At the forefront of the PRONUSTIC Research Laboratory vision of research and mission in the international community, is a desire to continually advance and improve the ways in which research methodologies can be most efficiently implemented in various environments and notably in resource-constrained settings, to yield the highest quality data and  provide  empirical evidence for the development of policies and programs, delivery of services and products in ways that meet the ever-changing needs of the local communities where research activities are fielded. Its ultimate goal is to help prevent and reduce major health inequities across population subgroups in order to reduce the burden of disease at the family, community, subnational, national, and global levels.

 

Its research interests focus on the methodological and empirical investigations of the determinants of mortality, health across the lifespan, and aging on the one hand, and the impact of population-based and clinical interventions on survival and burden of disease in human populations. The hallmark of its research is the wholehearted effort to understand better various causal relations - including the impact of contextual factors, familial and residential biographies, schooling, health, nutrition, family background, social networks and support, and policies - on a wide range of population and health outcomes over the life course and across generations. PRONUSTIC uses integrated state-of-the-art modeling-estimation approaches that incorporate imperfections within dynamic contexts and duration data as well as time-invariant data with multistate and multilevel complex structures.

 

In the genuine and eager search for the interpretation of these relations emerging from international research conducted in this Laboratory and involving over 195 countries around the world, its quest has been empirically articulated in the coherent and sustainable development, design and implementation of the community-owned population health research and intervention initiatives in Cameroon since 1995 in over 140 urban and rural localities and cohorts of over 12 000 individuals nested within over 2 500 families. It starts from the premise that a regularity of our human existence is that individuals in families, families in communities, communities in nations, and nations within continents around the world, commonly share at each of these levels of nesting and units clustering, a set of attributes, conditions and changing transformations. These are best comprehended within a framework of research conduct which encompasses the multilevel, contextual, and micro/meso/macro data that must be collected to reflect the dynamic and correlated nature of observations under investigation. That is why, its efforts in the research conduct and utilization of research findings have been to merge top-down and bottom-up approaches to mortality and disease reductions and health promotion, into one comprehensive “top-to-bottom-up bike-riding approach” on ‘known evidence-based paths’ whereby resources (human, material, financial, etc.) at the top, intermediate and grassroots levels of a society are used synergistically and dynamically to promote survival and reduce disease burden at a given level of social organization and functioning by promoting the existing sociocultural, educational and health-related structures, and by promoting democratic principles and good governance among community members and leaders.

 

These efforts have encompassed a number of intertwined domains designed to contribute to the understanding of what impact nutritional status, health and survival across the lifespan, such as the examination of the changing nature and relative contributions of compositional and contextual influences of social stratification/conditions, intergenerational transmission of inequalities, behavioral and biological factors, and changes in familial/community/national environments, on nutritional status, health/disability and mortality by cause across all ages (from conception to late life), and the opportunities for and obstacles/challenges to improving them. At the same time, we have also examined the reciprocal effects of early life health conditions and exposures (e.g., gestational age and birthweight, nutrition, infections, familial and residential trajectories, living conditions, socioeconomic status) on social stratification, intergenerational transmission of inequalities, and other socioeconomic outcomes that occur at later stages in the life course of individuals (e.g., health, disability and death) and families (e.g., dissolution by divorce or death) and policies that affect their prevalence and incidence. In both cases, the research at PRONUSTIC is conducted with the goal of deepening our understanding of risk, protective and resilience processes and factors across the lifespan that shape health-related behaviors, disease-specific conditions, morbidity and mortality at specific life stages (infancy, childhood, adolescence, adulthood, and elderly) as well as the health and well-being of individuals, families, and populations. Use of formative research in developing a knowledge translation top-to-bottom-up bike-riding approach to implementing interventions promoting public and population health, women's health, reproductive health, infant and child health and survival.

 

In conducting formative research in order to design, implement, monitor and evaluate  intervention research programs in the areas of infant and child nutrition and survival, reproductive health across the life course, and population health promotion in resources-constrained environments such as Cameroon where the bulk of our ongoing intervention research activities have taken place, we have worked collaboratively with research participants, stakeholders, community leaders and key informants, the civil society, the clergy, policymakers and planners, and high-ranking officials at various levels of the administration in Cameroon, to translate effectively all our key research findings into policies and programs as well as effective briefings on our key research findings for policymakers and planners, that have improved significantly: (1) the nutritional status of children in all provinces of Cameroon where we conducted household trials for using locally available food to enrich the diet of children; (2)  the reproductive health of adolescents and young people; and (3) the overall living conditions of the worst off in the rural and semi-rural communities where our activities have been carried, through income-generating and wealth-creation activities as communities served remain the ultimate owners of these intervention initiatives.