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Related Research Units

Research Overview

Dr. Chan’s lab seeks to design, test, and implement sustainable clinical and public health interventions to advance maternal and child health. Research interests focus on:

  • Surveillance of maternal and child morbidity and mortality to improve disease estimates
  • Infections in newborns and antimicrobial resistance
  • Risk prediction and causal modeling for pregnancy complications and adverse birth outcomes
  • Development and testing of newborn care packages to improve survival of preterm and low-birth weight babies

Dr. Chan is a co-founder of the HaSET Maternal and Child Health Research Program. She has led international collaborations with the World Health Organization (WHO) and Save the Children to develop and test models to scale up kangaroo mother care, an evidence-based intervention that reduces mortality among preterm and low birth weight babies up to 40%. These findings have influenced the recent global WHO guidelines on the care of preterm and low birth weight infants. Dr. Chan served as the epidemiology lead for a large-scale cohort study with 29,000 pregnant women and their newborns in seven low- and lower middle-income countries (LLMICs) to determine the epidemiology and patterns of antimicrobial resistance of neonatal sepsis. Results demonstrated that over 90% of neonatal sepsis isolates were resistant to first-line antibiotics and led to global and national programs on infection prevention and targeted antibiotic therapy. She is currently working on estimating the morbidity and mortality of women and young children globally. More details can be found at www.haset.org.

Research Background

Dr. Chan is a graduate of Harvard College and Harvard Medical School. She completed her PhD and post-doctoral work at Johns Hopkins Bloomberg School of Public Health and a research fellowship at ICDDR, B. She trained in pediatrics at Boston Children’s Hospital and Boston Medical Center in the Boston Combined Residency Program. Dr. Chan serves as an Attending Physician in the Division of Medical Critical Care. She is also an honorary faculty member at St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. She has mentored many talented students and fellows.

Selected Publications

  1.  Chan GJ, Moulton LH, Becker S, Muñoz A, Black R.  Non-specific effects of diphtheria-tetanus-pertussis vaccination on child mortality in Cebu, The Philippines.  International Journal of Epidemiology, 2007; 36(5):1022-1029.
  2. Chan GJ, Lee AC, Baqui AH, Tan J, Black RE. Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis. PLoS Medicine, 2013; 10(8):e1001502. Epub 2013/08/27.
  3. Boundy EO, Spiegelman D, Fawzi WW, Lieberman E, Missmer SA, Dastjerdi R, Kajeepeta S, Wall S, Chan GJ. Kangaroo Mother Care and Neonatal Outcomes: A Systematic Review and Meta-Analysis. Pediatrics. 2016;137(1):1-16.
  4. Bekele D, Hunegnaw BM, Bekele C, Van Wickle K, Tadesse F, Goddard FGB, Mohammed Y, Unninayar S, Chan GJ. Cohort profile: the Birhan Health and Demographic Surveillance System. International Journal of Epidemiology. April 2022;51(2). doi: 10.1093/ije/dyab225. PMID 34751768
  5. Milton R, Gillespie D, Dyer C, Taiyari K, Carvalho MJ, Thomson K, Sands K, Portal EAR, Hood K, Ferreira A, Hender T, Kirby N, Mathias J, Nieto M, Watkins WJ, Bekele D, Abayneh M, Solomon S, Basu S, Nandy RK, Saha B,  Iregbu K, Modibbo F, Uwaezuoke S, Zahra R, Shirazi H, Najeeb S, Mazarati JB, Rucogoza A, Gaju L, Mehtar S, Bulabula ANH, Whitelaw A, Walsh TR, BARNARDS Group, Chan GJ. Neonatal sepsis and mortality in low- and middle-income countries from a facility-based birth cohort: an international multi-site prospective observational study. Lancet Global Health. May 2022;10(5):e661-e672. doi:10.1016/s2214-109x(22)00043-2. PMID 35427523

Education

Undergraduate School

Harvard College
Cambridge MA

Graduate School

Johns Hopkins Bloomberg School of Public Health
Baltimore MD

Medical School

Harvard Medical School
Boston MA

Internship

Boston Combined Residency Program (BCRP)
Boston MA

Residency

Boston Combined Residency Program (BCRP)
Boston MA

Media

Answers Blog

Around the world, five million children die each year before the age of 5, often in the first month of life. Dr. Grace Chan found this unacceptable. This is her story.

Publications

  1. Building capacity for maternal, newborn and child health research in low-income country settings: A research fellowship experience in Ethiopia. J Glob Health. 2024 Nov 29; 14:04198. View Abstract
  2. Prevalence of diarrhoea and treatment-seeking practices among children <2 years of age in the Birhan cohort, Ethiopia, 2018-19. J Glob Health. 2024 Nov 01; 14:04181. View Abstract
  3. Prognostic prediction models for adverse birth outcomes: A systematic review. J Glob Health. 2024 Oct 25; 14:04214. View Abstract
  4. Utilisation and associated socio-demographic factors related to the maternal continuum of care in sub-Saharan Africa: A systematic review and meta-analysis. J Glob Health. 2024 Oct 18; 14:04180. View Abstract
  5. Birth outcomes and survival by sex among newborns and children under 2 in the Birhan Cohort: a prospective cohort study in the Amhara Region of Ethiopia. BMJ Glob Health. 2024 Aug 13; 9(8). View Abstract
  6. Estimates and determinants of health facility delivery in the Birhan cohort in Ethiopia. PLoS One. 2024; 19(7):e0306581. View Abstract
  7. Carriage of antimicrobial-resistant Enterobacterales among pregnant women and newborns in Amhara, Ethiopia. Int J Infect Dis. 2024 Jun; 143:107035. View Abstract
  8. Prevalence, Incidence, and Reversal Pattern of Childhood Stunting From Birth to Age 2 Years in Ethiopia. JAMA Netw Open. 2024 01 02; 7(1):e2352856. View Abstract
  9. Antenatal care coverage in a low-resource setting: Estimations from the Birhan Cohort. PLOS Glob Public Health. 2023; 3(11):e0001912. View Abstract
  10. Health care seeking behaviors of pregnant women in rural Amhara, Ethiopia: a qualitative study of perceptions of pregnant women, community members, and health care providers. Pan Afr Med J. 2023; 45:142. View Abstract
  11. Azithromycin to Prevent Sepsis or Death in Women Planning a Vaginal Birth. N Engl J Med. 2023 Jul 20; 389(3):282. View Abstract
  12. Development of risk prediction models for preterm delivery in a rural setting in Ethiopia. J Glob Health. 2023 May 26; 13:04051. View Abstract
  13. Vulnerable newborn types: analysis of subnational, population-based birth cohorts for 541?285 live births in 23 countries, 2000-2021. BJOG. 2023 May 08. View Abstract
  14. Small babies, big risks: global estimates of prevalence and mortality for vulnerable newborns to accelerate change and improve counting. Lancet. 2023 05 20; 401(10389):1707-1719. View Abstract
  15. Development of Prediction Models for Antenatal Care Attendance in Amhara Region, Ethiopia. JAMA Netw Open. 2023 05 01; 6(5):e2315985. View Abstract
  16. Setting a research agenda to advance maternal, newborn, and child health in Ethiopia: An adapted CHNRI prioritization exercise. J Glob Health. 2023 Feb 10; 13:04010. View Abstract
  17. Factors associated with small-for-gestational-age births among preterm babies born <2000 g: a multifacility cross-sectional study in Ethiopia. BMJ Open. 2022 11 22; 12(11):e064936. View Abstract
  18. Survival status and predictors of mortality among low-birthweight neonates admitted to KMC units of five public hospitals in Ethiopia: Frailty survival regression model. PLoS One. 2022; 17(11):e0276291. View Abstract
  19. Incremental costs of scaling up kangaroo mother care: Results from implementation research in Ethiopia and India. Acta Paediatr. 2023 08; 112 Suppl 473:86-94. View Abstract
  20. Antibiotic resistance genes in the gut microbiota of mothers and linked neonates with or without sepsis from low- and middle-income countries. Nat Microbiol. 2022 09; 7(9):1337-1347. View Abstract
  21. Characterisation of Staphylococci species from neonatal blood cultures in low- and middle-income countries. BMC Infect Dis. 2022 Jul 01; 22(1):593. View Abstract
  22. Implementation science to design, test and scale up effective Kangaroo Mother Care in Oromia region, Ethiopia. Acta Paediatr. 2023 08; 112 Suppl 473:56-64. View Abstract
  23. Impact of the COVID-19 pandemic on utilisation of facility-based essential maternal and child health services from March to August 2020 compared with pre-pandemic March-August 2019: a mixed-methods study in North Shewa Zone, Ethiopia. BMJ Open. 2022 06 03; 12(6):e059408. View Abstract
  24. Estimates of Stillbirths, Neonatal Mortality, and Medically Vulnerable Live Births in Amhara, Ethiopia. JAMA Netw Open. 2022 06 01; 5(6):e2218534. View Abstract
  25. Cohort Profile: The Birhan Health and Demographic Surveillance System. Int J Epidemiol. 2022 05 09; 51(2):e39-e45. View Abstract
  26. Neonatal sepsis and mortality in low-income and middle-income countries from a facility-based birth cohort: an international multisite prospective observational study. Lancet Glob Health. 2022 05; 10(5):e661-e672. View Abstract
  27. Enhancing Nutrition and Antenatal Infection Treatment (ENAT) study: protocol of a pragmatic clinical effectiveness study to improve birth outcomes in Ethiopia. BMJ Paediatr Open. 2022 01; 6(1). View Abstract
  28. Birhan maternal and child health cohort: a study protocol. BMJ Open. 2021 09 28; 11(9):e049692. View Abstract
  29. Effect of birthweight measurement quality improvement on low birthweight prevalence in rural Ethiopia. Popul Health Metr. 2021 09 22; 19(1):35. View Abstract
  30. Scaling up Kangaroo Mother Care in Ethiopia and India: a multi-site implementation research study. BMJ Glob Health. 2021 09; 6(9). View Abstract
  31. Effects of antibiotic resistance, drug target attainment, bacterial pathogenicity and virulence, and antibiotic access and affordability on outcomes in neonatal sepsis: an international microbiology and drug evaluation prospective substudy (BARNARDS). Lancet Infect Dis. 2021 12; 21(12):1677-1688. View Abstract
  32. Prevalence and risk factors for antimicrobial resistance among newborns with gram-negative sepsis. PLoS One. 2021; 16(8):e0255410. View Abstract
  33. Gaps in maternal, newborn, and child health research: a scoping review of 72 years in Ethiopia. Journal of Global Health Reports. 2021; 5:e2021033. View Abstract
  34. Characterization of antimicrobial-resistant Gram-negative bacteria that cause neonatal sepsis in seven low- and middle-income countries. Nat Microbiol. 2021 04; 6(4):512-523. View Abstract
  35. Equity Metrics as an Essential Component of Hospital Rankings. Health Affairs Blog. 2021. View Abstract
  36. Scoping review protocol on maternal, newborn and child health research in Ethiopia. BMJ Open. 2020 07 02; 10(7):e034307. View Abstract
  37. Kangaroo Mother Care implementation research to develop models for accelerating scale-up in India and Ethiopia: study protocol for an adequacy evaluation. BMJ Open. 2019 11 21; 9(11):e025879. View Abstract
  38. Distribution and determinants of pneumonia diagnosis using Integrated Management of Childhood Illness guidelines: a nationally representative study in Malawi. BMJ Glob Health. 2018; 3(2):e000506. View Abstract
  39. Barriers and enablers of kangaroo mother care implementation from a health systems perspective: a systematic review. Health Policy Plan. 2017 Dec 01; 32(10):1466-1475. View Abstract
  40. Profile and outcomes of women with pregnancy-related acute kidney injury requiring dialysis at a center in Ethiopia. Int J Gynaecol Obstet. 2017 Aug; 138(2):138-141. View Abstract
  41. Barriers and enablers of health system adoption of kangaroo mother care: a systematic review of caregiver perspectives. BMC Pediatr. 2017 01 25; 17(1):35. View Abstract
  42. Dietary iron and calcium intakes during pregnancy are associated with lower risk of prematurity, stillbirth and neonatal mortality among women in Tanzania. Public Health Nutr. 2017 03; 20(4):678-686. View Abstract
  43. Prevalence and risk factors of chorioamnionitis in Dhaka, Bangladesh. J Perinatol. 2016 12; 36(12):1039-1044. View Abstract
  44. What is kangaroo mother care? Systematic review of the literature. J Glob Health. 2016 Jun; 6(1):010701. View Abstract
  45. Risk factors for small-for-gestational-age and preterm births among 19,269 Tanzanian newborns. BMC Pregnancy Childbirth. 2016 05 17; 16:110. View Abstract
  46. Kangaroo Mother Care and Neonatal Outcomes: A Meta-analysis. Pediatrics. 2016 Jan; 137(1). View Abstract
  47. Kangaroo mother care: a systematic review of barriers and enablers. Bull World Health Organ. 2016 Feb 01; 94(2):130-141J. View Abstract
  48. Validation of a novel tool for assessing newborn resuscitation skills among birth attendants trained by the Helping Babies Breathe program. Int J Gynaecol Obstet. 2015 Nov; 131(2):196-200. View Abstract
  49. Prevalence of early-onset neonatal infection among newborns of mothers with bacterial infection or colonization: a systematic review and meta-analysis. BMC Infect Dis. 2015 Mar 07; 15:118. View Abstract
  50. The effect of intrapartum antibiotics on early-onset neonatal sepsis in Dhaka, Bangladesh: a propensity score matched analysis. BMC Pediatr. 2014 Apr 17; 14:104. View Abstract
  51. The effect of abnormal birth history on ambulatory blood pressure and disease progression in children with chronic kidney disease. J Pediatr. 2014 Jul; 165(1):154-162.e1. View Abstract
  52. Maternal and neonatal colonization in Bangladesh: prevalences, etiologies and risk factors. J Perinatol. 2013 Dec; 33(12):971-6. View Abstract
  53. Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis. PLoS Med. 2013 Aug; 10(8):e1001502. View Abstract
  54. Early-onset neonatal sepsis in Dhaka, Bangladesh: risk associated with maternal bacterial colonisation and chorioamnionitis. Trop Med Int Health. 2013 Sep; 18(9):1057-1064. View Abstract
  55. Improving health services to displaced persons in Aceh, Indonesia: a balanced scorecard. Bull World Health Organ. 2010 Sep 01; 88(9):709-12. View Abstract
  56. Non-specific effects of diphtheria tetanus pertussis vaccination on child mortality in Cebu, The Philippines. Int J Epidemiol. 2007 Oct; 36(5):1022-9. View Abstract
  57. Cognitive impairment screening in second offense DUI programs. J Subst Abuse Treat. 2000 Dec; 19(4):369-73. View Abstract

Contact Grace Chan