INTERNATIONAL MATERNAL AND CHILD HEALTH RESEARCH AND TRAINING PROGRAM Release Date: March 4, 1999 RFA: TW-99-002 P.T. Fogarty International Center Letter of Intent Receipt Date: April 1, 1999 Application Receipt Date: May 18, 1999 PURPOSE The Fogarty International Center (FIC) invites applications for the International Maternal and Child Health Research Training program (IMCHRT) for award in FY 1999. This RFA precedes an RFA for a complementary international collaboration research program to be issued by the National Institute of Child Health and Human Development (NICHD). Many of the applicants to this FIC RFA are anticipated to be interested in applying to the new NICHD RFA when it becomes available, and future training awards and areas of research training will depend in large part upon successful competition for the NICHD research awards. The training and research capacity building efforts of the IMCHRT are meant to facilitate the research to be undertaken under the NICHD's International Collaborations in Maternal and Child Health (ICMCH) program. The purpose of this FIC training program is to stimulate high quality training and build research capacity in support of current and future collaborative research on maternal and child health issues that are predominately endemic in or impact upon people living in developing countries. The intent of the IMCHRT program is to provide training opportunities for foreign investigators which will build research capacity and strengthen foreign and U.S. cooperation related to maternal and child health. Integration of the IMCHRT with the future ICMCH enhances the purposes of both programs such that they will mutually reinforce one another. The IMCHRT will support training experiences for foreign scientists in the context of the future ICMCH priority research areas. There are three overall objectives for the FIC IMCHRT: 1) to increase expertise of scientists in developing countries in maternal and child health related biomedical, behavioral, and prevention research; 2) to support collaborative training in maternal and child health biomedical and behavioral research between U.S. based and foreign scientists; and 3) to establish or strengthen maternal and child health biomedical and behavioral research and prevention centers of excellence in the home countries of trainees. Adverse pregnancy outcomes are associated with a variety of risk factors and claim millions of lives each year. The battle to improve maternal/child health is particularly critical in developing countries and is becoming increasingly important in Russia and newly independent states of the Former Soviet Union. This RFA is intended to address maternal/child health-related training and capacity building for risk factors other than HIV infection. In this regard, however, in situations where there is a high prevalence of HIV infection one must consider the totality of risk factors, both HIV and non- HIV, which contribute to poor pregnancy outcomes and poor health status of mothers and children. Further, recent advances in interventions to improve health outcome in HIV infection (e.g. nutritional supplements to pregnant women to decrease adverse pregnancy outcome; vitamin A supplements to improve health outcome in HIV-infected children; chlorhexidine vaginal cleansing at birth to decrease neonatal sepsis and improve maternal health as well as use of antibiotics to prevent and treat chorioamnionitis) may also have more general health benefits for mothers and children in developing countries regardless of HIV status. Consequently, investments made in HIV/AIDS research are now seen to provide general benefits to the health of HIV negative persons in developing countries. One of the most important factors contributing to the survival and health status of young children is the health status of the mother for children who become orphans of HIV-infected mothers are at greater risk whether or not they are HIV-infected themselves. The goal of this initiative is to strengthen and sustain, through collaborative research and training, the capability of developing countries to carry out research required to develop new strategies and to apply existing knowledge through operational research to improve health outcomes for mothers and children in developing countries. The areas of potential research training in this RFA are broad and programs are not expected to propose activities in most let alone in all areas. Applicants are encouraged to propose programs only in those areas where they have the greatest expertise. Potential interventions include strategies to improve health outcomes in mothers and infants such as; (a) improved management of risk factors and complications associated with adverse pregnancy outcomes, e.g. lack of adequate prenatal care, prematurity and low birth weight, malnutrition, use of alcohol, drugs and tobacco, pregnancy induced hypertension, gestational diabetes; (b) prevention and treatment of infections associated with adverse pregnancy outcomes with an emphasis on infections other than HIV/AIDS (with HIV/AIDS-related issues being emphasized under other FIC programs), e.g. STDs, bacterial vaginosis, chorioamnionitis, including such approaches as maternal immunization, information/education, condom promotion, chlorhexidine vaginal cleansing, use of antibiotics; (c) nutritional supplementation and (d) research to assess and interventions to reduce developmental pediatrics disorders. Strategies to improve health status of children include such approaches as enhanced prevention and treatment of diarrheal diseases through improved sanitation and oral rehydration; strategies to more effectively deploy existing vaccines against childhood infections; nutritional supplementation; improved treatment and prevention of malaria and acute respiratory infections including opportunistic infections associated with HIV/AIDS; and prevention of accidental injuries and deaths. Since this RFA is considered to be a non-AIDS program, applicants planning to work in HIV/AIDS endemic areas would be expected to consider HIV status in designing their research and training programs and in this regard are encouraged to form collaborations with FIC AIDS training and research programs working in common countries of interest. The RFA requires the inclusion of training and research capacity building in the responsible conduct of research. The training program is intended to be multidisciplinary, including biomedical as well as behavioral research which is required in order to examine the social and cultural determinants of health-related behaviors in various societies, for example, breast feeding, sexual practices, smoking, and alcohol use. HEALTHY PEOPLE 2000 The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of "Healthy People 2000," a PHS-led national activity for setting priority areas. This Request for Applications (RFA), International Maternal and Child Health Research and Training Program, is related to one or more of the priority areas. Potential applicants may obtain a copy of "Healthy People 2000" at http://www.crisny.org/health/us/health7.html. ELIGIBILITY REQUIREMENTS Applications may be submitted by domestic for-profit and non-profit organizations; public and private institutions, such as universities, colleges, hospitals, and laboratories. Only one application is allowed from any applicant organization. Applicants with a strong base of research support from the NICHD or other parts of the NIH related to maternal and child health are strongly encouraged to apply. While for-profit and non-academic organizations are eligible, they should establish linkages with academic institutions to be able to offer the full range of training opportunities included in the FIC IMCHRT. Racial/ethnic minority individuals and women are encouraged to apply as Principal Investigators. The U.S. grantee institution is responsible for developing an affiliations(s) with an established institution (e.g. university, research institute, federal or state health department, hospital) in the host country. Applicants for the FIC IMCHRT program are strongly encouraged to apply for an NICHD ICMCH award when that RFA becomes available. MECHANISM OF SUPPORT Awards will be made by the Fogarty International Center under the international training grants (D43) mechanism, which limits indirect costs to eight percent. The total project period for an IMCHRT application submitted in response to this RFA may not exceed five years. At this time, the FIC has not determined whether and how this solicitation will be continued beyond the present RFA. FIC, with NICHD, will conduct a program evaluation by the end of the fourth year of the IMCHRT. The results will assist the NIH in determining the re-issuance of the RFA. If, by the end of the fourth year of the award, the FIC has not announced their intent, due to budget uncertainties or other reasons, to reissue the RFA, incumbents should contact program staff before preparing a recompeting application to seek advice on the most appropriate method of application submission. The applicant organization's administration must provide the necessary management for the transfer of funds and material to the off-site component. Indirect costs will not be paid on any expense incurred by the foreign institution(s) although expenses required to support in-country training and training-related research such as access to facilities, library services, the internet, can be charged as direct expenses when well justified. Travel, salaries, and fringe benefits will be subject to the applicant institution's rules and regulations. Grants will be made as D43 training grant awards for a project period of up to five years. Continued support during this period depends on satisfactory performance of the FIC IMCHRT (as well as any companion NICHD ICMCH award that may be made) as judged by: annual progress reports; site visits and meetings of program directors; career progress of trainees (e.g., positions occupied in home country, first author publications, presentations, research undertaken and research awards received); and development of national capacity for maternal and child health related research, and prevention, including the establishment or strengthening of model maternal and child health research centers of excellence in the home countries of trainees. Assessment of performance will be made jointly by FIC and NICHD. Special program reviews will be conducted by the FIC and NICHD. FUNDS AVAILABLE Approximately $500,000 is anticipated for support of this program in FY 1999 and an estimated $1,000,000 more for new awards in FY 2000 depending upon availability of funds. The maximum allowable support for the first year is $200,000 (total costs including 8% facilities and administrative costs). Awards will be made in FY 1999 and in FY 2000 with the expectation that 3 new awards can be made in FY 1999 and 6 additional new awards can be made in FY 2000 depending upon merit and availability of funds. A budget increase of 3% may be requested for years 02 to 05. Depending on the availability of funds for support of IMCHRT in the future, FIC will consider this requested increase when making future-year awards. Also, administrative supplemental budget requests up to 20% may be requested in any one year to cover unusual, unique scientific opportunities or emergency situations. These requests will be reviewed jointly by FIC and NICHD and awarded based upon merit and depending upon available funds. RESEARCH OBJECTIVES Scope of Training A. Training Objectives The integration of the FIC IMCHRT program and the future companion NICHD ICMCH will facilitate training of foreign scientists in the context of ICMCH research priority areas and facilitate sustainable collaborative research between the U.S. and foreign countries. The establishment and strengthening of scientific linkages between U.S. and foreign investigators stimulates self- sufficiency of the collaborating foreign institution and enhances the scientific infrastructure for additional international collaborative arrangements. The linkage of the ICMCH research and the IMCHRT training and research capacity building programs is a logical extension of collaborative efforts between FIC and NICHD to build research capacity and support interventions to improve the health of mothers and children in the developing world, as well as in Russia and the newly independent states of the former Soviet Union. B. Training Plan The training plan should include U.S.-based, long-term (usually a minimum of two years) training leading to an advanced degree or to provide mentored postdoctoral research training. The IMCHRT will promote and facilitate training courses targeted toward specific needs, such as learning laboratory or social science or behavioral research techniques and transfer of medical informatics, biotechnology and other methods required to support maternal and child health research efforts in the home countries of the trainees involved in the companion ICMCH research projects. When a specific scientific course is given by one IMCHRT program it is expected that this course will be open to trainees of other IMCHRT award institutions with the expenses for this to be included within the regular budgets for each program that intends to send its trainees to such courses. Training activities will be coordinated, facilitated and monitored by networking meetings of IMCHRT Principal Investigators, major foreign collaborators and the FIC and NICHD program officers or their designees. C. Types of Training: 1. Pre-doctoral training in maternal and child health-related biomedical and behavioral research disciplines, and data management and analysis in support of that research, which may lead to an M.S. or Ph.D. or equivalent degree for individuals with or without previous field research experience. Programs should relate directly to ICMCH research, and may range up to four years. In general, academic courses will be taken at the U.S. institution. Field studies and research may be conducted in the U.S. but, to the greatest extent possible, should occur in the trainees' home country in the context of future ICMCH projects. Active involvement in on-going research and prevention projects is vital for a successful research and/or public health training experience. Innovative ways to involve trainees in ICMCH research projects conducted in their home countries is encouraged for awardees receiving both an IMCHRT and future ICMCH award; 2. Postdoctoral research experiences including related clinical training as needed, generally of two years duration for foreign health scientists; 3. Short-term training (either in the U.S. or in-country) of up to four weeks in focused research methodologies, related to improvement of maternal/child health outcomes; 4. Medium-term training of about three to six months duration conducted in the U.S. in laboratory procedures and research techniques, for example, development of pilot biomedical studies or development of behavioral research instruments for individuals with M.S. and M.D. or Ph.D. as well as nurses and nurse midwifery degrees; 5. One-time awards for advanced research training (1-2 years duration) upon return to the home country (supported through this award or a companion ICMCH award if available) at levels of funding specified under allowable costs in this RFA; 6. Research training experiences for exceptionally promising pre- and postdoctoral U.S. health science students (including medical students and residents), with prior FIC approval. D. Trainees: Trainees shall be individuals who are, or are expected to be, involved in maternal and child health-related biomedical and behavioral research and prevention activities in their home country. The following categories of foreign individuals are eligible for training: 1. Health professionals with doctoral degrees (M.D., D.D.S./D.M.D., Ph.D., or equivalent); 2. Health professionals with a bachelors or masters degree in a basic or health science, including nurses and nurse midwives; 3. Medical technicians and health care workers (short courses); 4. Allied health professionals such as behavioral scientists, and social workers (short courses); 5. Current or former FIC trainees involved in advanced research training in their home countries; and, in addition, with prior FIC approval, 6. Pre and post doctoral U.S. health science students. Programs are strongly encouraged to give special emphasis to include women in selecting foreign trainees and to insure adequate representation of women and minorities in selecting U.S. trainees under this program. SPECIAL REQUIREMENTS Each awardee will have a U.S. Principal Investigator (PI) and a Major Foreign Collaborator (MFC). The PI and MFC will be responsible for the overall conduct of the IMCHRT. Training in Responsible Conduct of Research. Applicants are required to include training in responsible conduct of research as a part of the program. An award will not be made unless a description of such training is included. Recruitment and Selection Plan. The applicant institution must include a plan describing the recruitment and selection procedures for trainees, a detailed description of peer review for training-related and advanced in-country research (re-entry grants), and plans for continued collaboration with former trainees. Degree candidates must meet all entrance requirements of the U.S. degree granting institution. The grant applications should clarify and completely specify: (a) criteria and procedures for the selection of trainees as, for example, by a committee composed of U.S. and foreign investigators at participating institution(s) and (b) a mechanism for internal peer review of applications to support in-country research projects. Tracking System For Long Term Impact. As part of their obligations under this program, awardees are required to initially design as part of their application and ultimately to implement a system to fully track and document the long-term impact of this training program on: (1) the careers of current and former trainees; (2) research capacity in the home institution of trainees; (3) types of positions the proposed trainees may assume upon completion of training; (4) the contributions to future NIH international maternal and child health research and prevention efforts; (5) the establishment or strengthening of maternal and child health research centers of excellence in the home countries of trainees; and (6) the impact of program graduates in contributing to improving the health status of women and children in their home countries. Examples of such impact include how training received under the program has allowed participants to assume more responsible positions upon returning home, how continuing collaborations with former trainees resulted in the funding of maternal and child health prevention or collaborative research projects for which trainees were either principal investigators or co-investigators, publications in which trainees were first authors and which were based upon support under this program, and health policies that were influenced or implemented by returning trainees in their home countries. After awards have been made, but before tracking of impact is implemented, FIC will work with awardees to design a standardized tracking system building upon the ideas in the original proposals combined with FIC experience in other similar programs. Once this standardized tracking system has been agreed to it is expected to be implemented across all programs. Impact will be an important criteria for recompetition of this program. Coordination and Collaboration. Coordination and collaboration of the IMCHRT Program with other FIC award programs and affiliated institutions, especially when operating within the same country, will be of benefit to all partners. The coordination of activities among training sites will be facilitated by the FIC, in conjunction with NICHD, and will include organization of joint meetings to be held during international and regional scientific or public health meetings. Program applicants are strongly encouraged to include plans, if possible for coordination and collaboration with other FIC training programs: these include the FIC AIDS International Training and Research Program, the International Training and Research Program in Emerging Infectious Diseases (and the related TB initiative), the International Training and Research Program in Environment and Occupational Health, the International Training and Research Program in Population and Health, the Minority International Research Training Program (maternal and child health- related activities), the International Medical Informatics Program as well as with other NIH-sponsored programs when working in common countries and/or regions. Given the increased emphasis on maternal and child health research and research training globally, FIC will also facilitate coordination and collaboration with other government agencies (e.g., CDC, USAID, DoD, etc.) and with bilateral and multilateral international organizations, including the World Health Organization (WHO), Pan American Health Organization (PAHO), the World Bank and in-country projects funded by NIH including those by NICHD and other Institutes. Allowable Costs The following cost categories are allowable but serve only as a guide under the research training program. Programs are encouraged to be as cost- effective as possible in implementing their activities. A. Stipend and Salary 1. Living allowance (stipend) comparable to trainee's professional level, in accordance with grantee institutional policies but not to exceed $45,000 per annum while undergoing training in the U.S.; 2. Living allowance (stipend) while conducting in-country dissertation research or in-country advanced research training (re-entry grants) at a level comparable to that received by similar professionals and compatible with salary scales in-country, in accordance with grantee institutional policies, but also not to exceed $45,000 per annum; 3. Stipend support (not to exceed $45,000 per year) for foreign and (with prior FIC approval) for U.S. postdoctoral researchers compatible with salary scales in the U.S. and in-country; 4. Up to 10 percent of annual salary (maximum of $10,000) for the program director to administer the program and to enable U.S. faculty (including the program director) to be involved in advanced research training activities conducted in-country. In addition, salary support for up to one FTE of administrative support staff is allowable. B. Travel 1. Round trip economy class air fare between the U.S. and home country (two trips for M.S./Ph.D. candidates and advanced research trainees, one for all others); 2. Travel and per diem for the program director or selected faculty colleagues to provide guidance to students conducting dissertation-related field studies and/or advanced research training in their home countries; 3. Travel and per diem for faculty presenting short-term, in-country courses; 4. Travel for participation in networking and program coordination meetings. C. Tuition Tuition for foreign trainees, not to exceed 15% of total direct costs. Exceptions to this policy require prior approval from the FIC. Programs are strongly encouraged to cost-share tuition costs, for example, by providing for reduced tuition for long-term trainees and/or not charging tuition for short- term courses in the U.S. and in-country, etc. D. Training-Related Expenses 1. Allowance for the grantee institution of up to $600 monthly per student to cover health insurance, scientific meetings, and incidental research expenses; 2. Support of up to $10,000 as a one-time expense for in-country field research in partial fulfillment of the M.S./Ph.D. training program; 3. Research support of up to $10,000 per trainee to facilitate the conduct of advanced research training (re-entry grants) in the home country conducted by current and/or former FIC program trainees; the program director is expected to have projects submitted for this funding peer reviewed for scientific as well as ethical aspects by the U.S. institution (and collaborating foreign institutions) in accordance with plans outlined in the grant application. INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of the NIH that women and members of minority groups and their subpopulations must be included in all NIH supported biomedical and behavioral research projects involving human subjects, unless a clear and compelling rationale and justification is provided that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research. This policy results from the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43). All investigators proposing research involving human subjects should read the "NIH Guidelines for Inclusion of Women and Minorities as Subjects in Clinical Research," which was published in the Federal Register of March 28, 1994 (FR 59 14508-14513) and in the NIH Guide for Grants and Contracts, Vol. 23, No. 11, March 18, 1994, available on the web at: https://grants.nih.gov/grants/guide/notice-files/not94-100.html. INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of NIH that children (i.e., individuals under the age of 21) must be included in all human subjects research, conducted or supported by the NIH, unless there are scientific and ethical reasons not to include them. This policy applies to all initial (Type 1) applications submitted for receipt dates after October 1, 1998. All investigators proposing research involving human subjects should read the "NIH Policy and Guidelines" on the Inclusion of Children as Participants in Research Involving Human Subjects that was published in the NIH Guide for Grants and Contracts, March 6, 1998, and is available at the following URL address: https://grants.nih.gov/grants/guide/notice-files/not98-024.html Investigators also may obtain copies of these policies from the program staff listed under INQUIRIES. Program staff may also provide additional relevant information concerning the policy. LETTER OF INTENT Prospective applicants are asked to submit, by April 1, 1999, a letter of intent that includes a descriptive title of the overall proposed research; the name, address and telephone number of the Principal Investigator; the country(ies) and possible institutions to which the U.S. institution will be linked; and the number and title of this RFA. Although the letter of intent is not required, is not binding, does not commit the sender to submit an application, and does not enter into the review of subsequent applications, the information that it contains allows NIH staff to plan for the review in a timely fashion for the benefit of the investigators and to avoid conflict of interest in the review. The letter of intent is to be sent to Dr. Kenneth Bridbord at the addresses listed under INQUIRIES APPLICATION PROCEDURES Applications are to be submitted on the standard research grant application form PHS 398 (rev. 4/98), using the instructions and forms for Institutional National Research Service Awards. Application kits are available at most institutional offices of sponsored research and may be obtained from the Division of Extramural Outreach and Information, National Institutes of Health, 6701 Rockledge Drive, MSC 7910, Bethesda, MD 20892-7910, telephone (301) 710-0267, email: grantsinfo@nih.gov For purposes of identification and processing, item 2 on the face page of the application must be marked "YES" and the RFA number "TW-99-002" and the words "International Maternal and Child Health" must be entered on the face page. Applications must be received by May 18, 1999. The RFA label available in the application form PHS 398 must be affixed to the bottom of the face page. Failure to use this label could result in delayed processing of the application such that it may not reach the review committee in time for review. Initial funding is anticipated in September 1999. Submit a signed, typewritten original of the application, including the checklist, and three signed, exact, single-sided photocopies, in one package to: CENTER FOR SCIENTIFIC REVIEW NATIONAL INSTITUTES OF HEALTH 6701 ROCKLEDGE DRIVE, ROOM 1040 - MSC 7710 BETHESDA, MD 20892-7710 BETHESDA, MD 20817 (for express/courier service) At the time of submission, two additional exact copies of the grant application and all five sets of any appendix material must be sent to Dr. Charlotte Catz at the address listed under INQUIRIES. REVIEW CONSIDERATIONS Upon receipt, applications will be reviewed for completeness by the Center for Scientific Review (CSR) and for responsiveness by FIC staff; those judged to be incomplete or considered to be non-responsive will be returned to the applicant without review. NICHD will conduct the initial scientific review on behalf of the FIC, as part of the overall review of the IMCHRT applications. Applications that are complete and responsive to the RFA will be evaluated for scientific and technical merit by a peer review group convened by the NICHD in accordance with the review criteria stated below. As part of the initial merit review, all applications will be discussed, assigned a priority score and receive a written critique as well as receive a second level review by the FIC Advisory Board. Review Criteria The scientific evaluation of each application will include assessment of the linkage between proposed training and maternal and child health-related research supported by NICHD and other components of the NIH. Evidence of support for the IMCHRT from collaborating institutions and host governments must be submitted with the application. A. Significance 1. The expected public health and scientific contributions of the proposed activity; and 2. The demonstrated capacity and/or potential to achieve sustained maternal and child health-related research and training efforts, and to build associated clinical and operational research and public health capacity within a country. B. Approach 1. Balance in the proposed training program to provide breadth of training opportunities in the field of academic-based, maternal and child health- related training in biomedical, and behavioral science, and clinical sciences and prevention research; 2. The mix of long- and short-term training to achieve the goals of this RFA, including focused efforts to build long-term biomedical, behavioral, clinical and operational research and public health capacity at a model maternal and child health center of research excellence within a collaborating country; 3. Adequacy of proposed procedures and criteria for 1) recruitment, review and selection of trainees, and 2) peer review of research and related maternal and child health prevention projects; and 4. Adequacy of plans to include an adequate representation of women among foreign trainees as well as women and minorities among U.S. trainees. C. Innovation 1. Plans for trainees to become involved in maternal and child health biomedical and behavioral research, and prevention projects conducted in their home countries; and 2. Adequacy and creativity of plans including use of the modern information technology to facilitate access to scientific information, distance learning, coordination and research collaboration. D. Investigator(s) 1. Qualifications of the program director to lead and the named faculty to participate in the proposed training and research program; and 2. Active research support of the program director and participating faculty. E. Environment 1. The strength of resources and training environment in-country as evidenced by 1) the quality of teaching and the in-country research facilities and other resources; 2) the availability of high-quality candidates chosen on the basis of merit; and 3) past history of success of former trainees returning to their home countries and their continued involvement in the program; for example, the participation of past trainees in advanced in-country research and as faculty and mentors for new trainees; and 2. Training environment in the U.S., including the institutional commitment, the caliber of preceptors, the quality of teaching and research facilities and resources. F. The initial review group will also examine the adequacy of the process for providing for the protection of human and animal subjects and the safety of the research environment, and plans to include training in responsible conduct of research and training in the operation of IRBs, data and safety monitoring boards and community advisory boards as a part of the program. IRBs in the home countries of trainees will be responsible for determining the adequacy of inclusion of women and minorities as well as children in research involving human subjects in their countries. Schedule Letter of Intent Receipt Date: April 1. 1999 Application Receipt Date: May 18, 1999 Scientific Review Date: July 1999 FIC Advisory Board: September 1999 Earliest Award Date: September 1999 AWARD CRITERIA In addition to the scientific merit as determined by peer review, the following will be considered in making funding decisions: 1. The extent to which NICHD currently supports research efforts in the proposed collaborating countries and/or any future plans to make a companion ICMCH award; and 2. The extent and effectiveness of efforts made by applicants in developing biomedical behavioral, and prevention research training programs necessary to support maternal and child health research and related research efforts in the home countries of trainees including efforts made to focus resources to build long-term clinical research, operational research and public health capacity at a model maternal and child health research center in the home country of trainees; 3. Cost-effectiveness of programs; 4. Efforts made to collaborate with other NIH Institutes and Centers, CDC, and USAID and WHO programs and institutions and with other organizations; 5. The extent to which proposed training programs support and complement other NIH international maternal and child health research efforts; 6. Availability of funds including the capability to expand training and research capacity building efforts should additional resources become available for this purpose from FIC or other sources; 7. Program balance among critical research and public health training areas of emphasis; and 8. Geographic distribution among countries included in applications under consideration, including the need for a given program to work in a specific country. Before any funds can be expended from this award, the grantee institution must show evidence of approval for collaborative research and training between the U.S. and foreign countries and institutions included in the program through an endorsement from the Minister of Health or Education or other appropriate government official as well as from the collaborating institutions. INQUIRIES Written and telephone inquiries concerning this RFA are strongly encouraged. The opportunity to clarify any issues or questions from potential applicants is welcome. Direct inquiries regarding IMCHRT programmatic (training scope and eligibility) issues to: Kenneth Bridbord, M.D. Director, Division of International Training and Research Fogarty International Center 31 Center Drive, Room B2C39, MSC 2220 Bethesda, MD 20892-2220 Telephone: (301) 496-1653 FAX: (301) 402-0779 Email: ken_bridbord@nih.gov Direct inquiries regarding review issues and special instructions for application preparation; and mail two copies of the application and all five sets of appendices to: Charlotte Catz, M.D. Center for Research for Mothers and Children National Institute of Child Health and Human Development 6100 Executive Boulevard, Room 4B03 Bethesda, MD 20852 Telephone: (301) 496-5576 FAX: (301) 496-3790 Email: cc87z@nih.gov Direct inquiries regarding IMCHRT fiscal matters to: Ms. Silvia Mandes Division of International Training and Research Fogarty International Center 31 Center Drive, Room B2C39, MSC 2220 Bethesda, MD 20892-2220 Telephone: (301) 496-1653 FAX: (301) 402-0779 Email: silvia_mandes@nih.gov AUTHORITY AND REGULATIONS Awards are made under authorization of the Public Health Service Act, Title IV, part A (Public Law 78-410, as amended by Public Law 99-158, 42 USC 241 and 285) and administered under PHS grants policies and Federal regulations 42 CFR 52 and 45 CFR Part 74. This program is not subject to the intergovernmental review requirements of Executive Order 12372 or to Health Systems Agency review. The PHS strongly encourages all grant and contract recipients to provide a smoke-free workplace and promote the non-use of all tobacco products. In addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain facilities (or in some cases, any portion of a facility) in which regular or routine education, library, day care, health care or early childhood development services are provided to children. This is consistent with the PHS mission to protect and advance the physical and mental health of the American people.
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