Center for Indigenous Health Research

Created by potrace 1.10, written by Peter Selinger 2001-2011

Since 2007, Maya Health Alliance has been a leader in developing practical solutions to improve the quality of medical care in rural and indigenous communities in Guatemala. The Center for Indigenous Health Research (Centro de Investigación en La Salud Indígena or CISI) was founded by a multidisciplinary group of researchers at Maya Health Alliance, with the goals of advancing scientific investigations into the health needs of these communities. 

 

Central Research Topics

The central CISI Research themes share methodological approaches, especially mixed methods, applied anthropology and implementation science:

  • Chronic Malnutrition and Food Security

  • Noncommunicable diseases, such as cancer, diabetes, and chronic kidney disease

  • Civil Society and the study of Development and Gender Equity in health

  • Early child development

  • Family planning

  • Midwifery and Emergency Obstetrics

  • Medical Anthropology

Research Projects
Summary of major current and recent projects

Created by potrace 1.10, written by Peter Selinger 2001-2011


LOCAL ADVOCACY AND THE POWER OF COMMUNITY FOR COVID RECOVERY. (2023-)

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This interdisciplinary project will draw together scholars of, and community organizations in, Canada, Brazil, and Guatemala. It will explore the pandemic lived experiences of ‘small’ and ‘local’ health and service organizations and activists.

PARTNERS: University of Manitoba

 

FUNDING: New Frontiers in Research Fund

Created by potrace 1.10, written by Peter Selinger 2001-2011


IMPLEMENTATION OF A NATIONAL MODEL FOR DIABETES AND HYPERTENSION TREATMENT IN GUATEMALA. (2024-)

This project is working in collaboration with the Ministry of Health and INCAP to scale up diabetes and hypertension treatment in public health facilities around the country.

PARTNERS: INCAP

 

FUNDING: World Diabetes Foundation

Created by potrace 1.10, written by Peter Selinger 2001-2011


ARTIFICIAL INTELLIGENCE AND QUALITY IMPROVEMENT TO REDUCE NEONATAL MORTALITY. (2024-)

mhealth2

This project builds on Wuqu’ Kawoq’s long standing Mobile Health Program, but now focusing on specific quality improvement initiatives (include enhanced real-time smartphone decision support) to detect neonatal complications and prevent neonatal deaths.

PARTNERS: Emory University

 

FUNDING: Google Nonprofit Foundation

Created by potrace 1.10, written by Peter Selinger 2001-2011


PROMOTING SAFE AND HEALTHY WORKPLACES IN HONDURAS, GUATEMALA, AND EL SALVADOR (2023-)​

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The Promoting Safe and Healthy Workplaces in Honduras, Guatemala, and El Salvador (PREP for Change) project seeks to improve occupational safety and health (OSH) conditions for workers in the sugar and garment (maquila) sectors. The project will focus on workplace illnesses and injuries, chronic kidney disease of non-traditional causes (CKDnt), and COVID-19

PARTNERS: La Isla Network

 

FUNDING: US DOL

 

Created by potrace 1.10, written by Peter Selinger 2001-2011


AI-DRIVEN LOW-COST ULTRASOUND FOR AUTOMATED QUANTIFICATION OF HYPERTENSION, PREECLAMPSIA, AND IUGR (2023-)

ultrasound 4

In low-resource settings, high rates of perinatal mortality are due in part to challenges accessing affordable technologies to screen and monitor high-risk maternal-fetal conditions, such as intrauterine growth restriction and preeclampsia. To address these issues, we will use artificial intelligence to develop techniques for predicting intrauterine growth restriction and preeclampsia from low-cost hand-held maternal and fetal Doppler recordings.

PARTNERS: Emory University

FUNDING: NIH/NICHD
Created by potrace 1.10, written by Peter Selinger 2001-2011


AFLATOXIN EXPOSURE, GROWTH FALTERING, AND THE GUT MICROBIOME AMONG CHILDREN IN RURAL GUATEMALA (2023-)

aflatoxin exposure

We will study the role of aflatoxin exposure on child growth, and whether the effect of aflatoxin is mediated by the gut microbiome and inflammation. We will evaluate aflatoxin exposure and examine markers of inflammation, gut microbiome composition and function, and microbial nutrient extraction and aflatoxin microbial biotransformation.

PARTNERS: ASU- Arizona State University

FUNDING: NIH/NIEHS

Created by potrace 1.10, written by Peter Selinger 2001-2011


EXPLORING RISK FACTORS AND PREDICTORS OF ENDEMIC CKDU IN AGRICULTURAL REGIONS OF FOUR CENTRAL AMERICA COUNTRIES (2022-)

CKDU

Chronic kidney disease of unknown origin (CKDu) has taken a terrible toll on young working families living in rural areas of Central America. This project aims to identify risk factors for CKDu and decline in kidney function in four Central American countries: Costa Rica, Panama, Nicaragua and Guatemala. This work will be conducted though the SALTRA (Central American Program for Health, Work and Environment) network connecting locally-based universities, NGOs, governmental organizations, public health authorities and local healthcare workers.

PARTNERS: Programa Salud, Trabajo y Ambiente (SALTRA), Universidad Nacional de Costa Rica

FUNDING: NIH/NIEHS/NIDDK

Created by potrace 1.10, written by Peter Selinger 2001-2011


UNDERSTANDING VACCINE ACCEPTANCE AND MESSAGES AMONG INDIGENOUS POPULATIONS (2022-)​

Vacunas

The objective of this project is to understand social networks in indigenous communities as a way to address vaccine concerns and increase confidence in COVID-19 vaccines.

PARTNERS: UCSF – University of California San Francisco, Stanford Center for Health Education | Digital Medic

FUNDING: Vaccine Confidence Fund

Created by potrace 1.10, written by Peter Selinger 2001-2011


MOBILE HEALTH INTERVENTION TO PROMOTE POSITIVE INFANT HEALTH OUTCOMES IN GUATEMALA (2021-)

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The objectives of this project are to develop and determine the effectiveness of an mHealth smartphone technology which can be used to engage primary caregivers directly in the active monitoring of their infants’ development, and to provide tailored feedback and support for the provision of nurturing care and positive infant developmental outcomes.

PARTNERS: CHLA-Children’s Hospital Los Angeles

FUNDING: NIH / NICHD (PI Beth Smith, Children’s Hospital Los Angeles) NCT05106894

Created by potrace 1.10, written by Peter Selinger 2001-2011


A HYBRID EFFECTIVENESS/IMPLEMENTATION TRIAL OF THE INTERNATIONAL GUIDE FOR MONITORING CHILD DEVELOPMENT (2021-)

GIMDI

The aim of this study is to conduct a hybrid effectiveness/implementation assessment of the International Guide for Monitoring Child Development (GMCD) in two LMIC settings, India and Guatemala, within established rural CHW programs. The primary objectives are (a) to evaluate the real-world effectiveness of the GMCD; (b) to use an implementation science framework to understand barriers and facilitators to effective population coverage, provider implementation, and maintenance; (c) to conduct an economic evaluation of the GMCD.

PARTNERS: Brigham and Women’s Hospital

FUNDING:  NIH / NICHD (PI Peter Rohloff, Brigham and Women´s Hospital, Inc.) NCT04665297

Created by potrace 1.10, written by Peter Selinger 2001-2011


EFFECTS OF COMPLEMENTARY FEEDING OF EGGS ON INFANT DEVELOPMENT AND GROWTH IN GUATEMALA (2020-)

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Investigating the impact of daily egg consumption during the period of complementary feeding, in addition to the standard nutritional care provided by Wuqu’Kawoq, compared to the local standard of nutritional care alone on childhood development.

FUNDING: American Academy of Nutrition and Dietetics NCT04316221

Created by potrace 1.10, written by Peter Selinger 2001-2011


WEARABLE SENSORS FOR EARLY IDENTIFICATION OF POOR NEURODEVELOPMENT IN GUATEMALA (2019-2022)

Evaluating new technology to detect early developmental delay in infants at risk.

PARTNERS: CHLA-Children’s Hospital Los Angeles

FUNDING: NIH / NICHD (PI Beth Smith, Children’s Hospital Los Angeles)

Created by potrace 1.10, written by Peter Selinger 2001-2011


EVALUATING A FAMILY-BASED NUTRITION AND GARDEN INTERVENTION IN RURAL GUATEMALA (2019-2021)

Nutrition

Investigating integration of home gardening into nutrition interventions to improve growth and diet quality for stunted children.

FUNDING: Academy of Nutrition and Dietetics. NCT03689504

Created by potrace 1.10, written by Peter Selinger 2001-2011


SCALING-UP SELF-MANAGEMENT INTERVENTIONS FOR TYPE 2 DIABETES (2018-2021)

diabetes

Using an implementation science framework to evaluate the impact of a home-based self management intervention for adults with type 2 diabetes in two health districts in central Guatemala. 

FUNDING: World Diabetes Foundation

Created by potrace 1.10, written by Peter Selinger 2001-2011


POPULATION-BASED SURVEY OF CHRONIC KIDNEY DISEASE (2018-)

CKD

Representative, population-based study surveying prevalence and risk factors for traditional and nontraditional chronic kidney disease in adults in rural Guatemala.

FUNDING: NIH / FIC

Created by potrace 1.10, written by Peter Selinger 2001-2011


CARE NAVIGATION TO IMPROVE OBSTETRICAL CARE (2017-2020)

care navigation 2017

Using a quality improvement framework and care navigation to improve patient satisfaction and emergency obstetrical referral outcomes.

FUNDING: Grand Challenges Canada

Created by potrace 1.10, written by Peter Selinger 2001-2011


MHEALTH TECHNOLOGY TO SUPPORT OBSTETRICAL CARE (2015-2019)

M-health 2015

Using smartphones and decision support mHealth applications to support identification and referral of high-risk pregnancies by lay midwives.

FUNDING:  NIH / NICHD (PI Gari Clifford, Emory University). Registro: NCT02348849

Created by potrace 1.10, written by Peter Selinger 2001-2011


INDIVIDUALIZED HOME-BASED INTERVENTIONS TO IMPROVE DIET QUALITY AND DEVELOPMENTAL OUTCOMES IN STUNTED CHILDREN (2015-2017)

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Investigating optimal strategies for empowering caregivers and improving nurturing care for infants at risk.

FUNDING:  Grand Challenges Canada. Registro: NCT02509936

Created by potrace 1.10, written by Peter Selinger 2001-2011

Research Team

Researchers at CISI come from diverse backgrounds, but we share an interest in core themes (noncommunicable diseases; chronic malnutrition and food security; child development; gender and health). We also share an interest in certain methodological approaches, especially in mixed methods, applied anthropology, quality improvement and implementation science.

 

Research Leadership

Anita Chary MD PhD: medical anthropology
Meghan Farley Webb PhD: medical anthropology, occupational health
David Flood MD MPH: cardiometabolic diseases, implementation science
Gabriela Montenegro PhD: infant and child nutrition
Peter Rohloff MD PhD: child nutrition and development, noncommunicable diseases, mHealth
Anahí Venzor Strader MD MMSc: neonatal health

Core Research Team

Stephen Alajajian, RDN : diabetes, early childhood development, nutrition Vilma Borón Surec : early childhood development, nutrition Ana Canu : obstetrics Esteban Castro MD : mHealth, obstetrical and neonatal care Karyn Choy : nutrition, early childhood development Enma Coyote : obstetrics, mHealth Magdalena Guarchaj : diabetes, early childhood development Sara Hernández Hidalgo MS : early child development Rafael José Peñate : chronic kidney disease Irma Yolanda Piló Palax : obstetric care, mHealth. Edlyn Ramos MD : obstetrics Hans Roche : laboratory science Wendy Rodriguez, MD : child growth, nutrition, maternal and child health Olga Marina Saloj Chiyal : early childhood development, nutrition Elsa Sebaquijay : obstetrics Emily Serech : obstetrics Yesika Simon : child nutrition Rosibely Sut : obstetrics Yolanda Raquec Teleguario : nutrition, chronic kidney disease Scott Tschida MS : implementation science Eva Leticia Tuiz Ordoñez : chronic kidney disease, early childhood development Cindy Villalobos : laboratory science

Key Collaborators and Affiliating Scientists

Dr Aurora Aragon, Affiliate Research Scientist at Wuqu’ Kawoq
Dr. Joaquin Barnoya, Unidad Cardiovascular de Guatemala, Universidad Rafael Landivar. Affiliate Research Scientist at Wuqu’ Kawoq
Dr. Gari Clifford, Department of Biomedical Informatics, Emory University
Dr. Jennifer Crowe, El Instituto Regional de Estudios en Sustancias Tóxicas de la Universidad Nacional de Costa Rica
Dr. Ilgi Ertem, Department of Pediatrics, Ankara University
Dr. Marvin González Quiroz, Department of Renal Medicine, University College London. Affiliate Research Scientist at Wuqu’ Kawoq
Dr. Maria del Pilar Grazioso, Department of Psychology, Universidad del Valle de Guatemala. Proyecto Aigle Guatemala. Affiliate Research Scientist at Wuqu’ Kawoq
Dr. Subodh Gupta, Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences
MSc Pharm Carol Guzman, Department of Toxicology, Universidad de San Carlos de Guatemala. Affiliate Research Scientist at Wuqu’ Kawoq
Dr. Rachel Hall-Clifford, Department of Sociology, Emory University
Dr. Nasim Katebi, Department of Biomedical Informatics, Emory University. Affiliate Research Scientist at Wuqu’ Kawoq
Dr. Rosa Krajmalnik-Brown, Center for Health through Microbiomes, Arizon State University
Dr. Vibha Krishnamurthy, Ummeed Child Development Center
Dr. Indiana Lopez, Affiliate Research Scientist at Wuqu’ Kawoq
Dr. Ann Miller, Department of Global Health and Social Medicine, Harvard Medical School
Dr. Manuel Ramirez, Centro de Investigación para la Prevención de las Enfermedades Crónicas, Instituto de Nutrición de Centro América y Panamá
Dr. Vicente Sánchez Polo, Universidad de San Carlos de Guatemala. Affiliate Research Scientist at Wuqu’ Kawoq.
Dr. Beth Smith, Department of Pediatrics, University of Southern California, Children’s Hospital Los Angeles
Dr. Alison Steiber, Academy of Nutrition and Dietetics
Dr. Lee Voth-Gaeddert, Center for Health through Microbiomes, Arizona State University. Affiliate Research Scientist at Wuqu’ Kawoq.
Dr. Bradley Wagenaar, Department of Global Health, University of Washington
Dr. Elizabeth Yakes Jimenez, Department of Pediatrics, University of New Mexico

Publications

2024
2023
2022
2021
2020
2019
2018
2017
2016
2013 and earlier