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Women’s and Children's Health

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Theme leader: Professor Nick Freezer, Medical Director, Women's and Children's Health, Monash Health

The service operates collaboratively across both the Monash and Alfred Health sites, although the bulk of patients present through Monash Health, which delivers 20% of Victoria’s births and 4% of births nationally for a diverse and highly complex patient cohort. Monash Children’s Hospital is also the third largest in Australia.

Our services are led by clinician researchers who also provide complex care for women and babies. We integrate basic, clinical, health services and public health research into clinical care, policy and guidelines.

In Excellence in Research (ERA) we rank second nationally, having won $60 million in research funding in five years. Exemplars include Monash Health’s world first foetal surgery and subsequent statewide collaborative foetal surgery service.

Four research hubs work with the Monash Health’s clinical services to support complex clinical requirements for women’s health and women’s and babies’ health.

1. The Ritchie Centre, which has a strong track-record in foetal, neonatal and reproductive medicine, using a research supported healthcare improvement model of care.  Pivotal neonatology and foetal medicine advances include development of inhibin A as a screening test for Down syndrome, still used worldwide.

The Centre also first reported antenatal steroids effects on foetoplacental blood flow in growth restriction, changing foetal surveillance worldwide and recently developed the first antenatal neuroprotective therapy for growth restricted foetus - now in clinical trial.

2. The Monash Centre for Health Research and Implementation (MECHRI) works on a specific health issues, such as Polycystic Ovary Syndrome (PCOS) – which affects 18% of Australian women. Prof Teede led a National Alliance on PCOS, engaging consumers, primary care, academics and health professionals to develop the world’s first evidence based guidelines, leading to national translation and improved early diagnosis by 60%.

This model of engagement was a recognised exemplar by the NIH and is contracted by the World Health Organization (WHO) for international scale-up. The work has been selected by the NHMRC obesity translation faculty as the primary obesity translation priority for feasible scale up to deliver health impact.

MECHRI is ranked fourth internationally as a team. In the field of PCOS, they fundamentally changed understanding of this complex reproductive/metabolic condition.

3. Alfred Health, Women’s Health program focuses on midlife health including the epidemiology of breast cancer (Prof Bell) and menopause, where the group leads nationally in menopause. Prof Davis is ranked fourth internationally.

The Alfred Health Program has leadership roles in practitioner training initiatives and guidelines for international societies. Work by Prof Davis’ team produced the PROSPECT tool for screening women for osteoporosis/ silent fracture, which is now used widely across Australia. On the back of extensive menopause research produced the Practitioner Toolkit, designed to assist GPs in menopause management (endorsed by local and international societies and adopted by international societies), it was downloaded more than 10,000 times in the weeks after publication.

4.The Jean Hailes Research Unit is a unique formal partnership between Monash University and Jean Hailes for Women's Health, a leading community-based, not-for-profit organisation with a government funded translation program for consumers and health professionals. The program enables unparalleled community reach to drive evidence into policy and practice.

This team focus on women’s mental health, with exemplars including postnatal mental health promotion research and translation programs from randomised controlled trials (RCTs) to government engagement with programs being implemented into standard postnatal primary care nursing platform. Team leaders have roles with the WHO in women’s mental healthcare in resource poor settings.

Future Goals: 

1. Develop a birth registry, including fertility treatments, to identify challenges in pregnancy care for further research and healthcare improvement initiatives

2. Build research programs utilising Monash Health’s statewide collaborations in gestational diabetes, obesity and healthy lifestyle in pregnancy

3. Prioritise mental health impact into clinical research programs.