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Grand Challenges is a family of initiatives fostering innovation to solve key global health and development problems. Each initiative is an experiment in the use of challenges to focus innovation on making an impact. Individual challenges address some of the same problems, but from differing perspectives.

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Postpartum Empowerment: An Integrated Approach Driving Demand and Delivery of High-Quality, Low-Cost Postnatal Services in Kenya

Nick PearsonJacaranda Health LimitedNairobi, Kenya
Grand Challenges for Development
Saving Lives at Birth
31 Dec 2012

In this proposal we focus on the postpartum period, and compare several low-cost and easily scalable approaches to improve the uptake and quality of postnatal care - approaches that take advantage of our strengths in technology, task shifting, clinical checklists, and community sales networks. In Kenya fewer than 20% of women receive postnatal care in the six-week postpartum period. Our objective is to find a cost-effective way to increase coverage of postnatal care and postnatal family planning within our patient population.

Saving Mothers and Babies with Reliable Solar Power

Susan WanderaThe African Medical and Research Foundation (AMREF)Kampala, Uganda
Grand Challenges for Development
Saving Lives at Birth
3 Dec 2012

The new and innovative WE CARE Solar Suitcase is a simple, user-friendly technology that provides a sustainable source of power, allowing health workers to provide life-saving interventions 24 hours a day. The Solar Suitcase makes solar-power accessible, affordable, and useful in developing rural communities. This program ensures Solar Suitcases for 200 health centers and additionally provides an innovative package of interventions to improve service delivery, including a fetal Doppler to detect fetal well-being, phone charging to enhance patient referrals, and a computer to for data entry in the electronic Health Management Information system.

RESOLuTION Study

Tom MyersMicroLab Devices LtdLeeds, United Kingdom
Grand Challenges Explorations
Global Health Solutions
10 Nov 2012

Tom Myers of MicroLab Devices in the United Kingdom proposes to develop an electrochemical point-of-care device to provide rapid and accurate diagnosis of malaria and serious bacterial infections in children using a finger-prick blood sample. Integrated diagnosis will allow prompt and accurate treatment and limit needless antibiotic dissemination, which leads to drug resistance.

Identification of Biomarkers for Environmental Enteropathy in Children Using an Evidence-Based Approach

Asad AliAga Khan University - PakistanKarachi, Pakistan
Grand Challenges in Global Health
Gut Function Biomarkers
6 Nov 2012

Asad Ali of Aga Khan University in Pakistan and co-­investigators will test a selected group of candidate biomarkers to identify and monitor environmental enteropathy, which causes malnutrition and stunting. The biomarkers, which include markers of inflammation and enteric pathogens, will be tested in blood, urine and stools, and correlated with structural features of the small bowel using biopsies from malnourished children. They will also attempt to identify new candidate biomarkers in these biopsies using mRNA sequencing. Their results will provide important insight into disease pathophysiology and enable the development of evidence-­based interventions.

Gut Permeability in Environmental Enteropathy

William FaubionMayo ClinicRochester, Maryland, United States
Grand Challenges in Global Health
Gut Function Biomarkers
2 Nov 2012

William Faubion of the Mayo Clinic in the U.S. and colleagues will develop a non-­invasive test of small intestinal permeability to improve the reliability of detection of environmental enteropathy, which causes childhood growth failure. The test involves quantification of sugar absorption in urine samples using mass spectrometry, and will be validated in at risk infants in the developing world. The aim is to provide a simple, safe and inexpensive test to identify all cases of this condition on a global scale, and drive the development of preventative interventions.

Hydroelectric Power for Cold Chain

Anthony BattersbyRiver Energy NetworksBath, Avon, United Kingdom
Grand Challenges Explorations
Immunization Systems
1 Nov 2012

Anthony Battersby of River Energy Networks in the United Kingdom will develop and field test a simple inexpensive micro-hydroturbine that can drive a generator to power vaccine refrigerators and other health care facility equipment. Proof-of-concept models will be tested in Nigeria using components designed for simplicity and reliability.

Metabonomic Biomarkers of Gut Function and Health: Modeling Enteropathy (EE) and Field Validation

Richard GuerrantUniversity of VirginiaCharlottesville, Virginia, United States
Grand Challenges in Global Health
Gut Function Biomarkers
1 Nov 2012

Richard Guerrant of the University of Virginia in the U.S. and co-­investigators will develop and validate non-­invasive metabolic biomarkers of gut health to identify children at risk of environmental enteropathy and developmental impairment, in order to assess interventions. They will use ongoing MAL­-ED (malnutrition and enteric diseases) and NIH­-supported clinical studies in malnourished and control children, and their own studies in novel murine models, along with a nuclear magnetic resonance approach to perform metabolic profiling of urine, plasma and feces samples. Their goal is to improve the growth, nutrition and development of children at high risk of environmental enteropathy that can lead to morbidity and mortality.

Development of Human mRNA as a Biomarker for Environmental Enteropathy

Mark ManaryWashington University School of MedicineSt. Louis, Missouri, United States
Grand Challenges in Global Health
Gut Function Biomarkers
26 Oct 2012

Mark Manary of Washington University in the U.S. and colleagues will develop a strategy for the non-­invasive diagnosis of environmental enteropathy, which causes malnutrition and growth failure in young children in the developing world. They will devise a robust protocol to isolate human RNA of the small bowel from samples of stool, and will test a broad panel of candidate biomarkers for their ability to identify environmental enteropathy with high sensitivity using samples from at risk Malawian children. These tools will be critical for studying disease etiology and for the development of effective intervention strategies.

A Buddy Program for Immunisation System Managers

Ben GilbertUniversity of CanberraCanberra, Australian Capital Territory, Australia
Grand Challenges Explorations
Immunization Systems
24 Oct 2012

Ben Gilbert and Andrew Brown of the University of Canberra in Australia will develop a regional support network for medical supply managers in Pacific Island countries that can help them to better apply the formal training they received to manage vaccine supply systems. By engaging them in a buddy support system, Gilbert and Brown hope to empower these managers to overcome cultural, educational, social and historical factors that hinder effective management styles, and help them operate supply systems that are more responsive to immunization challenges in those developing countries.

Reducing Harmful Inflammation and Attenuating Immune System Deterioration in HIV-Infected Malian Women

Daniel NixonVirginia Commonwealth UniversityRichmond, Virginia, United States
Grand Challenges Explorations
Global Health Solutions
24 Oct 2012

Daniel Nixon and colleagues at Virginia Commonwealth University in the U.S. will test the theory that gut bacterial flora (microbiome) and nutrition influence inflammation, immune activation, and HIV disease progression. The team will determine whether a safe, inexpensive probiotic bacteria oral supplement can treat an abnormal gut microbiome and attenuate immune system deterioration in HIV-infected Malian women.

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