As of June 28, 2021, the SARS-CoV-2 virus has infected more than 181 million people and resulted in more than 3.9 million deaths worldwide . Compared to similarly aged adults, the case fatality rate is reported to be higher in pregnant women with SARS-CoV-2 infection or COVID-19 disease , and while the immediate impact on mortality is less apparent in newborns and children, severe COVID-19 disease including multisystem inflammatory syndrome temporally associated with SARS-CoV-2 infection can occur in children [3,4]. Additionally, the indirect effects of the pandemic on social, economic, educational, and other upstream determinants of health coupled with the disruption of essential maternal and child health services are likely to increase morbidity and mortality and cause significant unintended harm to the overall health and well-being of these populations [5–7].
In all countries, the COVID-19 pandemic has led to major changes to all levels of health care service delivery, and disruptions to access and use at the individual level driven by personal, social, economic, and other factors [8–11]. Most of the service delivery changes are driven by fear and the need for infection risk reduction with experimental solutions not necessarily informed by evidence. Further, little is known about the short- and long-term impact of such adaptations . Additionally, there remain many gaps in understanding the short- and long-term effects of SARS-CoV-2 infection and COVID-19 disease in the pediatric population as well as during pregnancy. Therefore, knowledge gaps must be identified considering the new challenges facing women, newborns, children and adolescents, their health care providers, and the health system more widely. This could lead to research to better understand and treat infection and disease in these populations, and potential solutions to suitably address the problems created because of and shaped by this new context.
The World Health Organization (WHO) Maternal, Newborn, Child, Adolescent Health and Ageing (MCA) and Sexual and Reproductive Health and Research (SRH) departments undertook a global, rapid research prioritization exercise to identify the most urgent research questions to address the above need. The objective was to identify priority research questions related to maternal, newborn, child, and adolescent health (MNCAH) to help mitigate the direct and indirect effects of the COVID-19 pandemic. This research prioritization exercise was coordinated by the WHO on behalf of the WHO MCA-SRH COVID-19 research network (COVID-19 research network is a global network of researchers working on COVID-19 research on maternal, newborn, child and adolescent health, which has been convened and is coordinated by the department of MCA at WHO, Geneva. The purpose of the network is help with the harmonization, prioritization, use and sharing of COVID-19 research output on MNCAH), led by a WHO secretariat.
We used the Child Health and Nutrition Research Initiative (CHNRI) process with expedited steps to identify the priorities within a short period given the urgency posed by the pandemic . There were three phases in this process: the preparatory phase (Jul-Aug 2020), the sourcing of research ideas (Aug-Sept 2020), followed by the curation of research ideas into research questions (Oct 2020), and scoring of the research questions (Nov-Dec 2020).
The preparatory phase (Jul- Aug 2020) involved defining the scope, domains, and themes for classification of the research ideas sought and criteria for scoring the research questions. This was done based on a review of the existing frameworks and CHNRI criteria by the WHO secretariat [14,15]. This was followed by a consultation with the global experts of the COVID-19 research network to finalize the same. Four domains were defined for the type of research: 1) discovery research – research emphasizing the need to invest in science and technology to understand the disease and expand the range of effective interventions; 2) development research – research with a focus on new and improved solutions or interventions; 3) delivery research – research that will help improve the coverage of existing interventions; and 4) descriptive research – epidemicological research directed at understanding the disease, burden, and the effects. Five themes were defined to classify the focus of research: pathogenesis, immune response, and immunogenicity; burden and risk factors; clinical characterization and management; modes and prevention of transmission; and indirect effects of the COVID-19 pandemic. The focus was on research questions that could be addressed over the next two years (2021-2023).
Research including prevention and treatment strategies or other interventions that are common to all populations, eg, preventive measures like physical distancing, handwashing or use of face mask, development of safe and effective vaccines (except specificities related to MNCAH), or effective treatments in general (eg, anticoagulants or antivirals), were not included in this exercise unless they addressed an aspect specific to the populations of interest. Only research ideas specific to MNCAH were included.
The second phase (Aug-Sept 2020) involved generating potential research ideas. We used the non-probability sampling technique (snowball sampling) to invite via email and an online link, a large group of experts in research, program planning and implementation, policymaking, government representatives, funding agencies, donor and international organizations, academia and civil society organizations from low- and middle-income as well as high- income settings, to submit their research ideas in the areas of maternal and newborn health, child and adolescent health or cross-cutting or health systems. The experts were requested to suggest up to three research ideas for any of the five identified themes in their self-reported field of expertise (eg, maternal and newborn health, child and adolescent health, and/or cross-cutting or health systems). The research ideas were curated by the WHO secretariat comprising technical experts in each area (ie, maternal health, newborn health, child and adolescent health, and cross-cutting-health systems; n = 9). The curation steps involved tasks such as identifying the main idea and rephrasing the research question where the idea was not clearly articulated, separating different research ideas presented together, removing duplicate ideas, combining similar research ideas, and improving the clarity of language, as required. For scoring, we categorized the research questions in the area of maternal and newborn health into two separate areas- maternal health and newborn health, respectively. In the cross-cutting or health systems area, we retained only those research questions in the list which were specific to maternal, newborn, child, and adolescent health. We excluded the generic questions, eg, health systems interventions that could affect all populations or those which were covered in individual areas. All curated questions in the discovery, development, and delivery domains were presented in the PICO (P: population, I: intervention, C: comparison/control, O: outcome) format and the PEO (P: population, E: exposure, O: outcome) format for epidemiological research (description domain), whenever possible. The secretariat ensured that the fidelity to the originally submitted research idea by the participants was maintained as much as possible in the process to develop the final list of research questions to be scored.
In the third phase (Nov-Dec 2020), the WHO secretariat contacted all the experts who were approached in the second phase for providing research ideas for scoring the final list of research questions. We shared, along with scoring instructions, the weblink to the final list of curated research questions in the four areas (maternal health, newborn health, child and adolescent health, and cross-cutting- health systems) with experts who consented to score the research questions in that area according to their self-reported field of expertise. Experts in maternal and newborn health scored both maternal health and newborn health research questions. Research questions in the discovery, development, and delivery domains were scored using all the six pre-defined criteria (Box 1), while those in the description domain were scored using only three of the six criteria (answerability, effectiveness, timeliness).
Box 1. Criteria and scoring scale for scoring research questions (RQ).
Step 1. Intermediate score for each criterion:
Intermediate score for criterion 1 = sum of score for Q1 for criterion 1/number of respondents who scored criterion 1 (excludes blank answer)
Step 2. Research priority score (RPS):
RPS for research questions in discovery, development and delivery domain = (intermediate score for criterion 1 + intermediate score for criterion 2 + intermediate score for criterion 3 + intermediate score for criterion 4 + intermediate score for criterion 5+ intermediate score for criterion 6)/ 6
RPS for research questions on description domain = (intermediate score for criterion 1 + intermediate score for criterion 2 + intermediate score for criterion 6)/ 3
Analysis and ranking. The research priority score (RPS) was calculated for each research question. The RPS is an average of the intermediate scores for each criterion. The intermediate score for each criterion was calculated by summing the score for each criterion and dividing by the number of respondents who scored that criterion, excluding those who scored blank. Thus, the research priority score for a research question could range from a maximum of 1 to a minimum of 0 (Box 2).
Box 2. Formulas for calculation of research priority scores.
1. Answerability– The RQ is likely to be clearly answered through ethical research
2. Effectiveness– The RQ is likely to result in effective interventions/programs to mitigate the direct and/or indirect effects of COVID-19 on MNCAH outcomes of interest
3. Deliverability– The RQ is likely to lead to solutions that are deliverable through existing systems within the current context of the COVID-19 pandemic
4. Maximum potential impact-The RQ is likely to produce results that are likely to have a large effect on MNCAH outcomes of interest within the current context of the COVID-19 pandemic
5. Equitable– The RQ is likely to lead to interventions/programs that will be accessible to the entire MNCA population irrespective of income or socio-economic strata or preferentially to MNCA population
6. Timeliness– The RQ is likely to be answered rapidly such that the results are useful to address challenges of the current COVID-19 pandemic
Scoring scale for each criterion.
1 = Yes, research question meets the criterion
0 = No, the research questions does not meet the criterion; or
Blank (no score) = Do not want to score on this criterion
The research questions were ranked based on the RPS within each area (maternal health, newborn health, child and adolescent health, and cross-cutting or health systems). The top 10 research questions with the highest RPS in maternal health, newborn health, and child and adolescent health and the top 5 research questions in the cross-cutting-health systems area were presented as the priority research questions for that area.
Furthermore, the research questions were ranked by domains and themes within each area and presented the top five research questions in each domain and theme.
Patients and public were not involved in the current study.
A total 206 experts contributed to 664 research ideas in three areas- 237 on maternal and newborn health (36%), 226 on child and adolescent health (34%), and 201 for cross-cutting or health systems area (30%).
Of them approximately 51% were researchers, 22% were program managers, 7% were clinicians/academia, 6% were policy makers/government officials, 6% were research funders or donors and 7% were in multiple roles. About 46% were based in low and lower middle-income countries. More than half of the participants reported involvement in COVID-19 research, and involvement in programmatic response (38%) and developing guidelines or policy related to the COVID-19 pandemic (35%) (Table S1a in the Online Supplementary Document).
Following curation, research questions in the area of maternal and newborn health were separated, and 220 final research questions in four groups (maternal health, n = 31; newborn health, n = 45; child and adolescent health, n = 118; and cross-cutting or health systems, n = 26) progressed to scoring.
A total of 132 experts consented to the process (maternal and newborn health = 61, child and adolescent health = 51, and cross-cutting-health systems = 20), of whom 121 (92%) experts provided scores. The maternal questions were scored by 58 out of the 61 maternal and newborn health experts (95%), newborn questions by 56 out of the 61 maternal and newborn health experts (92%), child and adolescent health questions by 43 out of the 51 child and adolescent health experts (84%) and cross-cutting questions by all 20 cross-cutting-health systems experts (100%).
The profile of experts who scored the final research questions in each area is provided in Table S1b in the Online Supplementary Document.
Research priorities in maternal health
The median score in this area was 0.83 ranging from 0.48 to 0.90 (IQR 0.75 to 0.85; n = 29). Three similar questions with the same research priority score were combined into one question, resulting in a total of 29 questions for maternal health. The questions that were combined pertained to how the COVID-19 pandemic has affected the health care-seeking behavior for antenatal care (score 0.88), childbirth care (score 0.88); and postnatal care (score 0.88).
The top ten research questions from among 29 research questions scored in the area of maternal health are listed in Table 1.
Table 1. Top ten research priority questions on maternal health ranked by research priority score
The median score in this area was 0.77 ranging from 0.44 to 0.90 (IQR 0.70 to 0.82; n = 45). The top ten research questions from among the 45 research questions scored in the area of newborn health are listed in Table 2.
Table 2. Top ten research priority questions on newborn health ranked by research priority score
Child adolescent health
The median score in this area was 0.79 ranging from 0.47 to 0.95 (IQR 0.70 to 0.82; n = 111).
The top ten research questions from among the 111 research questions scored in the area of child and adolescent health are listed in Table 3.
Table 3. Top ten research priority questions on child and adolescent health ranked by research priority score
The median score in this area was 0.83 ranging from 0.50 to 0.93 (IQR 0.73 to 0.86; n = 25). Two interlinked questions ranked serially with a score of 0.93 and 0.92 were combined into one question, resulting in a total of 25 questions for cross-cutting or health systems area. The top five questions from among the 25 research questions scored in the cross-cutting or health systems area are listed in Table 4.
Table 4. Top five research priority questions in cross-cutting or health systems area, ranked by research priority score
The ranking of the questions by theme and domain is presented in Tables S2a and S2b in the Online Supplementary Document.
Median (IQR) of the RPS across different areas remained similar irrespective of income classification of the scorer’s country of work or residence (high, upper-middle, lower-middle, and lower-income) (Table S3 in the Online Supplementary Document). The ranking of the top ten research priorities by income classification of the scorer’s country of work is presented for each area (Tables S4a, S4b, S4c, and S4d in the Online Supplementary Document).
In March 2020, the WHO published a Global Research Roadmap to target and respond to SARS-CoV-2 with immediate, mid-term, and longer-term priorities to build a robust global research response based on the deliberations during the Global Research Forum, and other global organizations have made similar calls [14,152]. The document captured major thematic areas (from virus natural history to social sciences in the outbreak response) and strategic actions, but it was beyond the scope to capture the unique aspects of research related to the health and well-being specific to mothers, newborns, children, and adolescents. This study was conducted with a focus on the maternal, newborn, child, and adolescent populations, to identify priority research needs that may help in addressing the direct and indirect effects of the COVID-19 pandemic and mitigation interventions on these populations.
In maternal health, three key focus areas emerged: 1) the indirect effects of the COVID-19 pandemic on care for women (including health-seeking behavior, access to care, and provision of care) and measures to improve access and provision of care, 2) the health risks and outcomes for pregnant women in the context of SARS-CoV-2 infection or COVID-19 disease including perinatal outcomes (stillbirth, fetal growth restriction); and 3) prevention and management of SARS-CoV-2 infection or COVID-19 disease during pregnancy including the safety and efficacy of SARS-CoV-2 vaccine for pregnant women.
In newborn health, the focus was on clinical characterization and management of SARS-CoV-2 infection or COVID-19 disease (most effective treatment strategies, clinical presentations, burden of severe disease, risk and protective factors especially breastfeeding, kangaroo mother care, Bacillus Calmette Guerin or other vaccinations, most yielding sample for diagnosis, etc.), mode of possible transmission from mother to child (routes of transmission, incidence, and severity by route of transmission), and effectiveness of different interventions to prevent transmission from an infected and/or symptomatic mother.
For child and adolescent health, there were four focus areas: 1) Indirect effect of COVID-19 pandemic on care (impact on essential health services and maintaining routine vaccination services); 2) Clinical status and outcomes of SARS-CoV-2 infection or COVID-19 disease in this population (impact of comorbidities on clinical severity of infection, risk stratification tools to predict severity and outcome of infection); 3) Interventions that might protect against SARS-CoV-2 infection or COVID-19 disease; and 4) Educational institutes (effective and safe strategies/intervention for in-class education and effect of reopening of schools on SARS-CoV-2 transmission). The cross-cutting priorities focused on: 1) safe and effective access to oxygen therapy; 2) effects of the COVID-19 pandemic on availability, access, care-seeking, and utilization of MCH services; and 3) potential solutions.
These global priorities provide a starting point for countries to tailor these research questions to their local realities and priorities, with a note that the research on these priorities should not be separated from broader research priorities in the area of maternal, newborn, child, and adolescent health. Learning across different contexts will help inform how different interventions might be adapted or replicated to answer some of the priority research questions. Sharing evidence generated by research and lessons from the implementation of the identified solutions will be crucial for ensuring effective and efficient responses.
The current priorities have been developed using adapted CHNRI methodology in a transparent, ethical, and equitable manner using a systematic process , and highlight key gaps in knowledge and are relevant both for clinical practice and programmatic implementation. There have been other research prioritization exercises in the context of the COVID-19 pandemic which are broader in scope , or specific to a particular area, eg, surgery or mental health [18,19], and one very recent one on maternal and newborn health from the African continent , but we are not aware of any other attempt at defining priorities across the area of maternal, newborn, child and adolescent health at a global level. The added value of the current study lies in the engagement of a large number of global experts for generating ideas and scoring the research questions.
Our exercise highlights the importance of generating evidence to understand effective strategies and intervention measures to mitigate the direct and indirect effects of the COVID-19 pandemic on mothers, newborns, children, and adolescents. Research on some of the identified priorities is already under way, eg, epidemiology of COVID-19 disease in pregnancy to determine risk factors and associations with adverse maternal and neonatal outcomes , maternal to newborn transmission , viral transmission following implementation of COVID-19 preventive measures in schools [23–25] and the effect of reopening schools on SARS-CoV-2 transmission [26,27], etc., which support the validity of the focus on these priorities in the current exercise. We hope that the current exercise will bring to focus issues that have not yet been addressed and appropriate research in these areas. This could help us be prepared with evidence-based approaches to minimizing the adverse impact on mothers, newborns, children, and adolescents during the future waves of the pandemic.
The ranking of the top ten research priorities was similar irrespective of income classification of the scorer’s country of work except for a few questions in each area, eg, the question on the safety and efficacy of the SARS-CoV-2 vaccine in pregnant women was ranked higher by scorers working in high and upper-middle income countries, while the one on documenting the impact of the COVID-19 pandemic on essential child health services at the community and facility levels was ranked higher by scorers working in low and lower-middle income countries. This reflects that the priorities are influenced by the context and may differ across settings.
One limitation of this study pertains to the fact that the pandemic is a fast-moving field, wherein new emerging issues arise quickly while the exercise is in progress, and some issues such as the recent circulation of new viral variants safety and efficacy of SARS-CoV-2 vaccines for children and adolescents are not adequately captured. Another limitation could be that the self-selected experts may have their interests for priority research areas. However, in this exercise, we tried to approach as many experts as possible to participate to generate research ideas and to score the research questions. Therefore, we think there is limited scope for selection bias in the process. It is also acknowledged that while the pandemic is not yet over, with many countries experiencing a second or anticipating further waves, there is still a need to initiate post-pandemic planning, which could be informed by identified research priorities.
Research in the area of SARS-CoV-2 infection and COVID-19 disease has been progressing substantially since the beginning of the pandemic, driven by experts across the globe. However, key issues like those identified in this study present collective knowledge and experience of a large, diverse group of global experts which was a challenge but a timely achievement. The identified priorities now need careful planning, coordination, and quick implementation to be effective. We call on partners, including governments, non-governmental organizations, research institutes, and donors, to collaborate to ensure that this urgent research agenda be addressed with a specific focus on priority areas that have not yet been taken up for research.
We thank all the international experts who provided research ideas for this exercise (Table S5 in the Online Supplementary Document). Additionally, Pavani Ram (email@example.com) submitted questions on behalf of the USAID’s Office of Maternal and Child Health and Nutrition, Arushi Singh (firstname.lastname@example.org) from UNESCO Education Sector shared questions on behalf of UNESCO, and Kiersten Israel-Ballard (email@example.com) and Kimberly Mansen (firstname.lastname@example.org) submitted questions on behalf of PATH.
COVID-19 Research Prioritization Group on MNCAHASM
Nawshad Uddin Ahmed1, Abdellatif Maamri2, Adegoke G Falade3, Adejumoke Idowu Ayede4, Adnan Bhutta5, Ajay Gambhir6, Alfredo Tagarro7, Ali Abdelmegeid8, Ali Reza Ahmadi9, Aluísio J D Barros10, Amha Mekasha11, Anantha Kumar Srinivasaiyer12, André Ricardo Araujo da Silva13, Andreas Schultz14, Batool Fatima15, Bishnupada Dhar16, Brian Magowan17, Bridget Wills18, Camille Raynes-Greenow19, Caroline Homer20, Carolyn Maclennan21, Catherine Ward22, Daniel Martinez Garcia23, David Ross24, David Murdoch25, Deborah Joy Wilson26, Ebun Adejuyigbe27, Ecaterina Stasii28, Elaine Scudder29, Emma Sacks30, Eric D McCollum31, Fernando Althabe32, Fiona Russell33, GS Kumar34, Halvor Sommerfelt35, Hamish Graham36, Hannah Blencowe37, Hannah Tappis38, Haroon Saloojee39, Hesham Abdussalam Ben Masaud 40, Hiresh Tiwary41, Ifeyinwa Asiodu42, James B Newton43, Jessica Bourdaire44, Joel Amwe Adze45, Jose Martines46, Juan M Lozano47, Judd Walson48, Judith Rankin49, Karel Allegaert50, Karell G Pellé51, Karen Edmond24, Katayoun Rabiei9, Kathleen M Rasmussen52, Khalid Yunis53, Laura Ferguson54, Leith Greenslade55, Lilian Kiapi56, Lisa Noguchi57, Louis Bont58, Louise T Day59, Lynne Mofenson60, Maher Aboumayaleh61, Majda Aquzouz62, Mamdouh Wahba63, Mari Nagai64, Marian Knight65, Marina Melkumova66, Mariyam Jenyfa67, Mark I Neuman68, Martin Meremikwu69, Mary Kinney70, Michael Gravett71, Michael T Hawkes72, Michel Pacqué73, Michele Walsh74, Michelle K McGuire75, Nagiba AAbdulghani AlShawafi76, Najwa Khuri-Bulos77, Naveen Thacker78, Nigel Rollins24, Niranjan Kissoon79, Olena Starets80, Olivier Picone81, Olufemi T Oladapo32, Omer Erdeve 82, P Brian Smith83, Philippe Van de Perre84, Praveen Kumar85, Punam Mangtani86, Qalab Abbas87, Rabeya Khatoon88, Rajiv Bahl24, Rakesh Lodha89, Rebecca Grais90, Rebecca Richards-Kortum91, Reeta Rasaily92, Richmond Aryeetey93, Robert Pattinson94, Roberta Petrucci95, Rodolfo Rossi96, Ryan M Pace75, Sachiyo Yoshida24, Salimah R Walani97, Sanjeeva SP Godakandage98, Sarah Bauler99, Sarah S Comstock100, Saurav Basu101, Senait Kebede102, Senjuti Saha103, Shinjini Bhatnagar104, Shoo Kim Lee105, Shuchita Gupta24, Simon Nyovuura Antara106, Soo Downe107, Stephen Freedman108, Stephen J Lye109, Suellen Miller110, Suha Sulimani 111, Sylvia H Ley112, Tara D Mangal113, Tina Lavin32, Ting Shi114, Todd A Florin115, Ulrik Kræmer Sundekilde116, Valentina Baltag24, Veronica Valdes117, William Cherniak118, Yasir Bin Nisar24, Zainularab Zohra Shamszai119, Zohreh Sadat Navabi9
1Dhaka Shishu (Children) Hospital & Child Health Research Foundation (CHRF), Dhaka, Bangladesh
2University Mohammed first Oujda, Morocco
3College of Medicine, University of Ibadan, Ibadan, Nigeria
4University of Ibadan & University College Hospital Ibadan, Nigeria
5Department of Pediatrics, University of Maryland School of Medicine, US
6Vaccine India Trust, National Newborn Foundation, Delhi Medical Association
7Pediatrics Department Hospital Universitario Infanta Sofía, Unidad Pediátrica de Investigación y Ensayos Clínicos (UPIC) Instituto de Investigación 12 de Octubre, Universidad Europea de Madrid
8Allied Experts for Health Systems; Egypt
9Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
10Universidade Federal de Pelotas, Pelotas, Brasil
11Department of Pediatrics and Child health, Addis Ababa University, Ethiopia
12Swami Vivekananda Youth Movement, Karnataka, India
13Federal Fluminense University, Materno Infantil Department, Niterói, Brazil
14Institute for Hygiene and Public Health Section Global Health, University of Bonn, Germany
15Department of Mental Health and Substance Use, World Health Organization
16Independent Consultant & Researcher
17NHS Borders, Scotland
18Oxford Centre for Global Health Research, University of Oxford, UK and Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
19Associate Prof, The University of Sydney, Sydney School of Public Health, Australia
20Burnet Institute, Australia
21Northern Territory Australia
22University of Cape Town, South Africa
23Médecins Sans Frontières (MSF) – Women and Children’s Health Unit, Medical Department, Operational Centre Geneva, SWITZERLAND
24Department of Maternal, Child and Adolescent Health and Ageing, World Health Organization
25University of Otago, Christchurch, New Zealand
26United Nations World Food Programme
27Obafemi Awolowo University, Ile-Ife, Nigeria
28State Medical and Pharmaceutical University after Nicolae Testemitanu, Moldova
29Inter-Agency Working Group on Reproductive Health in Crises (IAWG) / International Rescue Committee
30Department of International Health, Johns Hopkins School of Public Health, USA
31Global Program in Respiratory Sciences, Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, Johns Hopkins School of Medicine, USA
32Department of Sexual and Reproductive Health, World Health Organization
33The University of Melbourne; and Murdoch Children’s Research Institute, Australia
34Swami Vivekananda Youth Movement, Saragur, Mysuru District, Karnataka, India
35Centre for International Health, University of Bergen and Cluster for Global Health, Division for Health Services, Norwegian Institute of Public Health, Norway
36University of Melbourne, Murdoch Children’s Research Institute, Royal Children’s Hospital Melbourne, Australia
37London School of Hygiene & Tropical Medicine, UK
38Jhpiego – an affiliate of Johns Hopkins University Baltimore, Maryland, USA and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
39University of the Witwatersrand, Johannesburg, South Africa
40Libyan medical board, Libyan general practice society, Libyan emergency medicine association, Primary health care institute, Libya
41Society for Applied Studies, India
42University of California, San Francisco (UCSF) School of Nursing, San Francisco, US
43University of Pittsburgh; Lean Med, LLC, USA
44United Nations World Food Programme, Nutrition Research Officer
45Kaduna State University, Kaduna, Nigeria
46CISMAC, University of Bergen, Norway
47Division of Medical and Population Health Sciences Education and Research Department of Translational Medicine Herbert Wertheim College of Medicine Florida International University, USA
48University of Washington, USA
49Population Health Sciences Institute, Newcastle University, UK
50Erasmus MC Rotterdam, Netherlands
51Foundation for Innovative New Diagnostics, Switzerland
52Cornell University, Ithaca, New York, USA
53American University of Beirut, Lebanon
54Institute on Inequalities in Global Health, University of Southern California, USA
55Every Breath Counts Coalition
56International Rescue Committee
57Johns Hopkins Bloomberg School of Public Health, USA
58UMC Utrecht, Netherland
59Maternal & Newborn Health Group, Centre for Maternal Adolescent Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine (LSHTM), UK
60Elizabeth Glaser Pediatric AIDS Foundation
61Aga Khan Health Services, Syria
62Sexual and Reproductive Health Advisor, International Committee of the Red Cross
63Egyptian Society for Adolescent Medicine, Egypt
64Bureau of International Health Co-operation National Center for Global Health & Medicine (NCGM), Japan
65Professor of Maternal and Child Population Health, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
66Arabkir Medical Centre-Institute of Child and Adolescent Health, National Institute of Health, Armenia
67Health Protection Agency, Ministry of Health, Maldives
68Division of Emergency Medicine, Boston Children’s Hospital, Department of Pediatrics, Harvard Medical School, USA
69University of Calabar, Nigeria
70School of Public Health, University of the Western Cape, South Africa
71Global Health University of Washington Seattle, WA (USA)
72Department of Pediatrics, University of Alberta, Canada
73Child Health Team Lead, JSI Research & Training Institute, Inc, USA
74Case Western Reserve University, Cleveland OH USA
75Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, USA
76Medical & Health Science Faculty, Sanaa University, Yemen
77University of Jordan, Amman, Jordan
78Deep Children Hospital & Research Center, India and International Pediatrics Association
79Children’s and Women’s Global Health, UBC and BCCH Professor in Acute and Critical Care, Global Child Health, BCCH Research Institute, Global Sepsis Alliance, Vancouver
80National Medical University, Department of Pediatrics, Odessa, Ukraine
81Hôpital L Mourier, Colombes, France, University of Paris
82Ankara University School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
83Duke University Medical Center, USA
84University Montpellier, INSERM, Establishment Français du Sang, Antilles University; CHU Montpellier, France
85Post Graduate Institute of Medical Education and Research, Chandigarh
86Department of Infectious Disease Epidemiology London School of Hygiene and Tropical Medicine, UK
87Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
88Free-lance consultant RMNCAH
89Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
91Malcolm Gillis University Professor, Rice 360 Institute for Global Health, Rice University, Houston, TX (USA)
92Indian Council of Medical Research, New Delhi, India
93University of Ghana School of Public Health Legon, Accra, Ghana
94SAMRC/UP Maternal and Infant Health Care Strategies
95Medecins Sans Frontieres – International Pediatric Working group
96International Committee of the Red Cross (ICRC)
97Global Programs, March of Dimes, USA
98Consultant Community Physician Family Health Bureau/ Ministry of Health, Sri Lanka
99Senior Advisor, DME & Research, World Vision International; Global Health Instructor, Appalachian State University, USA
100Michigan State University, USA
101Maulana Azad Medical College, New Delhi, India
102Adjunct Associate Professor of Global Health, Emory University, USA
103Child Health Research Foundation, Bangladesh
104Translational Health Science and Technology Institute (DBT, Govt of India), Delhi, India
105University of Toronto, Canada
106African Field Epidemiology Network
107University of Central Lancashire, UK
108University of Calgary, Canada
109University of Toronto, Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Sinai Health and University of Toronto, Canada
110University of California, San Francisco, USA
111Ministry of Health, Saudi Arabia
112Tulane University School of Public Health & Tropical Medicine, USA
113Imperial college, London
114Usher Institute, University of Edinburgh
115Ann and Robert H Lurie Children’s Hospital of Chicago & Northwestern University Feinberg School of Medicine, UK
116Deptartment of Food Science, Faculty of Technical Sciences, Aarhus University Denmark, Denmark
117Universidad Católica de Chile, Chile
118Bridge to Health Medical and Dental Canada & USA and University of Toronto, Department of Family and Community Medicine, Division of Emergency Medicine, USA
119Obstetrician, Gynecologist, RMNCAH consultant, The Netherlands