In the wealthiest parts of the world over the last century, there have been remarkable improvements in the health outcomes of pregnancy. Much of that improvement can be traced to specific medical interventions such as the use of antibiotics for infection, blood transfusions for hemorrhage, monitoring the fetus for risk of asphyxia before and during birth, safe cesarean section, and mechanical ventilation for newborns. The ability to diagnose medical complications early, prevent some of the most severe consequences of these conditions once they occur, and provide appropriate medical care has led to these improvements.
Unfortunately, these improvements are uncommon in the poorest countries where most of the world’s 500,000 maternal deaths, 3.2 million stillbirths and 4 million neonatal deaths occur. Specifically sub-Saharan Africa and South Asia have the highest maternal, fetal, and neonatal mortality rates and the lowest use of hospitals for delivery or newborn care. Less than half the women deliver in hospitals and uptake of many potentially life-saving interventions aimed at the mother or infant are equally low.
In those locations, people often have few resources, little or no electricity, lack of clean water, poor transportation, and there are few trained health professionals or functional hospitals. Some birth attendants in those locations are illiterate and have difficulty reading and interpreting numbers.
What We Are Looking For:
We seek technologies to improve the health of mothers and newborns, specifically addressing a critical set of conditions occurring during pregnancy and shortly after birth. For the mother, these include hemorrhage, hypertensive disorders (e.g., preeclampsia), serious infections, and obstructed labor, which account for 59% of maternal deaths in poor countries. For the newborn, these conditions are serious infections, complications of preterm birth, and birth asphyxia, which account for 76% of neonatal deaths. Important causes of stillbirth include many conditions, such as hemorrhage, fetal bacterial infection, obstructed labor, syphilis, and malaria.
The goal of this topic is to solicit novel and innovative technological approaches to reducing maternal, fetal or neonatal mortality and morbidity in communities or primary clinics. These new interventions would need to:
- Have a strong likelihood of achieving a substantial impact on one or more important adverse maternal, fetal, or neonatal outcomes described above.
- Be designed to the requirements of minimally-trained health workers in homes and communities as well as in workers in primary clinics;
We seek proposals that may be "off the beaten track," daring in premise, and are clearly differentiated from approaches currently being developed or employed. Technologies or approaches should enhance uptake, acceptability and provide for sustained use; enable or provide for low-cost solutions; promote effective delivery and administration of new solutions; and ensure or enhance safety.
Desirable attributes include:
- Approaches that can be used effectively to improve pregnancy and neonatal outcomes in community and primary clinic settings, where the large majority of births occur;
- Technologies that can be used in a setting with limited electricity, which need minimum maintenance, require minimal training and are relatively inexpensive to obtain and maintain;
- Products that favor early detection and prevention, as opposed to treatment of complications at a later stage;
- Technologies that enable self-care at home by women during pregnancy;
- Technologies embedded within a solid business plan to drive market penetration and uptake in poor countries;
- Simple adaptation of technologies with characteristics important to meeting unmet needs of pregnant women or newborns;
- Technologies that can be translated quickly into approved products;
- Technologies which consider reduction in not only the cost of the technology but how the technology can reduce the total cost of care.
A few of the many options to be considered include:
- Methods to sustain or treat preterm newborns;
- Methods to identify diagnose preeclampsia, including devices that measure blood pressure and proteinuria;
- Methods to prevent birth asphyxia;
- Methods to improve availability to blood and fluid replacement for maternal hemorrhage;
- Methods to diagnose and treat both maternal and newborn bacterial infection.
We will not consider funding for:
- Solutions that are not applicable to the developing world setting;
- Technologies that detract from favorable family practices such as immediate and exclusive breastfeeding;
- Exclusively social or behavioral interventions;
- Technologies or solutions mature in clinical testing and product development.
Grants will be selected on ability to create impact in the context of our existing global health priorities. For more information on The Bill & Melinda Gates Foundation's priority global health conditions, please click here.