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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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Novel Tool for Surveillance of Antimicrobial Resistance among Urinary Tract Care Infections Seen in Primary Care Settings

Sudeshna AdakOmiX Research and Diagnostics Laboratories Pvt Ltd.Bangalore, , India
Grand Challenges India
India-GCE
21 Apr 2017

Sudeshna Adak from OmiX Research and Diagnostics Laboratories Pvt Ltd. In India will develop a point-of-care AMR test and polymer card combined with a phone based surveillance system to detect and track AMR molecular signatures in primary care settings or in settings where access to AMR testing is currently unavailable. They will demonstrate a proof-of-concept for detection of AMR in urinary tract infections (UTI), establish and validate a 5-gene AMR signature assay in the proposed AMR test.

Pairing Maternal Wearables with a Holistic Model of Care

Molly GuyMedtronic LabsMinneapolis, Minnesota, United States
Grand Challenges Explorations
Wearable Sensors
1 Nov 2017

Molly Guy and Chemuttaai Lang'at of Medtronic Labs in the U.S. will lead a team seeking to redefine how pregnant women manage hypertension and how clinicians remotely monitor patients' health. Hypertensive disorders of pregnancy have overtaken hemorrhage as a main cause of maternal mortality in some sub-Saharan African settings. Management requires careful monitoring, which is problematic in settings with limited access to care. The team will assess integration of locally-appropriate wearable sensors into their existing hypertension management model of care. The model combines automated blood pressure monitors, mobile devices, and a software application, together allowing for data collection, real-time feedback, SMS messaging, and efficient access to referrals and prescriptions. The team will conduct a six-month pilot of 150 pregnant hypertensive women in Kenya to evaluate usability, feasibility, and desirability of this wearable-enhanced holistic care ecosystem.

Parent-Centric Kangaroo Mother Care Wearable

Yamile JacksonNurtured by DesignSugar Land, Texas, United States
Grand Challenges Explorations
Wearable Sensors
1 Nov 2017

Yamile Jackson of Nurtured by Design in the U.S. will develop a digital, wearable wrap with biosensors and a smartphone application to monitor kangaroo mother care - skin-to-skin contact between mother and infant - in low-resource areas, and improve its duration and frequency. The sensors will monitor the infant's temperature, position, and heart rate, and transmit the data to a smartphone provided to the mother, and to the cloud to be monitored by healthcare teams. The application will contain a user-friendly graphical interface and will also provide the mothers with information on the importance of kangaroo mother care and enable them to communicate with other mothers and health workers. They will build and test a prototype at a local research university with the participation of local kangaroo care leaders.

Perspectives on Side Effects of Hormonal Contraceptives

Takudzwa SayiUniversity of South FloridaTampa, Florida, United States
Grand Challenges Explorations
Family Planning
14 Jun 2017

Takudzwa Sayi of the University of South Florida in the U.S. will use journey mapping to discover women's experiences and responses to hormonal contraceptives, as well as their interaction with providers, in Zimbabwe to help design new contraceptives. They will also hold focus group discussions with family planning providers to find out their views on the uptake of specific methods. They will enroll women and providers in rural and urban areas across Zimbabwe. The journey mapping will involve a series of six sessions and will document from the time a woman chooses a contraceptive through her experience of side effects and how she interacts with the providers. They will validate their approach by comparing it to results from standard survey methods.

Rapid Cryptosporidium Drug Target Identification

Gregory GoldgofUniversity of California, San DiegoSan Diego, California, United States
Grand Challenges Explorations
Cryptosporidium Infection
14 Jun 2017

Gregory Goldgof and Elizabeth Winzler of the University of California, San Diego in the U.S. will use a genetically modified drug-sensitive yeast strain to quickly and inexpensively identify the cellular target of compounds that can kill the parasite Cryptosporidium, which is a major cause of diarrhea-associated deaths of young children in developing countries. Currently, there is only one treatment available and it is of limited use in some of the more severe cases. The yeast strain has been modified to lack transporter proteins that remove toxic compounds from the yeast cells. By treating the modified yeast with a selection of compounds that can kill Cryptosporidium, they hope to drive some of the yeast cells to develop resistance by mutating genes that are responsible for the drugs activity. By sequencing the resistant yeast using whole genome sequencing, they can then discover the likely target of the drug and how it kills the parasite. This would help to develop new drugs that may be more effective.

Rapid and Multiplex Diagnosis of Maternal Bacterial Infections

Jesse GitakaMount Kenya UniversityThika, Kenya
Grand Challenges Africa
Africa-Innovation Seed Grants
28 Sep 2017

Jesse Gitaka of Mount Kenya University in Kenya will lead the development and deployment of a point-of-care diagnostic for bacterial infections that have been implicated in poor pregnancy outcomes such as premature deliveries, still births, maternal and newborn sepsis and deaths. Their project will enable quick detection of these bacteria allowing for prompt treatment. They will test whether treating for these bacterial infections, which are usually not diagnosed, improves pregnancy outcomes in field situations. This strategy has the potential to inform pregnancy monitoring and follow up practice and policy.

Rational Antibiotic Use for Treatment of Sick Children in Local Health Facilities

Eric OgolaJaramogi Oginga Odinga University of Science & TechnologyBondo, Kenya
Grand Challenges Africa
Africa-Innovation Seed Grants
28 Sep 2017

Eric Ogola of Jaramogi Oginga Odinga University of Science & Technology proposes to reduce deaths in young children by developing an easier way to decide which antibiotic to use in blood-borne infections in children less than one month old. This will lead to judicious use of antibiotics and prevent the development of drug resistance. Clinicians in health facilities without laboratories will be able to make an educated guess on the best treatment that is likely to give an effective outcome. Authorities will also be able to monitor the rate of treatment failure and recommend new guidelines in time, thereby preventing more deaths over time.

Real-Time, Dynamic Capture of Contraceptive Behaviors, Experiences, and Needs of Kenyan Women

Alison DrakeUniversity of Washington Foundation, Global WACHSeattle, Washington, United States
Grand Challenges Explorations
Family Planning
14 Jun 2017

Alison Drake of the University of Washington Foundation, Global WACh in the U.S. will conduct an automated SMS-based survey to gather the opinions of women and adolescents on family planning methods in Kenya in order to characterize contraceptive use, reasons for discontinuation, and experience with side effects over a 6-month period that can help develop more acceptable methods. Current surveys capture only a single impression, whereas experiences can change over time. Using a mobile platform requires minimal personnel, and participants can register their opinions remotely. Adolescents will also be included. They will recruit 1,000 women and adolescents at five family planning clinics in Kenya and send them automated SMS messages weekly for six months that ask them to choose from numbered options regarding, for example, if and what side effects they are experiencing from their current family planning method. A monetary incentive will be offered for each SMS response.

Replicating the cStock Approach, a Mobile Health Logistics Management Information and Resupply System, to Make Health Commodity Supply Chains More Efficient at the Community Level in Kenya.

Sarah AnderssonJohn Snow, Inc. (JSI)Boston, Massachusetts, United States
Grand Challenges for Development
Saving Lives at Birth
31 Mar 2017

cStock is an approach to improving the supply of life-saving commodities to community health workers (CHWs) through technology - a mobile health logistics management information and resupply system (cStock) - while improving service delivery and demand generation through change management and system strengthening interventions - quality improvement teams. The approach is designed to make data visible, create a culture of data use, and drive accountability for performance.

Ride-Sharing for Sample Transport

Ruth BetchelVillageReachSeattle, Washington, United States
Grand Challenges Explorations
Diagnostics Systems
1 Nov 2017

Ruth Betchel of VillageReach in the U.S. will create a hub to coordinate and track the transport of clinical samples from health facilities to laboratories for diagnosis in Mozambique so that diseases such as HIV and tuberculosis can be identified and treated earlier. Timely diagnosis of disease is also critical for preventing spread. In Mozambique, the existing transport system for patient samples relies on outside providers and is largely uncoordinated, unreliable, and inefficient. They will create a transport coordinating center equipped with an information system to enable dispatchers to match the planned transport routes of a network of existing drivers with samples waiting to be transported. They will also build a sample tracking tool that works via a smartphone application for health workers to request transport and to monitor samples during transport. This will help identify ways to increase the efficiency and speed of delivery.

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