Randomized controlled trial of the Effect of intraVenous iron on Anaemia in Malawian Pregnant women Implementation Science (REVAMP-IS)

Project Details

Anaemia in pregnancy is a significant global health problem. Antenatal anaemia is a critical risk factor for both maternal and neonatal mortality. Across sub-Saharan Africa access and adherence to oral iron is subpar and very few women receive the recommended course of antenatal iron. Pregnant women most commonly present for the initial antenatal visit late in the second trimester, limiting opportunities to treat antenatal anaemia.
Modern IV iron products are available in high-income countries and provide an opportunity to give high doses of iron in a single short infusion. Given the high prevalence and severe consequences of iron deficiency in pregnancy there is a real need for the establishment of a parenteral iron formulation in pregnant women with anaemia in this setting. However, there is limited knowledge of the drivers and barriers for such an intervention to be effectively delivered in a low-and-middle-income country setting.

This implementation research programme aims to support the REVAMP-TT trial run by the Walter and Eliza Hall Institute of Medical Research, that is testing out the efficacy of an IV iron intervention, in Malawi for pregnant women with moderate and severe anaemia. Our work aims to investigate the feasibility and acceptability of the intervention and how best to implement it in this setting using a mixed-methods approach.

Our project aims seek to answer the following questions:

• What are the health system barriers and facilitators to implementing IV iron in the Malawian healthcare system?
• What are the ‘touchpoints’ and strategies for the successful implementation of REVAMP-TT?
• What are the processes and contextual factors affecting implementation?

Project Resources

Researchers

• Dr Khic-Houy Prang (Australia) (Project Lead)
• Prof Lucinda Manda-Taylor (Malawi Lead)
• Ebony Verbunt, PhD Candidate, University of Melbourne
• Hana Sabanovic, Research Assistant, University of Melbourne
• Ms Elisabeth Mamani-Mategula , PhD Fellow, School of Global and Public Health, Kamuzu University of Health Sciences
• Dr Effie Chipeta, Senior Research Scientist, School of Global and Public Health, Kamuzu University of Health Sciences
• Ms Naomi Von Dinklage, Program Coordinator, Population Health and Immunity Division, WEHI
• Dr Ricardo Ataide Trial Manager, Population Health and Immunity Division, WEHI
• Professor Sant-Rayn Pasricha, Principal Investigator, Population Health and Immunity Division, WEHI

Collaborators

• Walter and Eliza Hall Institute of Medical Research (WEHI)
• Kamuzu University of Health Sciences,  Malawi
• TRUE (Training and Research Unit of Excellence), Malawi