supplementation continues to prevent under-5 mortality. Critically, the widespread practice of fortifying staple foods with preformed vitamin A would need to be limited if we find high liver vitamin A stores in some of the CHAMPS countries, as we did in South African and Zambian children on the background of vitamin A supplementation, fortification, and adequate dietary intake.

Biology of Mansonellosis Infecting Indigenous Populations in Amazonia

P.I. Mostafa Zamanian, Ph.D., Department of Pathobiological Sciences, School of Veterinary Medicine, with Jorge Osorio, UW-Madison, Juan Pablo Hernandiz-Ortiz, and Karl Ciuoderis Aponte, Universidad Nacional de Colombia and Colombia-Wisconsin One Health Consortium

Mansonellosis is an insect-transmitted disease that infects hundreds of millions of people globally and is caused by three species of filarial nematode parasites (Mansonella perstans, Mansonella ozzardi, and Mansonella streptocerca). Despite the prevalence of this parasite, there are fundamental gaps in our knowledge of basic Mansonella population genomics, insect transmission, responses to antiparasitic drugs, and association with human health. Parts of Latin America, including Colombia’s Amazon region, are co-endemic for M. ozzardi and M. perstans and are therefore ideally situated to help elucidate some of these questions. This project will leverage collaboration through the Colombia-Wisconsin One-Health Consortium (CWOHC) to

  • measure species-specific mansonellosis prevalence in villages with recent reports of infections and
  • to isolate parasite tissue from infected volunteers for genomic analyses.

Mansonella infections will be detected using a sensitive and species-specific fingerpick LAMP assay donated by New England Biolabs (NEB). Venous blood draws will be used to extract parasites from Mansonella-positive volunteers for downstream molecular analyses, including the sequencing of Mansonella genomic DNA and RNA from parasite-infected blood. These data will help establish the foundations of a collaborative research program focused on dissecting the basic biology and impact of Mansonella parasites in human populations.

2019 Seed Grant Recipients

MOSQUITOS Y YO: STUDENT SCIENTISTS IN ECUADOR

Principal Investigator: Lyric Bartholomay, Department of Pathobiological Sciences, School of Veterinary Medicine

Recent events, including the emergence of Zika, catastrophic hurricanes and flooding, have drawn significant attention to mosquito-borne disease-related health concerns. We propose a community-level response that involves empowering youth to be agents of public health service through an innovative and inclusive STEM education and participatory service learning approach. This proposal was inspired by a project through which we developed a curriculum called Mosquitoes and Me with historically underrepresented youth in the U.S. In collaboration with an NGO in Ecuador called Walking Palms, we successfully piloted implementation of Mosquitoes and Me, translated into Mosquitos Y Yo, in two communities. We propose to formalize and grow this collaboration. To achieve this, we will develop, implement and assess culturally- and community-responsive curricula. These curricula will build on our existing lessons and expand to service learning experiences in mosquito surveillance and control. This project marries perfectly with the mission and vision of the Global Health Institute because we will foster deeper understanding of mosquitoes and mosquito-borne disease with young science learners in Ecuador to advance community health and will do so with students at UW-Madison who will participate in 10-week experiences where they will implement Mosquitos Y Yo camps in Ecuador.

Key personnel: Katherine Bruna, Iowa State University; Anna Stewart, SUNY Upstate; Avriel Diaz, Walking Palms, NGO

TRANSFORMING HEALTHCARE EDUCATION: A PARTNERSHIP BETWEEN UNIVERSITY OF WISCONSIN & ADDIS ABABA UNIVERSITY SIMULATION CENTERS

Principal Investigator: Krystle Campbell, UW Health Clinical Simulation Program, School of Medicine and Public Health (SMPH)

A global critical shortage in trained medical professionals exists. New medical schools have been opened globally with the aim of increasing the number of trained medical professionals annually. However, these schools have lacked opportunities for training via clinical sites. Simulation-Based Education (SBE) within these newly opened medical schools has been proposed as a solution. The Addis Ababa University College of Health Sciences (AAUCHS) built a simulation center to meet this need. Since its inception, this center has been grossly underused due to a lack of simulation content expertise. Therefore, University of Wisconsin Health simulation content experts traveled overseas to conduct an in-person needs assessment. Data collected identified gaps at AAUCHS, preventing the center from being fully utilized. Funded by the GHI visiting scholarship, AAUCHS stakeholders were solicited to send two AAUCHS faculty to partake in a weeklong mentorship at UWH to define the partnership charter. During the weeklong visiting scholarship, it was recognized that a longitudinal partnership was needed for AAUCHS Simulation Center to become successful and sustainable. The aim of this partnership is to establish a sustainable center at AAUCHS through mentorship, faculty development, and partnership in the areas of administration, education, facilitation, simulator procurement (development) and research.

Key personnel: Helen Yifter, Addis Ababa University; Mary Kate O’Leary, UW Health Simulation Program

FERTILITY DECISION-MAKING AND RAINFALL VARIATION IN RURAL MALAWI

Principal Investigator: Monica Grant, Department of Sociology, School of Letters & Science

The overarching goal of this project is to examine the link between rainfall variation and fertility with a focus on the narratives young adults use to make sense of their reproductive decision-making in contexts of extreme fluctuations in rainfall. Specifically, we pursue these questions with data from Malawi, a country considered to have one of the most erratic rainfall patterns in southern Africa. This project will collect life history narratives from young adults aged 25 to 30, asking them to reflect on their reproductive trajectories, experiences with rainfall shocks and perceptions of environmental uncertainty. These data will explicitly focus on unpacking how local experiences of climate change may influence reproductive desires and decisions and how gender informs reproductive life history narratives. Such detailed understanding of how rainfall affects fertility decisions and behaviors is crucial for identifying how future population growth and vulnerabilities to climate change intersect.

Key personnel: Katherine Curtis, Department of Community & Environmental Sociology, College of Agricultural and Life Sciences

GENDER ANALYSIS AND GLOBAL LEARNING FOR SAFE AND HEALTHY STREETS: IMPLEMENTING A COMPLETE STREETS POLICY IN MILWAUKEE, WIS.

Principal Investigator: Carolyn McAndrews, Department of Planning and Landscape Architecture, College of Letters & Science

Transportation systems comprise diverse elements; among these elements, streets are essential for realizing positive health outcomes and reducing health disparities. In the U.S. and throughout the world, engineers and planners are recognizing the need for streets to be inclusive of pedestrians, cyclists and transit riders, as well as travelers with disabilities. However, these “complete streets” practices lack explicit consideration of gender. In this proposed project we will develop and pilot a methodology for making clear connection between gender and complete streets. We will do this through stakeholder engagement in Milwaukee to address its new policy, adopted October 2018, and we will draw from global experiences in gender mainstreaming and gender analysis in the transportation and public health sectors. The project will result in three deliverables: 1. for the case of Milwaukee, an international synthesis of literature and practice, plus a local data scan that compiles in a single document information that will, 2. inform local workshops on gender equality as it relates to current efforts around complete streets and pedestrian planning in Milwaukee, and 3. a workshop at the 2020 Transportation Research Board Annual Meeting to develop the international network of researchers and practitioners and define a future research agenda for gender, transportation and public health.

Key personnel: Bob Schneider, UW-Milwaukee

MICROBIOME ANALYSIS OF INDIGENOUS PEOPLE IN COLOMBIA, SOUTH AMERICA

Principal Investigator: Jorge Osorio, Department of Pathobiological Sciences, School of Veterinary Medicine

Transportation systems comprise diverse elements; among these elements, streets are essential for realizing positive health outcomes and reducing health disparities. In the U.S. and throughout the world, engineers and planners are recognizing the need for streets to be inclusive of pedestrians, cyclists and transit riders, as well as travelers with disabilities. However, these “complete streets” practices lack explicit consideration of gender. In this proposed project we will develop and pilot a methodology for making clear connection between gender and complete streets. We will do this through stakeholder engagement in Milwaukee to address its new policy, adopted October 2018, and we will draw from global experiences in gender mainstreaming and gender analysis in the transportation and public health sectors. The project will result in three deliverables: 1. for the case of Milwaukee, an international synthesis of literature and practice, plus a local data scan that compiles in a single document information that will, 2. inform local workshops on gender equality as it relates to current efforts around complete streets and pedestrian planning in Milwaukee, and 3. a workshop at the 2020 Transportation Research Board Annual Meeting to develop the international network of researchers and practitioners and define a future research agenda for gender, transportation and public health.

Key personnel: Yoshihiro Kawaoka, Department of Pathobiological Sciences, School of Veterinary Medicine; Amie Eisfeld, Department of Pathobiological Sciences, School of Veterinary Medicine

MADISON TO MBALE: BRINGING CARDIOPULMONARY ULTRASOUND TO UGANDAN CHILDREN

Principal Investigator: Jessica Schmidt, Department of Emergency Medicine, SMPH

Sepsis is a leading cause of morbidity and mortality for children worldwide, especially in low-resource settings including rural Uganda. The University of Wisconsin-Madison has a long-standing partnership with Mbale Regional Referral Hospital (MRRH) where researchers are working to better understand pediatric septic shock. In this project, we will work with our collaborators at MRRH to better understand the cardiopulmonary physiology of children with septic shock and to improve the diagnostic capacity of local physicians. We will accomplish this using a two-fold approach. First, we will develop the capacity of local providers to diagnosis and treat patients by teaching skills in clinical ultrasound. Second, we will use clinical ultrasound to study children in the acute phases of shock to increase our understanding of the cardiopulmonary physiology of pediatric sepsis. We hope our project will foster an ongoing partnership between UW and MRRH by combining expertise in ultrasound and shock and improve health for the most vulnerable children.

Key personnel: James Svenson, Department of Emergency Medicine, SMPH; Nikolai Schnitt, Department of Emergency Medicine, SMPH, Arthur Chiu, Department of Emergency Medicine, SMPH

ACCIDENT, DISASTER AND EMERGENCY CARE ACTION IN HAWASSA, ETHIOPIA

Principal Investigator: Girma Tefera, Department of Surgery, SMPH

On an annual basis in Ethiopia, close to 27,000 people die as a result of road traffic accidents, making it the sixth leading cause of death in Ethiopia. Currently, death and disability caused by trauma is greater than HIV, Malaria and TB combined. However, the vast majority of foreign aid to Ethiopia and to other low-income countries has targeted the prevention and treatment of tuberculosis, malaria and HIV/AIDS.  The Accident Disaster, and EmerGency care Action (ADEGA) project proposes a partnership with the UW Department of Surgery (UW DOS) and Hawassa University Hospital (HU), Ethiopia to develop and administer a “train the trainer” (TOT) model to train healthcare providers on basic trauma and emergency care using simulation-based curriculum. The goal of this project is to train committed and confident healthcare professionals in HU with fundamental knowledge in trauma care. The aims of ADEGA are to: 1. Establish a Trauma Simulation Training Program at HU with qualified trainers and essential equipment to provide emergency training for other health care professionals; 2. Develop contextually relevant basic trauma training through simulation curriculum with local faculty; and 3. Identify and address barriers to the sustainability of the program.

Key personnel: Molly Vaux, Department of Surgery, SMPH; Ephrem Adem, Hawassa surgery clinical and academic director; Demelash Ambushe, College of Medicine and Health Sciences, Hawassa University; Tewodros Gebremariam, College of Health Sciences, Addis Ababa University

THE BREAK (BUILDING RESPITE EVIDENCE AND KNOWLEDGE) EXCHANGE

Principal Investigator: Kim E. Whitmore, Department of Nursing, School of Nursing

According to the World Health Organization, about 15percentof the world’s population lives with some form of disability, of whomtwo to four percent experience significant difficulties in functioning. Most of the time caregiving duties for people with disabilities fall to immediate family members. The demands of caregiving can contribute to significant negative health outcomes, such as stress, fatigue, depression and chronic health conditions. Respite care can provide a temporary relief to caregivers and has the potential to reduce stress and improve caregiver well-being; however, quality research on respite care outcomes has been limited. The BREAK (Building Respite Evidence and Knowledge) Exchange is a newly formed collaborative of researchers, respite providers, agencies and individuals who are committed to building a culture of evidence-based respite care. Our project will leverage and enhance the capacity of the BREAK Exchange to gain a global perspective on the current state of respite care, what is most effective and where respite systems can improve globally. Our knowledge gained through this project will allow us to build evidence-based respite programs and disseminate information to others around the world, ultimately improving caregiver well-being.

Key personnel: Jill Kagan, ARCH National Respite Network; Don Williamson, UK Short Breaks Research and Development Group

2017 Seed Grant Recipients

CARDIOVASCULAR RISK PREDICTION TOOLS FOR LATIN AMERICA

Principal Investigator: Leonelo Bautista, associate professor, Department of Population Health Sciences, School of Medicine and Public Health (SMPH)

Cardiovascular diseases (CVD) are the leading cause of global mortality, accounting for 31 percent of all deaths. In Latin America (LA), CVD account for 31 percent of all deaths and 10 percent of all DALYs. Management of CVD risk factors in individuals at high risk of disease is one of the main strategies for individual and population prevention. In most countries the Framingham equation (FrEq) is used for this purpose. However, the FrEq was developed using data from a cohort of mostly white middle class individuals from the U.S. and overestimates the risk when used in populations with a lower baseline risk of CVD, like the population in LA. In consequence, a high proportion of low-risk individuals is likely classified and managed as high-risk, leading to unnecessary interventions with potential adverse effects and lower cost-effectiveness of primary prevention programs. Unfortunately, the risk prediction has not been recalibrated and validated against incidence data in sub-regions and countries of LA. We will expand existing data from the Latin American Studies of Obesity to 14 countries and 300,000 individuals, estimate country-specific prevalence and incidence of CVD, recalibrate the FrEq, and validate it against external data on the incidence of CVD.

Key personnel: Jaime Miranda, Universidad Peruana Cayetano Heredia; Abraham Flaxi, University of Washington-Seattle

ANALYZING THE DOMESTIC AND SEXUAL VIOLENCE IMPACTS OF DODD-FRANK MINING LEGISLATION IN EASTERN DEMOCRATIC REPUBLIC OF CONGO

Principal Investigator: Jeremy Foltz, professor, Department of Ag and Applied Economics, College of Agricultural and Life Sciences (CALS)

In 2010, the U.S. banned purchases of conflict minerals from Eastern Democratic Republic of Congo (DRC). Advocates claimed that conflict over minerals fueled the decades-long conflict in DRC and contributed to the overwhelming amount of reported sexual violence. This research will test whether domestic and sexual violence levels have changed as a result of closing conflict mineral mines. The study will use the DRC’s Demographic Health Survey data from 2008 and 2014, which spans before and after the policy, and a difference in econometric methodology to estimate the effects of conflict minerals policies on partner and non-partner sexual violence. Based on previous work by the PI (Parker, Foltz and Elsea, 2017) on the effects of these policies on child health, we theorize that the policy caused greater harm to women in the post-implementation period. The seed grant will finance some initial research with aggregate data, which will help us succeed with grant competitions to collect our own data with women in the DRC.

Key personnel: Dominic Parke, CALS

IDENTIFICATION OF NEGLECTED AND NOVEL HUMAN VIRUSES IN SIERRA LEONE

Principal Investigator: Yoshihiro Kawaoka, professor, Department of Pathobiological Sciences, School of Veterinary Medicine

Neglected and novel viruses represent a major health risk for human populations. However, there is a limited understanding of the prevalence of these viruses particularly in developing countries such as Sierra Leone. A 2014 study by the Lassa Diagnostic Laboratory in Kenema, Sierra Leone, to identify the causative agents associated with febrile cases in humans found that approximately 29 percent of the febrile cases were caused by a neglected virus and in approximately 45 percent of the cases, the cause of the fever could not be established (Schoepp, R.J., et. al. EID vol. 20 pg. 1176-82, 2014). To catalog the viruses circulating in the population of Sierra Leone, we propose a surveillance study to determine the prevalence of neglected human viruses (Aim 1) and identify novel human viruses (Aim 2). These activities will provide valuable information about human viruses circulating in Sierra Leone. This information could be used to improve the diagnostic capability in Sierra Leone, which could lead to advancements in human health, the potential prevention of further outbreaks, and the alleviation of stress on already burdened healthcare systems.

IMPACTS OF THE INTRODUCTION OF LIVESTOCK ON CROP YIELD IN A RURAL AGRICULTURAL RESOURCE DEMONSTRATION CENTER IN LWEZA, UGANDA

Principal Investigators: James Ntambi, professor, Biochemistry, (CALS); John Ferrick, associate director CALS International Programs

Village Health Project (VHP), a registered 501 (c)(3) non-profit at UW- Madison, recently assisted in the construction a Community Rural Agricultural Resource Demonstration Center (RARDC) to teach innovative agricultural methods in Lweza, Uganda. This proposal seeks to maximize crop output and promote sustainability through the addition of various livestock, including cows, pigs, ducks and, chickens. Aside from their byproducts to improve nutrition, the livestock will produce manure that will serve as fertilizer for the crops. This addition will enhance the quality and quantity of fertilizer and increasing crop yields; creating a self-sustaining RARDC to better support the people of Lweza.

Key personnel: Paul Kimera, Uganda liaison; Ronald Nsimb, Uganda project coordinator; Kim Isely, VHP director

COMBATTING ANTIMICROBIAL RESISTANCE THROUGH A GLOBAL PERSPECTIVE

Principal Investigator: Nasia Safdar, vice chair for research, Department of Medicine, SMPH

Antibiotic resistant infections are a global public health crisis. A key driver of antibiotic resistance is antibiotic overuse and misuse. Antibiotic stewardship-the judicious use of antibiotics- is a key strategy to reducing world-wide resistance. India is at the epicenter of one of the most multi-drug-resistant strains of bacteria, one which carries the New Delhi Metallo-beta-lactamase-1 (NDM-1), an enzyme which has conferred resistance to almost all therapeutic options. Infection caused by these superbugs has an 80 percent mortality rate.

With partners in New Delhi, our infectious disease group at the UW-Madison has created a collaboration to undertake a qualitative study to increase current understanding of antibiotic stewardship practices and implement protocols for stewardship at a major health care system in India. We will use a mixed-methods approach to undertake

  1. semi-structured interviews of key stakeholders regarding antibiotic stewardship in acute care facilities in India,
  2. document review of antibiograms, antibiotic usage, guidelines and protocols, and
  3. create an implementation strategy for antibiotic stewardship activities as ongoing work.

This project will allow opportunities for students to work in India, synergize with undergraduate and graduate research and education, and will serve as a catalyst for collaboration with the South Asian diaspora at UW-Madison

Key personnel: Sharmila Seng, Medicity Hospitalk; Ajay Sethi, SMPH; Dawd Siraj, SMPH

SCHOOL ENRICHMENT AND LIVELIHOODS ACCELERATED THROUGH MILK (SELAM) PROJECT

Principal investigator:  Michel Wattiaux, professor, Department of Dairy Science, CALS; Heidi Busse, a postdoctoral research fellow in the Center for Community and Nonprofit Studies, SoHE

The School Enrichment and Livelihoods Accelerated through Milk (SELAM) project takes a multidisciplinary approach to enhance school and community nutrition environments by building participatory processes at individual, organizational, and community levels in three rural Ethiopian sites. The SELAM Project aims to improve child nutrition and educational attainment by building community capacity and aligning multiple agencies toward the collective goal of creating a sustainable school milk feeding program.

The issue the SELAM project will address is child malnutrition and chronic food insecurity among rural smallholder families. The project’s purpose is to establish a pilot school milk feeding program to address a low consumption of animal source proteins, a primary driver of child malnutrition in Ethiopia. In Year 1, our three strategic objectives are to:

  1. Develop a model for building participatory processes to identify inter- and intra-household, community, and systems barriers to and assets for strengthening nutrition;
  2. Implement a multisector platform for stakeholder engagement toward the collective goal of improving child nutrition through a school milk feeding program; and
  3. Design a multi-level evaluation framework for a school milk feeding program that considers individual/ household, community, and policy/systems-level impacts.

Key personnel: Brian Christen, SoHE; Ann Evensen, SMPH

2016 Seed Grants

FLOOD PREDICTION TO SUPPORT ADVANCED DISASTER PREPAREDNESS AND PUBLIC HEALTH RISKS: UNDERSTANDING, DEVELOPMENT, AND APPLICATION

Principal Investigator: Paul Block, assistant professor, Department of Civil and Environmental Engineering

Flood catastrophes lead all natural hazards in terms of impacts on society. Most floods occur in developing regions and tropical regions where the impact on public health is substantial.  The usage of such scientific forecasts on disaster management has been highlighted, however there are limited predictive factors and forecasting techniques for specific health risks, and equally limited capacity to develop the infrastructures for such a health forecasting system, particularly in developing countries. In this project, we propose to develop a global flood prediction model to support disaster preparedness and managements for potential flood and flood-induced public health risks.  Advanced long-term flood forecasts and early warning outputs from the model will contribute to developing practical pre-disaster actions and policies under current management systems. The model will be coupled with existing flood risk assessment models and health vulnerability indicators, and then provide innovative health risk forecasts for international and local disaster management agencies and health planners.

WATER, WOMEN, AND FISHERIES: ADDRESSING TWO ECOLOGICAL REALITIES IMPACTING HUMAN HEALTH AT LAKE VICTORIA

Principal Investigator: Jessica Corman, Ph.D., postdoctoral research associate, Center for Limnology

Lake Victoria water quality and fisheries impact livelihoods and health of local communities. Lake Victoria, surrounded by Uganda, Tanzania, and Kenya, represents the largest tropical lake by surface area in Africa and supports the largest freshwater lake fishery in the world. Population growth, land cultivation, nutrient pollution, climate variability, resource extraction, intensive fishing and other stressors have dramatically altered water quality and fisheries ecology, affecting 30 million people living around the lake. Satellite imagery and direct observation show harmful algae blooms and water hyacinth invasions, which can negatively impact livelihoods and health.

Ecological, health, and economic effects disproportionately place the burden of compromised water quality on women.

The Seed Grant will be used to investigate the interrelationship between these two ecological realities and empower communities through women-led initiatives and interventions to reduce impacts on fisheries livelihoods and community health. Focus groups and economic surveys within impacted communities will identify management strategies and establish a platform in which to empower women to reduce community health risks.

Analysis of fish tissues for cyanotoxins, heavy metals, and pesticides will provide an assessment of health risks for local and global consumers. Historical data, water quality surveillance, satellite imagery, and experimentation will be utilized to investigate the complex relationship between water hyacinth and cyanobacterial-associated health risks. Expected outcomes include publications, formation of partnerships for community based participatory research, identification of intervention strategies to improve water quality locally, establishment of a database for monitoring data and satellite imagery, and hypothesis testing of potential low-cost predictors of health risks associated with harmful blooms. The seed grant findings, establishment of community trust, and formation of collaborations will provide foundation for subsequent NSF and NIH solicitations.

POLLUTED FISH AND CYCLES OF POVERTY: TRACING THE GLOBAL SCOPE OF MERCURY CONTAMINATION OF FISHERIES

Principal Investigators: Peter McIntyre, Ph.D., assistant professor, Center for Limnology; James Hurley, associate professor, Civil and Environmental Engineering; director, UW Aquatic Sciences Center

This project addresses an unrecognized facet of the cycle of poverty: contamination of food fish with neurotoxins. Mercury from global and local sources biomagnifies in fish, and even low dietary levels can impair human cognitive development. The investigators will analyze archived tissues from four continents, yielding an overall assessment of the threat posed to hundreds of millions of poor people.

Pilot data reveals that mercury concentrations in Central Africa vastly exceed recommendations, and levels in most other regions are sufficient to threaten the health of women and children if consumed weekly. To elucidate needs for building awareness and creating regional consumption advisories, investigators will pursue three specific objectives:

  • assess the geography of mercury contamination of subsistence fisheries,
  • test whether simple correlates of contamination levels could be used to design appropriate advisories, and
  • quantify mercury stable isotopes to trace sources of contamination at each site.

Together, these efforts will set the stage for a major initiative to document and publicize the safety of eating wild-caught freshwater fish. Without such awareness, cognitive impairment of people who depend on subsistence fisheries will further reduce their odds of rising out of poverty.

RURAL GUATEMALA DIABETES INITIATIVE

Principal Investigators: James Svenson, MD, MS, associate professor, Emergency Medicine; Kevin Wyne, PA-C, faculty associate, Family Medicine

San Lucas Tolimán is a town of 17,000 people in southern Guatemala.  The population is mostly indigenous highland Maya with an average income of about $3 per day. This population is experiencing rapid growth in rates of chronic non-communicable diseases such as diabetes. There are many barriers to effective treatment of diabetes in this population including access to care and medications. Empowering health promoters to monitor and provide treatment in their communities is an effective way to improve glucose control and long-term outcomes for patients with diabetes in this region.

The investigators will collaborate with a group from Stanford University to develop a computer-based app that can be used by village health promoters to monitor their diabetic patients. They will develop protocols that can be administered by these promoters to enhance the care of their diabetic patients.  The project will be of great benefit in providing ongoing care for diabetic patients for the communities around San Lucas, and may also be used as a model in other resource poor settings.

2015 Seed Grants

MOBILE EMERGENCY GUIDELINES SOLUTION: SUB-SAHARAN AFRICA

Principal Investigators: Janis P. Tupesis, MD, FACEP, FAAEM; Mohammed Dalwai, MD, Ph.D Candidate

The investigators partnership goal is to improve access to clinical support information and educational materials for African healthcare workers through active dissemination of clinical practice guidelines (CPG) through mobile phone technology – such that providers will be able to navigate through local expert instructions. The researchers propose to develop, implement, and disseminate this technological innovation through local, regional, national and international partnership through a process of participatory and user centered design. The goal would be to implement in the South African emergency services infrastructure with goals to adapt to other African countries.

PALLIATIVE CARE IN RWANDA

Principal Investigators: James Cleary, MD, FRACP, FAChPM; Martha Maurer, BS, MPH; Aaron Gilson, MSW, MSSW, Ph.D; Barbara Hastie, Ph.D.; Mary Skemp Brown, MBA

This project’s primary long-term objective is to collaborate with Rwandan government to design expansions of the existing database for medication distribution, to allow submission of data related to opioid prescribing and patient treatment for pain and palliative care.

SYSTEM STRENGTHENING AND HUMAN BUILDING TO SCALE UP LONG-ACTING REVERSIBLE CONTRACEPTION IN SOUTHERN ETHIOPIA

Principal Investigators: Cynthie K. Anderson, MD, MPH; Eliza Bennett, MD; Cara King, DO, MS; Heidi Brown, MD; Nicholas Schmuhl, Ph.D; Zenebe Wolde, Millio Teshome, Jennifer Higgins, Ph.D, MPH

UW OB/Gyn has spearheaded a postpartum LARC program in Dane County, bringing free access to immediate postpartum LARC to women below the federal poverty level. The investigators are working with stakeholders statewide to promote Medicaid policy changes surrounding reimbursement, with confidence that efforts will result in statewide dissemination. Expansion of LARC is a priority shared with colleagues in Hawassa, Ethiopia. As envisioned by the “4W” initiative, the goal is to: 1) Assess desirability/feasibility of LARC scale-up in Southern Ethiopia through key informant interviews (physicians, midwives, policy-makers, users); 2) Formalize collaborations with invested partners; 3) Assess existing and promote future infrastructure to provide LARC and manage complications; 4) Enhance existing academic partnerships with Hawassa University through faculty and learner exchange and 5) Adapt UW Residency Program LARC curriculum to Ethiopian context.

WOMEN IN ONE HEALTH: EMPOWERMENT OF WOMEN IN RURAL AGRICULTURE

Principal Investigators: Janet Shibley Hyde, Ph.D; Mary Crave, Ph.D; Sophia Friedson-Ridenour, MA, Ph.D Candidate.

The interdisciplinary Women and One Health in Rural Agriculture research project will critically assess the Women’s Empowerment in Agriculture Index (WEAI), a relatively new tool used in 16 low-income countries. The UW team will recommend new indicators and develop and test a second generation WEAI to 1) broaden the way women’s empowerment is conceptualized and measured, and 2) incorporate “One Health” knowledge and practice. This research will create opportunities for future grants, both to further develop and test indicators and tools, and to develop programs that are aligned with the gender lens and the one health lens that will emerge. The overarching goal of this work is to expand the WEAI to foster innovation in agricultural development. Because what is measured naturally becomes a programmatic focus, this research will lead to programs that improve the lives of women, and sustain the health of people, animals and the environment.

2011 Seed Grants

Hypertension Awareness, Treatment, and Control in Latin America

Principal Investigators: Leonelo E Bautista, MD, M.P.H., Dr.P.H.; Lina M Vera, MD, MSc; Alberto Palloni, Ph.D.; Juan P Casas, MD, Ph.D.; Jaime Miranda, MD, MSc, for the LASO investigators.

We will use data from 10,496 hypertensives from the Latin American Consortium of Studies in Obesity-LASO to assess the prevalence and determinants of hypertension awareness, treatment, and control in the region. Our study will accurately characterize the magnitude of the problem of detection and management of hypertension, will identify sociodemographic factors associated with poor blood pressure control, and will provide an objective evaluation of the health and economic impact of potential population interventions to improve blood pressure control in this population.

A Multidisciplinary Approach to Understanding and Controlling Brucellosis in the Imbabura and Pichincha Provinces in Ecuador

Principal Investigators: Poulsen K.P.; Hutchins F.T.; Gaus D.P.; Van Kekerix M.J.; Lopez L.; Trueba G.; Czuprynski C.J.; Olsen C.W.

The goals are to understand upstream determinants/root causes of brucellosis in the Ecuadorian animal populations, and to educate Ecuadorian animal owners about risk factors for brucellosis in cattle and other species, and transmission to humans (e.g., unpasteurized dairy products, contact with parturient animals).

The Effects of Agricultural Productivity on Poverty and Household Food Security: The Sahel’s Silent Maize Revolution

Principal Investigators: Jeremy Foltz, Ph.D.; Sara Patterson, Ph.D.

This work seeks to investigate whether higher agricultural production translates into poverty reduction and better household food security outcomes. We hope to identify ways that farmers of both genders can continue to maintain or improve yields, provide needed nutrition and profit, and minimize damage to the environment.

Evaluation of Alternative Strategies for Emerging Disease Detection

Principal Investigators: Jerry Zhu, Ph.D.; Bret Shaw, Ph.D.; Lewis Gilbert, Ph.D.; Joshua Dein, V.M.D.

We propose to develop and improve on monitoring processes that will enhance our ability to detect changes in the patterns of wildlife disease occurrence that may signal the very earliest stages of disease emergence in human / animal systems. Expanding the observational corps may be accomplished by both examining content on social networks, and engaging existing citizen monitoring groups to extend their mission to include wildlife morbidity and mortality events.

Mobile Phone-Disseminated Health Information

Principal Investigators: Monica J. Grant, Ph.D.; Ajay K Sethi, Ph.D.; James H. Conway, MD

Using participatory-based research methods, our proposal aims to establish feasibility and to pilot the dissemination of health information within existing mobile phone networks using a theory-driven intervention. These demonstration projects will be conducted within existing study populations and collaborations in Malawi and Uganda that monitor and evaluate child survival and HIV/AIDS.

Pathways for Poverty Reduction in Haiti: Health and economic impacts of organic mango Production and Processing

Principal Investigator: Gary P. Green, PhD; Co-Investigator: Bradford L. Barham, PhD; Co-Investigator: Gergens Polynice, MS.

This project examines potential pathways to increase small-scale producers’ income through mango production and transformation for the local and international markets. It will investigate the production pattern and the effects of prices on farmers’ willingness to plant more mango trees as well as assess ways to diminish postharvest lost and disease transmission through proper fruits handling system.

Participatory Action Research and Planning to Improve Young Women’s Reproductive Health: A lever for change in reaching the MDGs

Principal Investigators: Nancy Kendall, Ph.D.; Claire Wendland, MD, Ph.D.

The study focuses on girls who are approaching the critical stage of finishing primary school (commonly ages 13 to 17), with the aim of developing innovative, gender responsive, multisectoral activities that both foster resilience and protect them from life-stage risks such as early pregnancy and HIV infection, and have broader benefits that enhance family and community health. This project aims to create a scalable model for change that: 1) provides a more participatory way of working with youth to recognize and address the barriers they face in making healthy decisions in their lives; 2) creates a space for new dialogue (and potentially models of governance) concerning the roles of the state, community leaders, and youth in addressing barriers to young women’s reproductive health; and 3) empowers communities, working together, to generate a locally appropriate, multisectoral intervention that draws on both local and international knowledge to improve young women’s reproductive health.

Fertility, Child Health and Human Capital in Low Income Countries

Principal Investigators: Ian Coxhead; Lia Fernald; Jenna Nobles; Alberto Palloni

We seek funding to estimate the effects of child nutritional status on individual characteristics associated with population-level human capital formation, economic growth, and income inequality. In combination, nutrition and attendant health status predict mental and emotional development, educational achievement and attainment and, ultimately, labor force participation, occupational attainment and wages. We choose to study these relations in the context of Indonesia, a country that simultaneously experiences a decline in fertility that favors maternal and child health and nutritional status and the adoption of behaviors associated with breastfeeding, diet and behavior that hinder them.