CHAMPS Bio
The Child Health and Mortality Prevention Surveillance (CHAMPS), supported by the Bill & Melinda Gates Foundation, is a program that aims to understand the causes for early child deaths around the globe.
The program mainly works in developing countries in Sub-Saharan African and South Asia in six sites: Kersa, Ethiopia, Kisumu, Kenya, Bamako, Mali, Manhiça, Mozambique, Soweto, South Africa, and Baliakandi, Bangladesh.
CHAMPS is a long-term program (approximately 20 years) that will ultimately take place across up to 20 sites with high (>50 deaths in children under five years of age per 1,000 live births) childhood mortality rates; during the first three years, the program will begin in six sites. CHAMPS is focused on the collection of data and the strengthening of public health capacity in developing countries. 
CHAMPS helps make the world a safer place by conducting research and strengthening capacity in poor and vulnerable countries, in order to recognize and address the root and emerging causes of child mortality. For more information, please visit the CHAMPS website. (https://champshealth.org/)
The CHAMPS Network is composed of more than 15 global organizations including the U.S. Centers for Disease Control and Prevention (CDC), the International Association of National Public Health Institutes (IANPHI), the Public Health Informatics Institute at the Task Force for Global Health, and Deloitte Consulting LLP. Partner organizations at the newest sites include icddr,b and the Institute of Epidemiology and Disease Control Research in Bangladesh; Haramaya University and the London School of Hygiene and Tropical Medicine in Ethiopia; and the Kenya Medical Research Institute (KEMRI), the CDC and the Henry Jackson Foundation in Kenya.
CHAMPS in Ethiopia
Haramaya University, one of the oldest higher education institutions in Ethiopia, has four campuses, of which three are located in Haramaya Town and the College of Health and Medical Sciences (CHMS) in Harar City. The University administers the Hiwot Fana Specialized Teaching Hospital, where health students take trainings and conduct their internships. CHMS Campus hosts the office of the two Health and Demographic Surveillance Systems sites (HDSS): Kersa (which is predominantly rural) and Harar (urban).
There are two main hospitals serving these HDSS: Jugel Hospital and Hiwot Fana University Hospital. In addition to these two hospitals in Harar, one district hospital located in Haramaya serves Kersa HDSS, as well as various district health centers and community health posts. These posts are staffed by health extension workers that provide immunizations and family planning services, as well as partner with birth attendants to support access to clean and safe community deliveries.
Websites for the Six CHAMPS Sites
https://champshealth.org/where-we-work/ethiopia-site/
https://champshealth.org/kenya2/
https://champshealth.org/where-we-work/mali-site/
https://champshealth.org/where-we-work/mozambique-site/
Bill & Malinda Gates Foundation
https://www.gatesfoundation.org/
Bill & Melinda Gates Foundation (BMGF), also known as the Gates Foundation, is a private foundation founded by Bill and Melinda Gates. It was launched in 2000 and is said to be the largest transparently operated private foundation in the world. The primary aims of the foundation are to enhance healthcare and reduce extreme poverty.
BMGF envisioned CHAMPS as a new global surveillance network to address the challenges of lack of robust primary data, gaps and heavy reliance on modeling; and non-standardized and unreliable siloed processes across geographies and difficulty to integrate and analyze verbal autopsies and syndrome-based data which are not granular. The initial focus is to describe and track causes of child mortality in 6 sites over 3 years, eventually expanding to 20-25 sites across Sub-Saharan Africa and South As
ia over 25 years.
London School of Hygiene and Tropical Medicine
The London School of Hygiene and Tropical Medicine (LSHTM) is a research university in London that specializes in global and public health.
The School is a world-leading center for research and postgraduate education in public and global health, with an annual research income ofmore than £110 million.
LSHTM has convened the consortium of stakeholders tocollaborate and support the establishment of CHAMPS in Ethiopia.
This consortium will include CHAMPS’ other national partners in Ethiopia: the Ministry of Health and the Ethiopian Public Health Institute, Armauer-Hansen Research Institute (AHRI) and the Ethiopian Public Health Association, as well as the HDSS and regional University.
Emory University-Emory Global Health Institute
University, a top-ranked private institution recognized internationally for its outstanding liberal arts colleges, graduate and professional schools, and one of the world’s leading health care systems, is located in Atlanta, Georgia’s historic Druid Hills neighborhood.
The Emory Global Health Institute was established in September 2006 as part of Emory University’s 2005-2015 strategic plan. The EGHI helps Emory University improve health around the world by supporting Emory faculty members and students engaged in a variety of global health research, scholarship, service, and training activities.
Emory’s relationships with prominent public health organizations and agencies also made it an ideal place to launch an academic center focused on improving global health. The University has longstanding, close working relationships with The Carter Center and the Task Force for Global Health, organizations that have formal affiliations with Emory. And Emory’s faculty, staff, and students partner routinely with other Atlanta-based health-related organizations such as the American Cancer Society, CARE, the Centers for Disease Control and Prevention (CDC), the Georgia Institute of Technology, Georgia State University, and the Morehouse School of Medicine.
Armauer Hansen Research Institute
The Armauer Hansen Research Institute (AHRI) was founded in 1970 through the initiative of the Norwegian and Swedish Save the Children organizations seconded by the Ministry of Health of Ethiopia. The Institute got its name from the Norwegian physician, Gerhard Henrik Armauer Hansen, who first described the leprosy bacillus (Mycobacterium leprae).
AHRI was established as a biomedical research institute located next to the All Africa Leprosy Rehabilitation and Training Hospital (ALERT). The Institute joined the Ethiopian Ministry of Health in 2004.
AHRI acknowledges receiving core-funding from Swedish International Development Cooperation Agency (Sida) and Norwegian Agency for Development Cooperation(Norad) in addition to Ethiopian Government contribution, which it uses to support among other things students’ research within the scope of the European & Developing Countries Clinical Trials Partnership (EDCTP) programme. These include epidemiological and social studies for characterisation of poverty-related and neglected diseases.
Ethiopian Public Health Institute
The Ethiopian Public Health Institute (EPHI) was formally established as an independent institution in 2014 – building on the strong foundation of the Ethiopian Health and Nutrition Research Institute (EHNRI) that was created in 1996.
Working closely with the Federal Ministry of Health and other stakeholders, EPHI provides evidence-based information for public health policy formation and resource allocation through the key functions of disease surveillance, outbreak investigation and control, health information analysis, research, training, health promotion, and laboratory science. With responsibility and authority for aggregating and centralizing public health functions within Ethiopia and promoting health security, EPHI is well positioned to achieve major national health goals and improve health outcomes for the country’s population.
Harari Region
Based on the 2007 Census conducted by the Central Statistical Agency of Ethiopia (CSA), Harari has a total population of 183,415, of whom 92,316 were men and 91,099 women. This region is the only one in Ethiopia where the majority of its population lives in urban area: 99,368 or 54.18% of the population are urban inhabitants. With an estimated area of 311.25 square kilometers, the region has an estimated density of 589.05 people per square kilometer. For the entire region 46,169 households were counted, which results in an average for the Region of 3.9 persons to a household, with urban households having on average 3.4 and rural households 4.6 people.
Harar Urban Health and Demographic Surveillance System (Harar Urban HDSS)
Harar Urban HDSS was established in 6 sub-districts among 19 urban sub-districts in the city of Harar, Harari People National Regional State in July 2011. It has a central coordinating office and field sites, both located in the city in College of Health and Medical Sciences (CHMS), Haramaya University.
A baseline population and housing census that covered the selected six kebeles was conducted in September 2012, and follow up of the demographic and health related events started soon after the census. The total population of the HDSS site at the baseline was 32,437 residents. Of these, 15,579 (48%) were male and the remaining 16,858 (52%) were female. Women of child bearing age accounts for 10,069 (31%) of the total population.
According to the four consecutive year surveillance (2013-2015), 1,983 births and 500 deaths were registered. The sex ratio at birth and general population sex ratio were 1.08 and 0.91, respectively. The Total Fertility Rate ranges from 1.29 to 3.49. Neonatal, postnatal, infant and under five mortality rates were observed below 10 per 1000 population.
Kersa
Eastern Hararghe
Eastern Hararghe is one of the 15 zones of Oromia Regional State.
It is bordered on the southwest by the Wabe Shebelle River, which separates it from Bale Zone; on the west by West Hararge Zone
the north by Dire Dawa Administration; and on the north and east by the Somali Regional State.
Based the 2007 census, the zone has an estimated total population of 2,739,390, of which 6.9% of its population is urban dwellers. The zone has an area of 24,900.21 square kilometers, and a population density of 102.64 people per square kilometer. The health coverage of the zone is 80 %. Forty four percent of the zone is malarious area.
Kersa District
Kersa District is one of the 
16 districts of Eastern Hararghe Zone, bordered on the south by Bedeno District, on the west by Meta District, on the north by Dire Dawa City Administrative Council,non the northeast by Haramaya District, and on the southeast by Kurfa Chele District. The district capital is Kersa Town which is 44 km from west of Harar City; other towns in the district include Lange and Weter.
According to a survey of the land in Kersa (released in 1995/96), 28.5% is arable or cultivable, 2.3% pasture, 6.2% forest, and the remaining 56.3% is considered built-up degraded or otherwise unusable. Khat, fruits and vegetables are important cash crops. Coffee is also an important cash crop; covering 5,000 hectares. Sorghum, maize, barley, wheat etc. are among the food crops cultivated in the district.
Kersa Demographic Surveillance and Health Research Center (KDS-HRC)
Kersa Demographic Surveillance and Health Research Center (KDS-HRC) is located in Kersa District of Eastern Hararege, Oromia Region, Eastern Ethiopia. It was established in 2007 with the vision of becoming center of excellence in health science research in Ethiopia. It conducts health and demographic surveillance. The major work on the ground are monitoring demographic altering events such as birth, death, and migration; and health related conditions such as pregnancy, immunization, and morbidity. It also conducts verbal autopsy for the deceased to identify causes of death.
The HDSS runs in 12 representative kebeles out of the 38 in Kersa District. Of the 12 kebeles, 10 are rural and two are urban (Kersa and Weter towns). There are 3 health centers and 10 health posts in the 12 kebeles, and all the kebeles have 2-3 health extension workers assigned to work on the 16 health extension packages. There are 18 elementary, 2 secondary, 1 preparatory, and 2 religious schools; 134 mosques, 8 churches and 6 farmers training stations in the study kebeles.
Social Behavioral Studies
CHAMPS Project is a child health and mortality prevention campaign also focusing on the social science aspect of the community as well. SBS includes Formative Research: understanding specific cultural, religious and socio-behavioral factors that may increase or decrease feasibility mortality surveillance on children under 5, and factors that may influence pregnancy and neonatal mortality; and Community Engagement: coming together and creating a group to a common set of goals, values, and work together to achieve those common goals.
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PICK-CHAMPS
Participatory Inquiry into Community Knowledge of Child Health and Mortality Prevention (PICK-CHAMP) is an example of information systems to meet specific needs while ensuring data consistency across the campaign.
When CHAMPS initiates work at a new site, an important first step is talking to community members and leaders. Learning more about their perceptions of childhood death, their experiences with the health care system, expectations for burial and other cultural ceremonies, and openness to Minimally Invasive Tissue Sampling (MITS), which CHAMPS uses to ascertain the cause of death for specific cases are issues of importance to the Project.
This application focuses on Acceptability-individuals and community understanding and reaction towards CHAMPS program activities in relation to their existing cultural, social, religious, political and economic aspects; Practicality- perceptions and capacity that may hinder or facilitate the approach or applicability of CHAMPS activity; and Implementation- requirements for carrying out activities which key stakeholders that will contribute to the achievement of CHAMPS activities.
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CHAMPS Child Mortality Study
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Principal Investigator (PI)
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Dr. Anna Seale (BMBCh MA MSc PGDipPID MRCPCH MFPH DPhil)
Dr. Anna has trained in pediatrics, and subsequently epidemiology and public health, with a focus on infectious diseases in maternal, child and newborn health. Her Wellcome Trust Research Training Fellowship based at the KEMRI-Wellcome Trust Research Programme, concerned the clinical and molecular epidemiology of Group B Streptococcus in coastal Kenya and its association with stillbirth and neonatal disease.
She is working on the aetiology of maternal infection and their association with stillbirth in Ethiopia (Haramaya University) and Kenya (KEMRI-Wellcome Trust Research Programme). Her work in Ethiopia is based at the new CHAMPS site in Harar City. This is being developed as a collaboration between LSHTM, Haramaya University, and Emory Global Health Institute, which are leading this global network.
Co-Principal Investigator (Co-PI)
Email: negaassefa@yahoo.com
Skype:
Phone No.: +251915321136
Dr. Nega Assefa (MPH-RH, PhD)
Dr. Nega Assefa is an Assistant Professor of Reproductive Health, Maternal and Child Health. He is the site lead for Kersa HDSS and Harar Urban HDSS. His research interests lie in Pregnancy and its Outcome, Neonatal and Child Survival, Neonatal and Child Morbidity, Family Health, Population Dynamics (Fertility and Mortality), Family Planning and Contraception, and Morbid Health Conditions during Pregnancy and morbidity during Birth and Postnatal Period.
Project Manager
Mahlet Mekonnen
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