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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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Bili-Hut: Saving Newborn Lives with Rapid Deployment of Phototherapy in Rural India

Donna BrezinskiLittle Sparrows TechnologiesWinchester, Massachusetts, United States
Grand Challenges for Development
Saving Lives at Birth
1 Oct 2014

The Bili-Hut is a novel phototherapy device designed to improve access to jaundice treatment in low resource areas. It is extremely light-weight, portable, and capable of prolonged operation with a battery. The working prototype complies with recommendations of the American Academy of Pediatrics for high intensity phototherapy, delivering treatment in the optimal therapeutic light bandwidth equivalent or superior to existing commercial devices. Most initiatives to improve access to neonatal phototherapy center on equipment donation or designing cheaper devices for urban hospitals that have electricity. The Bili-Hut will meet the specific needs of the previously unreachable, low resource areas without reliable electricity that have the highest mortality from jaundice.

Inhaled Oxytocin - Landscape and Stakeholder Analysis in Regions with High Maternal Mortality

Halina OswaldMonash UniversityClayton, Victoria, Australia
Grand Challenges for Development
Saving Lives at Birth
1 Oct 2014

Monash is seeking to develop an affordable heat-stable, self-contained, simple to administer inhaled delivery system for oxytocin. Such a product removes the challenges associated with access and use of the current oxytocin product and has the potential to ensure that a high-quality oxytocin product is accessible to women with greatest need. The project is innovative as it would, for the first time, provide an effective oxytocin product that does not rely on cold chain supply and storage to maintain quality or the presence of healthcare workers trained to safely administer injections. Current uterotonic products are presented either as injections susceptible to degradation in ambient conditions or, in the case of misoprostol tablets, do not provide the level of efficacy possible with oxytocin. The proposed inhaled oxytocin product presents the potential of delivering the gold standard therapy in a robust form that simplifies administration at a cost equivalent to current products. As such, this innovative product has the potential to significantly expand access to oxytocin across low- and middle-income countries by creating efficiencies within busy facilities, administration to lower tier healthcare workers and birth attendants.

Validation and Introduction of a Low-Cost Bubble Continuous Positive Airway Pressure Kit and Oxygen Blender for Neonates

Sara WatsonProgram for Appropriate Technology in Health (PATH)Seattle, Washington, United States
Grand Challenges for Development
Saving Lives at Birth
1 Oct 2014

Continuous positive airway pressure (CPAP) therapy is the standard of care for treatment of neonatal respiratory distress, but the availability of CPAP devices is limited by cost and facility infrastructure such as electricity and pressurized air. The bubble CPAP (bCPAP) kit and oxygen blender address the lack of electricity and pressurized air, common in rural health clinics, and have been demonstrated to provide a stable supply of blended gas. Our proposed work will further address this gap by collaborating with local distributors of hospital supplies to sell inexpensive, preassembled kits to hospitals, clinics, and pharmacies.

Breathalert: High-Performance, Low-Cost Method to Reduce Death Due to Apnea of Prematurity

Maria OdenRice UniversityHouston, Texas, United States
Grand Challenges for Development
Saving Lives at Birth
1 Oct 2014

Our idea is to develop BreathAlert, a $25 battery-powered monitor that detects and automatically corrects apnea. BreathAlert is a stretchy band placed around a baby's chest to detect if breathing has stopped; if apnea occurs, coin-sized vibrating motors in the strap are activated and the vibration automatically stimulates the baby to resume breathing.

A Simple Tool and Mobile Phone Application to Improve Community-Based Case Management of Premature and Jaundiced Newborns

Anne LeeBrigham and Women's HospitalBoston, Massachusetts, United States
Grand Challenges for Development
Saving Lives at Birth
1 Oct 2014

We aim to develop and validate simple, low-cost, low-technology tools to improve community-based identification, referral, and care of premature and jaundiced newborns by frontline health workers.

Thermal Images on Smartphones to Diagnose Bacterial Neonatal Pneumonia in Pakistan

Patricia HibberdMassachusetts General HospitalBoston, Massachusetts, United States
Grand Challenges for Development
Saving Lives at Birth
30 Sep 2014

Our objective is to develop a low-cost Smartphone attachment and application to diagnose and treat bacterial neonatal pneumonia in Pakistan. Currently, serious bacterial infection - pneumonia, sepsis and meningitis - results in preventable deaths of 700,000 neonates every year, 99% dying in resource limited settings such as Pakistan. Signs of serious infection in young babies are difficult to recognize. Diagnostic tests and chest X-rays are rarely available outside tertiary care hospitals. The proposed device has the potential to identify and treat bacterial pneumonia quickly and decrease mortality. Our technology is an attachment that snaps on to a Smartphone and acquires, then displays a thermal image of a neonate's lungs. An application (app) will calculate the chance a neonate has bacterial pneumonia, based on the presence of "hot spots" or temperature differences which represent the increased blood flow/inflammation that occurs with bacterial pneumonia. The app will produce a read-out recommending treatment with antibiotics if the thermal image is consistent with bacterial pneumonia. The attachment and app will work with most Smartphones that are increasingly available globally and will be powered by the Smartphone's battery. It will take minutes to acquire and process the images. No specialized equipment or technical expertise by the user will be needed. The device is non-invasive, low risk, easy to use and incurs a one-time (not per test) expense which is minimal compared to X-rays.

Collaborative Community-Based Technology to Improve Maternal and Child Health in Senegal

Gorgui DialloAFRICARE SenegalDakar, Senegal
Grand Challenges for Development
Saving Lives at Birth
12 Feb 2014

To increase demand for and access to quality maternal and neonatal services for women living in hard to reach areas of Senegal, Africare is proposing to develop an innovative model that integrates community based support services (Maternal Care Support Groups/MCSG) with mobile and telemedicine platforms. This innovative technology platform, combined with community services, will bring prenatal care services closer to 303,920 women in rural Senegal, allowing for early detection of potential problems and their quick referral to centers equipped to manage emergency obstetric care. The MCSGs will be used to deter the cultural practice of hiding pregnancy status till late in the second semester and reduce delays in seeking prenatal care.

Prevention of Maternal Death by Improving Iron Status of Women Through Iron Fortification of Tea

Levente DiosadyUniversity of TorontoToronto, Ontario, Canada
Grand Challenges for Development
Saving Lives at Birth
16 Dec 2013

Iron deficiency is a major contributor to maternal death. Improving the health of women through iron fortification of a universally consumed food vehicle will result in significant saving of lives at birth. Tea is universally consumed in South Asia; however, iron forms complexes in tea, reducing bioavailability, and thus thwarting earlier fortification attempts. Our approach will make tea viable as an iron fortification vehicle. We will develop spray-encapsulated iron premix that will be attached to tea leaves, and released into hot water during brewing, without altering the tea's sensory attributes. Iron will be encapsulated in enteric coating to prevent formation of non-bioavailable tannin complex in the stomach, the coating will dissolve in the small intestines to expose a high bioavailability self-emulsifying iron delivery system. Our innovations are: (1) the encapsulation/microemulsion approach which protects iron in the stomach and enhances absorption in the lower GI, and (2) using tea as the fortification vehicle which will ease adoption because no user behavior change will be required.

Augmented Infant Resuscitator (AIR)

Data SantorinoMbarara University of Science and TechnologyMbarara, Uganda
Grand Challenges for Development
Saving Lives at Birth
16 Dec 2013

Effective resuscitation could reduce intrapartum related neonatal deaths by 30%, and deaths from prematurity by 10%, creating the potential to save 347,200 babies annually. However, one in five trained healthcare professionals (HCPs) fail to perform the resuscitation technique correctly, and those that do, often experience a rapid decline in proficiency. Our Augmented Infant Resuscitator's advanced training capabilities, instant feedback mechanism, and objective self-audit and retraining abilities will maximize and sustain gains from effective resuscitation. The AIR prototype provides instant feedback to users about effective ventilation. This is measured using inexpensive instrumentation that calculates ventilation rate, air volume and air pressure delivered by the bag-valve-mask (BVM) across the resuscitation face-mask. These parameters correlate with the four most common mistakes that result in ineffective resuscitation: 1) Failed seal at the face-mask interface resulting in failure to inflate the lungs; 2) Blocked airways; and 3) Wrong ventilation frequency 4) Insufficient/shallow lung inflation. Each of these mistakes can cause death or brain damage. AIR also records performance on an internal memory card for future feedback, improving HCPs training by identifying persistent gaps in technique.

HIST-BIRTH: Innovative and Rapid Point-of-Care Histone Test Strips for Early Diagnosis of Sepsis in Pregnancy and Childbirth.

Federico Pallardo CalatayudUniversidad de ValenciaValencia, Spain
Grand Challenges for Development
Saving Lives at Birth
16 Dec 2013

We propose to develop a rapid, low-cost and effective method for detecting sepsis in early stages. We will take advantage of the potential of histones to be sensitive and effective biomarkers for sepsis, and of the versatility, simplicity and low-cost of test strips. The diagnostic test will be simple, comfortable, easy to interpret and low-cost for prognosis/early diagnosis of sepsis based on histone expression. The test can be used by non-technical experts in any hospital or health center worldwide, though it has been designed intentionally for low-resource countries. Proof-of-concept of this diagnostic test will be performed in Uganda, in order to analyze benefits and reduction in mortality of pregnant women and infants in that country. The innovative combination of histones and strips make this diagnostic test a significant improvement over the inefficient methods currently used for sepsis diagnosis, such serum lactate measurement, microbiological sampling, etc.

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