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Current Projects

Projects led by Global and Women’s Health

COVID-19 mental health research

How are you? Living with COVID-19 restrictions in Australia

Fisher J, Kirkman M, Tran T, Hammarberg K, Sastry J, Nguyen, Rowe H, Popplestone S, Stocker R, Stubber C.

Global and Women’s Health has undertaken two anonymous online surveys to see how people in Australia are experiencing the COVID-19 pandemic and the restrictions that have been necessary to contain it.

The first survey was launched in April 2020, four days after significant restrictions to limit the spread of COVID-19 were mandated in Australia. It attracted almost 14,000 responses from people aged from 18 to 90 years, from all Australian states and territories and from rural and urban areas.

This was the largest survey undertaken during the nationwide lockdown in Australia and the first to quantify the mental health impact of the restrictions. The survey found a widespread increase in psychological symptoms, including anxiety, depression, irritability and thoughts of being better off dead. The paper reporting the findings has been accepted for publication in the Medical Journal of Australia.

A second survey was conducted in July and August 2020 and secured 9,000 responses. The survey replicated the questions posed in the first survey and added questions asking what governments can do to help recovery. The findings of the survey will be made available soon on the Global and Women’s Health website.

This research was made possible by a generous donation from Professor John McBain and Dr Penny Foster. Neither the researchers nor the donors have any conflict of interest in the research.

Jane Fisher is supported by the Finkel Family Foundation which supports her position as the Finkel Professor of Global Health. Thach Tran is supported by a Monash University Senior Bridging Postdoctoral Fellowship.

Vale Dr Claire Stubber, Adjunct Research Fellow

15 August 1978 – 23 December 2020

It is with sadness that the Global and Women's Health Unit announces the death of researcher and advocate Dr Claire Stubber. Claire's life was shaped by her experience as an organ recipient, caused by significant congenital cardiac defects. Reflections on her own life drove her passion for research into improving outcomes and experiences for people receiving donated hearts and lungs. Claire was a remarkable woman and scholar. Read full obituary here.

Learning Clubs – Vietnam (NHMRC)

Learning Clubs – Vietnam (Grand Challenges Canada)

Addressing an unrecognised public health problem in Vietnam

Experiences of heart and lung transplantation in Australia

Latrobe Valley early parenting – What Were We Thinking

Contributing to optimal mental health for older women in Australia

Improving child health and development in resource-constrained settings

Improving child health and development in resource-constrained settings: a multi-component study to inform policy and more effective interventions

Tran TD (Fisher J is the Mentor).

Worldwide, over 200 million children under five years of age do not reach their potential because they are stunted and have compromised cognitive, motor, and social-emotional development, setting them on poor lifetime trajectories.

This project will extend knowledge about the effects of social determinants on child malnutrition and compromised development in low-and middle-income countries (LMICs) to inform policy and the development of targeted, effective interventions in disadvantaged groups worldwide.

The first component, a secondary analysis of The UNICEF Multiple Indicator Cluster Surveys conducted in ~ 60 LMICs, will describe the trends in the prevalence of child malnutrition in LMICs in the last 15 years.

The second, a secondary analysis of a longitudinal study in four LMICs which follows up a cohort of 8,000 children from one to 15 years of age, will examine the trajectories of child growth and development in this timeframe. It will determine the effects of factors at child, parental, family, community and country levels on the trajectories of child growth and development.

The last component is a cluster-randomised controlled trial in Vietnam to evaluate the impact of Learning Clubs for women and Infants; a structured universal program we have developed on the health of women and the health and development of their infants. This project is funded by the National Health and Medical Research Council (NHMRC).

Reported in:

Tran TD, Biggs B, Holton S, Nguyen H, Hanieh S, Fisher J. Co-morbid anaemia and stunting among children of pre-school age in low- and middle-income countries: a syndemic. Public Health Nutrition 2019, 22(1), 35–43, DOIs: 10.1017/S136898001800232X

Lokuketagoda BU, Thalagala N, Fonseka P, Tran T. Early Development Standards for Children Aged 2 to 12 Months in a Low-Income Setting. SAGE Open. 2016 Oct;6(4):2158244016673128. https://researchmgt.monash.edu/ws/portalfiles/portal/52958444/16788759_oa.pdf

Tran TD, Luchters S, Fisher J. Early childhood development: impact of national human development, family poverty, parenting practices and access to early childhood education. Child: Care, Health & Development 2017, 43 (3), 415–426 DOI: 10.1111/cch.12395.

Tran TD, Holton S, Nguyen H, Fisher J. Physical growth: is it a good indicator of development in early childhood in low- and middle-income countries? BMC Pediatrics 2019, 19(1), 276. doi:10.1186/s12887-019-1654-9 https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-019-1654-9

Fisher J, Tran T, Luchters S, Tran TD, Hipgrave D, Hanieh S, Tran H, Simpson J, Nguyen T, Le M, Biggs B-A. Addressing multiple modifiable risks through structured community-based Learning Clubs to improve maternal and infant health and infant development in rural Vietnam: protocol for a parallel group cluster randomised controlled trial. BMJ Open 2018, 8:e023539. DOI:10.1136/bmjopen-2018-023539 https://bmjopen.bmj.com/content/8/7/e023539

Tran TD, Hetzel B, Fisher J. Access to iodized salt in 11 low- and lower-middle-income countries: 2000 and 2010. Bulletin of the World Health Organization 2016, 94:122–129. DOI: 10.2471/BLT.15.160036. https://www.who.int/bulletin/volumes/94/2/15-160036.pdf

Tran TD, Nguyen H, Fisher J. Attitudes towards Intimate Partner Violence against Women among Women and Men in 39 Low- and Middle-Income Countries. PLoS One 2016, 11(11):e0167438. DOI: 10.1371/journal.pone.0167438. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0167438

Clinician-level Quality Indicator Reports

Strengthening mental health capacity/service integration: primary postnatal care

Strengthening mental health capacity and service integration in primary postnatal care in Victoria

Rowe H, Fisher J, Weller C, Campbell D, Meggetto K, Robertson J.

Postnatal mental health problems among women are associated with morbidity, reduced social participation, impaired infant development and family functioning, and constitute an Australian public health priority. Universal primary care health services (Maternal and Child Health and General Practice) are at the forefront of promotion, prevention and early intervention for postnatal mental health. However, they are under-resourced for these roles, and the two sectors are organisationally segregated.

Health service reform to increase consistency of care and service integration, supporting a comprehensive stepped-care model of prevention, early intervention and treatment, is required.

What Were We Thinking (WWWT) is an evidence-informed, effective, acceptable, psycho-educational model of postnatal care that addresses known but neglected risks for mental health at this phase of life. It is non-stigmatising, and facilitates clinician professional development, parent skill-building, and identification of, and early intervention for, mental health problems. The Department of Health and Human Services Victoria has commissioned Rowe and Fisher to implement WWWT in the Latrobe Valley (2018-2020).

The Flagship will leverage this project to bring implementation science experts and consumers together with key government, primary care and community health partners to translate and scale up successful implementation of the reform. The Theoretical Domains Framework will guide investigation of stakeholder perspectives about required modifications and how to achieve and measure change in barriers and enablers for implementation. The Flagship outcome will be rigorously-evaluated, practical, implementation tools, specifically for consumers, clinicians, and health services. The tools will support WWWT scale-up across Victoria, and will be readily transferrable to implementation of other complex interventions and health settings.

This project is being led by Global and Women's Health's Dr Heather Rowe. The project is funded through the 2019 Monash Partners Medical Research Future Fund (MRFF) Rapid Applied Research Translation funding round.

Actions louder than words: actualizing Respectful Maternal Care (RMC) in India

Cohort investigation of women admitted with their infants or toddlers to MPHEPC

Cohort investigation of women admitted with their infants or toddlers to Masada Private Hospital Early Parenting Centre to identify indicators of immediate- and medium-term program impact

Fisher J, Tran T, Stanzel K.

In Australia about 15% of women experience a depressive, anxiety or adjustment disorder in the year after giving birth and, about one per thousand, the severe mental disorder of postpartum psychosis. The postnatal mental health of women is a major determinant of their capacity to provide sensitive responsive care for their infants or toddlers and thereby optimise infant mental health and early childhood development. It is an Australian priority to provide clinically and cost-effective treatments for women with mental health problems and their infants and toddlers.

Ramsay Health Care is the main private sector provider of mother-baby psychiatric and residential early parenting services in Australia. Ramsay Health Care’s Masada Private Hospital Early Parenting Centre is the largest and most well-established private sector residential early parenting service in Australia. It has a systematic admission protocol and women admitted to the service complete self-report measures prior to admission, on day of discharge and six weeks post-discharge.

The overall goal of the research is to generate evidence about the characteristics of women and their infants or toddlers admitted to Masada Private Hospital Early Parenting Centre and indicators of short and medium impact to inform benchmarking of current clinical services and provide a comparison for new and enhanced services.

This project will provide the basis for maintaining continuous quality improvement in early parenting and mother-baby psychiatric services. It will generate the most detailed evidence to date about the characteristics of women admitted with their infants or toddlers to one early parenting centre and the most sensitive indicators of program impact. Together these will inform the development of assessment protocols that can be implemented at scale in all early parenting and mother-baby psychiatric services and enable quality improvement through benchmarking and program consistency.

This project is funded by the Ramsay Hospital Research Foundation.

Current Projects

Projects led by Global and Women’s Health

Projects on which Global and Women’s Health is a partner