Matthew Edmundson of Violet Health in the U.S. will develop iron-rich biscuits and tailor marketing campaigns to combat iron deficiency in adolescent girls in India. Iron deficiency is a global health concern and is particularly dangerous during pregnancy when it can increase the risk of maternal death and health problems for the infant. Nearly half of all adolescent girls in India are iron-deficient, and although iron tablets are available they are not taken properly, partly due to their bad taste and a cultural aversion to tablets. Thus, more culturally acceptable alternatives are needed. To address this, they developed a low-cost, iron-rich biscuit that could overcome anemia and non-compliance to iron tablets in clinical tests with pregnant women in India. They will now focus on helping low-income adolescent girls by adapting the biscuits to their nutritional needs and preferences, which will be determined by interviewing 50 girls from different areas. These insights will also be used for a pilot marketing campaign to generate demand amongst the girls and their families and community members. They will test their approach with 300 girls from rural and urban locations in India to determine the effects of different marketing methods on demand.

Lyndon Paul of Vissot Co Ltd in Cambodia will reduce production costs for their nutritional wafer biscuits, which are made from a micronutrient-fortified fish powder, to help treat severe acute malnutrition in children and prevent malnutrition in young children and pregnant women in Cambodia. Acute and chronic malnutrition are a major public health concern in Cambodia. They previously developed a fortified fish powder and showed that it could replace milk in food for infants and was effective at reducing malnutrition. However, unstable supply and variable quality of the inland fish used to make the wafers have led to fluctuating prices. To address this, they will set up an optimized supply chain to reduce production costs by 60%. They will train workers in five communities where the fish are caught to sort, clean and pack the fish for transport to their factory in Phnom Penh. There, the fish will be processed into fish meal with acceptable taste and texture. They will evaluate the supply chain by collecting data from the fishers to the final product and evaluate quality and food safety.

Muthupandian Ashokkumar at the University of Melbourne in Australia, along with Francesca Cavalieri, Meifang Zhou, and Srinvas Mettu, will produce edible microballoons made from protein that contain essential nutrients for adding to common foods to combat malnutrition in mothers and infants. Encapsulating the nutrients, rather than adding them directly to food, helps keep them stable and promotes their absorption in the body. It can also mask unpleasant tastes, and control the timing and location of nutrient release, which can increase their performance. They have developed a method that uses ultrasound waves to encapsulate oil- and water-soluble vitamins and minerals within edible shells made from a range of proteins including milk and pea proteins. They will analyze the stability and strength of microballoons made from different materials that contain the recommended daily doses of nutrients for mothers and infants. They will also develop methods to encapsulate water, which could be used to reduce the fat content of fat-rich products.

Gloraia Pena of Cooperativa Multiactiva De Madres Del Valle Coomac in Colombia will implement a hybrid value chain business model to leverage collective purchasing power in a community of low-income families in Colombia to reduce the price of nutritious local foods. Current food prices are relatively high for low-income families because they buy in small volumes. They will combine collective purchasing power with a hybrid value chain model, which incorporates the needs and roles of the public and private sectors, to increase access to nutritional foods. They will collect social and economic data from an existing group of 9,000 families in a poor neighbourhood in Colombia to understand how their approach should be implemented. This will include the numbers of participants needed to reduce the cost sufficiently to encourage people to buy the healthier foods and ultimately produce a positive long-term impact.

Amanda Stiles of Ripple Foods, PBC, in the U.S. will produce a low-cost protein isolate upcycled from locally-sourced agricultural by-products that can be used as a nutritious food additive or standalone high-protein broth. Protein malnutrition is a major health concern in southern Asia and sub-Saharan Africa. However, protein is expensive to produce and often has a bad taste. They have developed an automated approach to identify low-cost, efficient methods to isolate plant proteins from agricultural by-products in the U.S. They will apply their approach to by-products from low-resource settings, such as wheat bran, and perform a high-throughput protein isolation screen to identify optimal extraction and purification protocols for yield and purity. The final products will be taste-tested to ensure they have a limited impact on flavor when used as food additives.

Joshua Warren and Daniel Weinberger of Yale University in the U.S. will develop an analytical framework to improve local estimates of vaccine coverage in low- to middle-income countries. Current estimates can be unreliable, due to errors and biases in record-keeping and difficulties in estimating local population sizes, and are further complicated when children are vaccinated outside of their home administrative district. They will develop advanced spatial analytical methods including bias adjustments that take these issues into account and can generate more reliable local estimates also from poor quality data. They will collect higher quality survey data on vaccine coverage and population sizes from selected locations to calibrate and ultimately validate the estimates. Their approach can be used in other low-income settings to improve vaccine coverage.

Ali Turab of IRD Global Ltd. in Singapore will develop a decision support tool that can be integrated with digital immunization registries to automatically construct optimal appointment schedules for every child that can adjust for missed immunizations and the introduction of new vaccines. A large majority of children, in both developing and developed countries, are not immunized at the recommended times, which can increase the risk of severe diseases. When a vaccination is missed, it is left to the health care professional to work out the best alternative schedule, which is often inaccurate. To help with this, they will design software that incorporates a child's vaccination history and age to automatically construct a new immunization schedule after every appointment, and that can also identify opportunities to vaccinate children even when they are at a clinic for other reasons. The software will integrate with existing health systems in several developing countries. They will conduct a mixed methods study at the Indus Hospital Korangi Campus in Pakistan to validate their approach for generating optimal schedules and assess usability by health workers.

James Njeru of the Field Epidemiology Society of Kenya will develop an integrated electronic platform that collects immunization and health data from existing registries and automatically sends regular, user-defined reports via SMS and email to health workers to improve vaccine coverage. Healthcare facilities record their immunization data on District Health Information Systems, but access to the data is limited. To widen access, they will build a platform that analyzes relevant health data from various sources, which will improve data accuracy, displays it on dashboards, registers users, and tracks their activity. They will pilot test their platform over seven months by registering program staff and managers so that they can access the platform and receive reports. The platform will be evaluated for its ability to integrate data and produce reports such as coverage and dropout rates. Feedback from users will also be used to refine the platform.

Chibuzo Opara of DrugStoc E Hub Ltd. in Nigeria will equip vaccine storage and transport sites with calibrated weighing mats (Digimats) that automatically transmit vaccine quantities in real time to better monitor delivery chains in the community and improve supply. Monitoring the movement of vaccines at the national and district level is currently performed by the Nigerian immunization program. However, accurate monitoring at the local level requires alternative, more automated approaches to avoid human error. They will calibrate their Digimats to recognize the weight of specific vaccines, and identify 20 sites across three states, including storage warehouses and trucks, where they will be positioned to automatically transmit data over a period of six months. These data will be collected by mobile tablets and interfaced with the national vaccine delivery dashboard to provide real-time stock counts and resupply alerts.

Mustafa Naseem of the University of Michigan in the U.S. will apply machine-learning algorithms to identify potentially falsified digital vaccination records in Pakistan. Pakistan is one of only three remaining countries where polio is still endemic. Particularly rural healthcare facilities are struggling to provide enough vaccinations due to highly populous provinces and a lack of resources and staff, and there is a risk that records are falsified to save time or bias the results. They will first perform fieldwork to identify any putative recently falsified records by auditing 2,000 recorded vaccination events across 200 randomly-selected villages. These data will be used to generate an algorithm by using features such as record patterns that can then detect if a data-point is likely to be true or false. They will test their approach by auditing another 1,000 vaccination events that the algorithm predicted were falsified compared to 1,000 randomly selected vaccinations.

Julius Lucks of Northwestern University in the U.S. will develop a low-cost diagnostic test that can detect multiple plant pathogens with a simple visual output for farmers in low-income countries to better monitor their crops. Current diagnostic field tests can only detect one disease and are generally difficult to use and costly. The alternative is laboratory testing, which is often unavailable in low-resource settings. Taking a different approach, they will develop a sensitive, multiplexed test that only requires basic sample preparation, such as mixing and using body heat, and can detect multiple pathogens using biosensors. The results will be visually presented using color changes that can be recorded by cell-phone cameras for analysis and reporting to aid global plant pathogen surveillance efforts. They will develop the methods and tools to detect three model plant pathogens and field test their diagnostic system in the U.S., Uganda, and Kenya.

Jun Kameoka of Texas A&M University in the U.S. will develop multiplex, battery-less and wireless durable paper sensors for positioning under the soil in crop fields to detect the early signs of pests and diseases, and communicate the data to overhead drones via radio frequency to improve pest management. The sensor will be designed to monitor physical, biological and chemical soil conditions that are altered by plant diseases. They will test its performance in commercial garden soil with maize and sorghum plants in a vinyl house.

Jan Kreuze of the International Potato Center in Peru will develop a low-cost, mobile phone-based diagnostic test for African farmers that uses artificial intelligence to quickly and accurately detect plant diseases such as cassava brown streak and banana bunchy top, which devastate crops and are threatening to spread. Accurately diagnosing plant diseases is difficult because visual symptoms can be highly variable. Artificial intelligence (AI) has shown promise for analyzing images of plants taken by mobile phone to detect diseases in low-resource settings, but it is not accurate enough. Alternatively, chemical-based diagnostic tests that detect the underlying viruses are far more accurate but difficult to use without training and require costly equipment. They will enhance the accuracy of AI for diagnosing a range of plant diseases by mobile phone by training it with validated diagnostic test results from their microfluidic amplification and detection device used by researchers and inspection agents. Their approach has the potential to recognize hard-to-detect symptoms in plants that may even be missed by crop specialists.

David Hughes, and Nita Bharti of Penn State University in the U.S. together with James Legg at the International Institute of Tropical Agriculture in Tanzania and the Charity, Self Help Africa, will leverage daily, high-resolution satellite imagery of farms in Kenya to monitor crop pests and diseases. Publicly funded satellites have the capacity to measure crop health, soil moisture, and water availability across wide areas. However, they are unable to accurately diagnose crop diseases particularly in smallholder farms because of the presence of many different types of often unhealthy-looking vegetation caused by lack of water or nutrients rather than plant diseases. They will use ground data on crop diseases and pests being collected as part of a five-year EU-funded project at 1,400 farms in seven counties growing a variety of crops. They will also collect maps of the farms using drones flying at different heights and see how well any pests and diseases can be detected using the daily satellite data. They will validate their approach for detecting pests and diseases on an additional 1,400 farms.

Matteo Rinaldi of Northeastern University in the U.S. will develop a miniaturized, maintenance-free chemical sensor that can detect specific volatile organic chemical vapors released from diseased crops as an effective surveillance system suitable for low-resource settings. Manual surveillance is time-consuming and requires prior knowledge of disease symptoms. Automated, sensor-based crop surveillance is far more effective, but relatively expensive, and the sensors constantly consume power, making them unsuitable for low-resource settings. They will develop a low-energy sensor-based monitoring system by exploiting a recently developed technology that comprises a micromechanical switch made of two cantilever beams. One of the beams will be coated with a polymer sensitive to the plant-based chemical and exposed to the environment. In the presence of that chemical, the beam undergoes a change in mechanical stress, causing it to bend and make contact with the second beam to trigger the switch. They will develop the microswitch-based chemical sensors, integrate them with a low-power long-range wireless module to signal pest detection, and test the performance of prototypes in the laboratory.

Monica Nolan of MU-JHU Care Limited in Uganda will adapt the existing open source Smart Register Platform, which digitally stores health records, for the real-time collection and transfer of immunization data, to improve vaccine coverage and other healthcare services for women and children in Uganda. In many low- to middle-income countries, records of childhood vaccinations are usually written by hand and can be poor quality. Digital records are of better quality and value, as they also enable the integration of different types of healthcare services, such as HIV services and vaccinations, to improve overall health. They will adapt existing technology and infrastructure, including the Smart Register Platform, which is already integrated into several national health systems and can produce automated SMS reminders of appointments. They will also design methods informed by mothers with young families, health workers and managers, to optimize data use and delivery of health services. They will use surveys and analyze health data to evaluate their approach for improving vaccine timeliness and coverage at selected clinics.

Chinedu Chugbo of Avigo Health L.L.C. in the U.S. will develop an approach to crowdsource reports of infant births and deaths from community members by health workers to better monitor vaccine coverage in low- to middle-income countries. In Nigeria, only 30% of births are registered, making it difficult to estimate numbers of vaccine-eligible children and ensure every child is properly vaccinated. Current methods for estimating population sizes include household surveys, which are costly, or records from health clinics, which suffer from limited coverage. Crowdsourcing is a proven method for efficient data collection, although data quality may be variable. They will develop electronic data-collection and storage tools and pilot test their crowdsourcing approach in a selected region in Nigeria. Health workers will be trained to administer brief interviews to community members visiting clinics and during outreach programs to document local births and deaths. They will evaluate the performance of their approach and particularly data accuracy by comparing it with data collected by household surveys in the same region.

The idea is to develop an artificial intelligence model capable of simultaneously analyzing data from the Laboratory Information System and from the Hospital Information System. This technology aims to enable the delivery to hospital physicians of a ranked list of antimicrobials that are more suitable to treat infection by multi-resistant microorganism with a focus on newborn and young children.

This project proposes the development of the One Health Brazilian Resistance (OneBR), a curated and integrated genomic database. OneBR will use algorithms based on artificial intelligence to conduct surveillance, diagnosis, management and treatment of antimicrobial resistance (AMR) in the human-animal-environment interface. The goal is for this platform to be used by Brazilian health professionals in diverse settings, particularly within the Unified Healthcare System (SUS).

The project proposes to characterize the resistant determinants of microbial communities from key sources in hospitals, environment and farms to model the dynamics of the flow of antibiotic resistant microorganisms. The goal is to understand how the hospital environment and animal farming affect the ecology of antibiotic resistance movement. The project will rely on a methodology that allows the analysis of genes related to antibiotic resistance in a complex microbial community derived from specific samples instead of culture based methods for AMR identification.

This project will test a sustainable solar oxidation system as a way to remove antibiotic resistant bacteria from wastewater. The hypothesis is that this technology can enable the inactivation of antibiotic resistant bacteria and the elimination of antibiotic resistant genes from effluents in Brazil.

The project proposes to use an aerobic granular sludge (AGS) - a technology based on microbial community - to remove antibiotics and antimicrobial resistant genes from hospital wastewater. AGS is one of the latest innovations and it has not yet been applied for the treatment of hospital wastewater.

Aims to validate the International Fetal and Newborn Growth Consortium for the 21st century (Intergrowth-21st) standards for gestational weight gain (GWG) and create new recommendations of GWG based on those standards for first trimester normal and overweight women to be used in the Brazilian Unified Health System (SUS). GWG recommendations currently used in SUS have not been properly tested or validated, thus the project might improve prenatal nutritional care and reduce post gestational weight retention.

The study aims to develop an Early Childhood Development friendly index (ECD-FI) based on a core set of evidence-based nurturing care indicators to assess the factors contributing to enabling environments and promote ECD at the municipal level by monitoring and identifying opportunities to scale up ECD programs. The index will be created through machine learning and will run analytical models considering demographic information and risk factors at the municipal level. This disaggregated data is not available in Brazil.

The project will develop a platform to provide services for decision-making support for neonatal death preventive actions by using data from CIDACS cohort. The platform will offer three services: cohort data visualization for decision-making support by comparative human visual analysis, prediction of risk of neonatal death based on machine learning models, and simulator of public policies impact influencing on the risk of neonatal death.

By analyzing national children vaccination coverage from spatial perspectives, the study aims to uncover insights into the traditional surveillance. This will help to identify coverage rates, regions of greater vulnerability by providing a differentiated look at the logic of equity in health. Understanding the low childhood vaccination coverage will help to guide public policies for the purpose of interventions.

Studies show that seasonal influenza in Ceará, in the Northeast region of Brazil, occurs 2 to 3 months earlier than in the South and Southeast, which guides the national calendar of vaccination. By using data science approaches, the study will test if Brazil's current national policy targeting vaccination only during the months of April and May inadequately protects against the harmful maternal-fetal effects of influenza in the Semi-Arid and northern regions of Brazil. If the hypothesis confirms, the study has the potential to change policy and modify the vaccination calendar.

The proposal will develop a platform for the analysis and visualization of data that will allow managers, public servants and other stakeholders involved in the Mãe Coruja Program at Pernambuco state (PMCP) to extract strategic information to improve the intervention. The focus will be on the implementation and actual enforcement of public policies, considering the high gestational risk and sexually transmitted infections (STI). Currently, health databases are for consultations only. The innovation of this proposal is to create an intelligent cloud platform for the analysis and distribution of health information to improve health care of women enrolled in PMCP.

Infectious diseases may have only transitory impacts on pregnant mothers, but they can have lasting impacts on children. Can public interventions mitigate these impacts? This project aims to identify how exposure to localized epidemiological risk factors in the fetal period influences developmental outcomes for children through the early years of life. The researchers propose to evaluate in what extent the access to primary health care and social welfare programs mitigate negative impacts in child development.

Alizée Lozac'hmeur of Makesense in Paris will develop online mobile and web applications and provide opportunities to engage with experts and funders as part of a tailor-made approach to help young people learn about and solve the health and social issues that matter to them. They will integrate their digital platform, where participants can register their details and issue of interest, with a project database and events calendar to promote collaborations. Users will receive inspiration and advice and be informed of relevant opportunities by frequent emails or mobile phone messages to help them reach their goals. They will integrate the digital services, build a network of community organizers, and launch a marketing strategy to test their approach in France for engaging young people who are interested in solving a specific UN Sustainable Development Goal (SDG).

Hussein Khalil of the Federal University of Bahia in Brazil will provide young people in urban slums with knowledge and tools to identify elements that promote the spread of diseases by rats and mosquitos such as dengue and Zika virus infection, and engage their communities to help combat those diseases. They will recruit 40 young residents from two urban slums to test their approach. The youth will be taught to map rat- and mosquito-infested areas and identify possible causes, such as poor waste disposal, by photographing their environments, and to use tools to track rat movements and insect breeding. They will also use gamification methods to stimulate learning and promote collaborations between the youth and adult residents to identify the most effective interventions. Once simple solutions have been identified, the youth will help to implement them in their community and produce and share progress reports using online and offline tools.

Rimjhim Aggarwal of Arizona State University in the U.S. will use a digital learning platform and teaching network to teach young people how to create 360-degree spherical imagery of field sites that function as virtual field trips to share their experiences about specific UN Sustainable Development Goals (SDG) and better engage and teach others. These virtual field trips can be distributed on the internet, giving a large number of viewers the sense of actually being in the field, and are thus valuable teaching tools. However, they require specialized skills and equipment to create them. They will teach young people how to make them by holding a workshop to train 20 honors and undergraduate university students to create three new virtual field trips for local SDGs. These will then be presented to other students as part of a university course via a digital learning platform to evaluate their impact.

Alpha Sennon of WHYFARM in Trinidad and Tobago, along with Wainella Isaacs, Candace Charles-Sennon, Luke Smith, George Caesar, Akinola Sennon and their partners at TECH4Agri, will engage young people, who are the future feeders of 2050, in agriculture, and develop their knowledge and skills so that they can promote sustainable agriculture and improve food security in Trinidad and Tobago. They will implement four related projects in which participants can win cash prizes. These projects include an eight-week training course for ten professionals aged 18 to 30 that provides mentorship and skills to help develop their business plans, tours of ten primary schools with a local youth theater production company to teach nine to eleven year olds about the nutritional and economic value of baigan (eggplant), including a competition to design their own superheroes and nutritious snacks, and focusing their Agricultural Fun, Museum and Food Factory Park for the under 30's to teach visitors about food and local agricultural products using educational games. They will evaluate each project using surveys and metrics such as numbers of participants and related activity on social media.

Henry May of Coschool in Colombia will develop an integrated teaching course including in-person boot camps, mobile learning, and online communities, to equip teachers with advanced skills and tools to promote the wellbeing of themselves and their schools and communities. Teaching 21^st century skills can help bridge the wide achievement gap between urban and rural communities in Colombia, and also help peace building in post-conflict territory. Their method focuses on five skills: growth mindset, self-awareness, empathy, critical thinking, and grit. To promote teaching of these skills, they have designed an integrated course that involves a six-hour boot camp for effective face-to-face teaching of large numbers of teachers; a twenty-hour course on a mobile, gamified platform; and monthly webinars for small groups with workshops and interactive learning. They will create the new course content and evaluate it by running the program over nine months with 1,000 teachers in five regions in Colombia.

Malcolm Mooi of the Dr CL Smith Foundation in South Africa will further develop their common online platform for teachers, which provides training, materials, and support to improve the quality of teaching in South Africa. Teachers are the number one drivers of learning in schools, but there is a lack of curriculum and holistic support for teachers in many countries, which has a direct, negative impact on student performance. They will use a variety of mathematical and technological approaches to refine their preliminary platform by adding new features to improve user experience and work to grow an online community of educators and organizers to attract more users. The performance of the platform will be measured by analyzing growth and user engagement. By exploring opportunities to connect the platform and associated data with education councils and corporations and unlock added value for teachers such as rewards and discounts, they aim to elevate the status of teachers in society and further improve teaching quality.

Yen Verhoeven of the Paragon Learning Research Group in the U.S. will create a digital platform for massive open online courses (MOOCs) and a supportive online community of professionals for kindergarten to sixth grade teachers to transform their teaching practices and bring STEM and 21^st century skills to their schools. MOOCs were developed as a means to provide free education to everyone. However, their content is typically restricted to videos and reading with little interactive learning, which is inadequate for teaching life skills such as critical thinking and creativity. And encouraging teachers to adopt new teaching practices requires additional professional support from peers and mentors. To address these issues, they will work with teachers and teaching experts to formulate a new MOOC design containing a variety of instructional resources and free professional development classes and develop a beta version of the online community platform. They will evaluate the course by teaching it to local K-6 teachers and gathering feedback to refine the content.

Hans Brunner of Value Spring Technology, Inc. in the U.S. will build and test an artificial intelligence (AI) tutor to teach the scientific method and critical thinking skills to individual students at their pace and level. All children learn differently but one-on-one lessons are often prohibitively expensive or unavailable. To address this, in collaboration with two non-profit teaching institutions, they will adapt their AI software for education, and build and train an AI tutor, Ali. Ali will be designed to produce natural sounding language to engage students in conversation involving open-ended questions and answers that stimulate critical thinking, which is based on the Socratic method. Students will be taught at their own pace and level of understanding, and Ali will be built to ensure each topic is fully understood before starting the next. They will engage teachers to test and critique their AI tutor approach and to evaluate its teaching performance.

Amanda Nguyen of Rise Inc. in the U.S. will scale-up the existing grassroots social justice movement that they have established in the U.S. to create actionable recommendations to support the rights of survivors of sexual violence worldwide. Thirty-five percent of women – 1.3 billion people worldwide – are survivors of sexual assault, but many are denied basic rights and access to justice. Rise International’s approach involves communicating survivor stories, building alliances with influential people, and maximizing visibility through media coverage.

Brandon Kohrt of George Washington University in the U.S. will develop a tool using sensors associated with mobile phones that can identify and monitor young mothers suffering from perinatal depression in low-resource settings in Nepal so that personalized psychological treatments can be provided. The tool comprises a mobile phone for the mother and a small Bluetooth beacon attached to the baby's clothes. It can record location via GPS, the proximity between phone and beacon, and sound. They will build sensor data models that can associate specific activity recorded from the sensors with maternal depression, such as the length of time spent with the baby, the level of vocal interactions, and the frequency of outings. A community advisory board composed of young and older mothers, family members, and health workers will be established to evaluate the approach and help test and refine the tools. They will also co-develop a user-friendly interface with the mothers and health workers so that they can easily access the information and use it to improve their mental health.

Allya Paramita Koesoema of the eHealth and Telemedicine Society in Indonesia will develop a pro-vaccination campaign to counteract the widespread negative views of vaccinations in Indonesia by engaging religious leaders and health workers in local communities to directly address misconceptions. Anti-vaccination narratives, many based on religious misconceptions, have spread through the country, largely via social media, leading to a decrease in child vaccination coverage. Health workers often do not have the knowledge to explain away these misconceptions to mothers when they refuse to have their children vaccinated. To address this, they will engage stakeholders to identify the anti-vaccination messages and build a database of effective reasoning to directly challenge those messages that can be accessed by health workers and other respected, senior community members. They will perform a randomized controlled trial in different districts in Indonesia, and supplement the pro-vaccination messengers with vaccination reminders and schedules sent directly to mothers via mobile phone. They will test the usability of their approach and its effect on the willingness of the mothers to vaccinate.

Apostolos Alissandratos of the Australian National University in Australia will develop a biotechnology platform for the low-cost production of simple, just-add-water diagnostic tests for the early detection of infectious diseases in resource-limited settings. Diagnosis of infectious diseases generally involves detecting pathogen-specific nucleic acids in human samples, which requires unstable reagents, costly procedures, and skilled workers. They have engineered a safe bacterium that produces the biochemical reagents needed to detect the pathogenic nucleic acids as an extract. They will develop a method to freeze-dry this extract so that it is stable at room temperature, simplifying production and storage, and a protocol for incorporating it into a reaction mixture that only requires the addition of water to an individual tube for a diagnostic polymerase chain reaction. They aim to reduce the cost per test by at least 100-fold, and will evaluate their approach for detecting a malaria-causing pathogen.

Lisa Butler of the University of Connecticut in the U.S. will develop an approach to improve the mental health of pregnant and new mothers between 15 and 19 years old in Botswana that incorporates interactive group sessions mediated by trained community workers, informative text messages, and an SMS-based mental health screening tool. Between 19-25% of women in low- to middle-income countries suffer from depression during pregnancy, which can also have serious effects on the child. In Botswana, there are large numbers of young, single mothers, who lack support and are particularly vulnerable to depression. They will develop the materials and format for their approach with support from a community working group of adolescent mothers and health providers to ensure it is culturally appropriate and addresses their specific needs. They will also incorporate a theoretical model designed to address the triggers and reduce the stigma of mental health disorders. Their approach will be field tested with 80 pregnant adolescents in a traditional village in Botswana to evaluate its feasibility and acceptability.

Tara Hopkins of Mali Health in the U.S. will develop methods to improve vaccination coverage in rural communities in southern Mali by engaging community health workers together with traditional birth attendants who are present during home births. In southern Mali, particularly in rural communities, most children are born at home, so they are not registered with a health clinic or present for critical childhood vaccinations. Local health services have limited funds and resources to manage the health records of all the babies born in their communities, or to follow-up with families regarding the necessary vaccinations. This translates to low vaccine coverage of around 9% in some regions, and increased incidences of deadly infectious diseases. They will pilot the project in three rural health districts and create a quality improvement team in each, consisting of a coach, local health workers, birth attendants, and mothers. The teams will be given tools to engage in a group effort to identify the barriers to timely vaccinations, and generate solutions to test.

Xing Xie of the Georgia Institute of Technology in the U.S. will test whether super-absorbent polymers in sample tubes can improve the accuracy of diagnostics by absorbing molecules like DNA and viruses from liquid samples such as blood, and protecting them during transport to the laboratory. Normally, blood and urine samples degrade over time, particularly when they are exposed to heat or cold. This makes the subsequent diagnostic result unreliable. They propose that low-cost, super-absorbent polymers can preserve diagnostic target molecules by separating them from contaminating cells and bacteria, which can be poured away from sample tubes, and providing a pH buffer and preservatives to extend their shelf-life. They will optimize synthesis of the beads and test their ability to preserve different analytical targets including a human virus surrogate and an antibody against HIV.

Gerard Cangelosi of the University of Washington in the U.S. will develop reagents to visually validate oral swabs and stabilize them for storage and transport to diagnostic laboratories in low-resource settings without the need for a cold chain. Oral swabbing to extract saliva is a non-invasive and effective method for diagnosing tuberculosis, and is faster and safer than traditional sputum collection. However, it is more difficult to review the quality of a swab sample as they are hard to see, and processing currently requires refrigeration. To address these limitations, they will develop a low-cost, quality control test with chemical reagents for detecting human mitochondrial DNA using human oral swabs from U.S. volunteers spiked with an avirulent strain of Mycobacterium tuberculosis. This will be coupled to a visual fluorescent readout that can be used to distinguish adequate from inadequate samples. They will also test different buffers for their ability to stabilize the swab samples at different temperatures for up to six months.

Dyuti Sen and Tushar Garg from Innovators in Health in India will test whether a communal game of snakes and ladders in maternity health clinics and in homes of pregnant couples can demonstrate the value of childhood immunization to improve coverage in rural communities in Bihar, India. Gameplay may be a valuable way of informing parents about the importance of immunizing their children because it is fun and interactive. Snakes and ladders, which is a popular game in India, can also visually illustrate the positive (ladder) and negative (snake) effects of immunization, such as the economic cost of having a sick child. The board is built up interactively by the parents as they make choices about vaccinating their children from the start (newborn) to the finish (fully protected child). They will train community health workers to facilitate communal games of snakes and ladders, trial their approach in around 15 municipal wards over 12 months, and determine its impact on immunization coverage and local knowledge.

Agnes Ronan, from Pediatric Adolescent Treatment Africa, in South Africa will develop a training and supervision tool for young health workers that combines screening and support in an accessible format to reduce depression in HIV-positive, adolescent mothers. There are an estimated two million adolescent mothers living with HIV in Africa, and stigma prevents many of them accessing health care. Young HIV-positive peer supporters work in local clinics and use informal chats, text messages, and home visits to support HIV-positive adolescents. However, they lack the skills to support the mental health of HIV-positive adolescent mothers. They will adapt existing cognitive behavioral therapy methods based on the WHO's Thinking Healthy program, and co-develop their approach with adolescent mothers, peer supporters, and developers. They will train 70 peer supporters from six southern African countries and each will recruit three HIV-positive adolescent mothers to test the approach.

Jan Willem Alffenaar of the University Medical Center Groningen in the Netherlands will develop two simple tests that measure the concentration of anti-tuberculosis drugs in treated patients in low-resource settings in order to optimize dosage and limit the emergence of deadly multi-drug resistant Mycobacterium tuberculosis (MDR-TB). The increased incidence of MDR-TB is due in part to low levels of anti-tuberculosis drugs, thus dosage optimization during treatment is important. However, doing this in low-resource settings is currently challenging. They will develop a method for use in Tanzania to measure the concentration of the anti-TB drug fluoroquinolone in saliva using a battery-operated UV spectrophotometer. They will also modify a high-performance liquid chromatography (HPLC) platform for detecting drug concentrations in dried blood spots, which are collected on filter paper and do not require refrigeration to remain stable. The on-site saliva test will allow detection of patients with too low levels of drug at risk for treatment failure, who can then have their dose optimized following the more detailed dried blood spot analysis at a centralized laboratory.

Jerome Ateudjieu of Meillerur Acces aux Soins de Sante in Cameroon will test whether training community volunteers to record demographic movements and monitor births and immunizations of residents and visitors in their villages can improve timely childhood vaccination coverage in Cameroon. Many health districts in Cameroon have reported outbreaks of vaccine-preventable diseases. One underlying cause is that many people in these regions travel extensively, making it difficult for health facilities to identify newborns that need vaccinating, and to inform parents when and where the necessary vaccinations can be received. They will select 60 villages in the Noun Health District of West Cameroon, and train community volunteers to record the movements and immunization status of infants up to 11 months in their village. These records will be sent by the WhatsApp mobile messaging application to the relevant health facility to identify the children eligible for the next immunization session. The necessary appointments will then be communicated back to the parents by the community worker, who will also inform them of the importance of timely immunization, and encourage pregnant mothers to give birth in health facilities.