NIHR Global Health Research on reducing Preterm and Stillbirth (DIPLOMATIC)


DIPLOMATIC. Using eviDence, Implementation science, and a clinical trial PLatform to Optimise MATernal and newborn health in lICs (Low Income Countries).

Funded by the National Institute for Health Research (NIHR), DIPLOMATIC is a Global Health Research Group based in the UK, Malawi and Zambia. 

Our vision is to reduce mortality of children under 5 years (one of the targets of sustainable development goals) by reducing preterm birth and stillbirth and to optimise outcomes for babies born preterm.


Annual deaths from preterm birth and stillbirth in Malawi and Zambia are over 36,500: the World Health Organisation has estimated that the majority are preventable.

Specifically we aim to:

  • Enhance clinical care strategies for the prevention of stillbirth and preterm birth in Malawi and Zambia, reducing rates of preterm birth, stillbirth and under-5 deaths
  • Generate new knowledge on the effectiveness of interventions and on how best to implement them
  • Develop a clinical trials platform to test NOVEL INTERVENTIONS, initially for stillbirth and preterm birth, but longer term in an NIHR unit on maternal newborn global health
  • Enhance the collection of perinatal outcomes in vital statistics and hospital datasets
  • Increase the accuracy of prematurity estimates by using first trimester ultrasound scanning to optimise assessment of gestational age

We recognise the differences that cultures, traditions, gender roles, resources, workforce constraints, disease burdens and community understandings of pregnancy and birth bring, and have therefore designed this group to examine strategies to develop and implement contextualised, evidence based local practices building on successes and challenges of current best practice in the UK and other high income countries.

Together with partners, and using a consensus exercise, we will identify Evidence Based Practices (EBPs) from recommendations from the World Health Organisation (WHO), other stakeholders and from regional expertise: for example, first trimester ultrasound scanning to accurately determine gestation.

By sharing existing knowledge on evidence- based practices and implementing new trial designs, our aim is to see a significant improvement at the end of this three year study.