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Bill & Melinda Gates Foundation

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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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Validation Study of an Electricity-free Oxygen Concentrator in Western Uganda.

Roger RassoolUniversity of MelbourneMelbourne, Victoria, Australia
Grand Challenges for Development
Saving Lives at Birth
9 Nov 2016

One of the reasons oxygen therapy is not reaching the many thousands of babies and children it could save is due to the fact that electricity is not always available in small health facilities. To address this problem, this team has successfully developed FREO2, an electricity-free oxygen concentrator which runs on the energy from water flowing in a nearby stream, and which requires no fuel. This project will enable a major field trial in a health center in Western Uganda, where the design for this innovation will be refined in close collaboration with the health workers.

Validation of an Onsite, Easy-to-Use Chlorine Generator (SE Flow) for Infection Prevention and Control in Labor Wards

Chelsea SchillerProgram for Appropriate Technology in Health (PATH)Seattle, Washington, United States
Grand Challenges for Development
Saving Lives at Birth
1 Mar 2018

Validation of an onsite, easy-to-use chlorine generator (SE Flow) for infection prevention and control in labor wards

Validation of an Innovative Newborn Respiratory Package of Equipment and Training

Thomas BurkeProgram for Appropriate Technology in Health (PATH)Seattle, Washington, United States
Grand Challenges for Development
Saving Lives at Birth
1 Mar 2018

Validation of an innovative newborn respiratory package of equipment and training

Validation of a Point-of-Care Bilirubin Measurement to Diagnose Neonatal Jaundice and Monitor Phototherapy in Hospitals in Sub-Saharan Africa

Rebecca Richards-KortumRice UniversityHouston, Texas, United States
Grand Challenges for Development
Saving Lives at Birth
1 Mar 2018

Validation of a POC Bilirubin Measurement to Diagnose Neonatal Jaundice and Monitor Phototherapy in Hospitals in Sub-Saharan Africa

To Scale Up Specialized Training and Technology Provision for Reliable Anesthesia to Improve Surgical and Obstetric Care

Adam LewisGradian Health SystemsNew York, New York, United States
Grand Challenges for Development
Saving Lives at Birth
1 Mar 2018

To scale up specialized training and technology provision for reliable anesthesia to improve surgical and obstetric care

The Maternity Episode of Care Prototype (Liberia)

Sarah ScheeningOpen Development, LLCWashington, District of Columbia, United States
Grand Challenges for Development
Saving Lives at Birth
16 Nov 2016

This project will build and test a prototype application that streamlines and automates patient, provider and payer transactions across the maternal/newborn EOC. The goal is to pilot the application in Liberia, where the government must overcome operational challenges to engage private providers in the Liberia Health Equity Fund.

The Design and Assessment of a Task-Shifting Contraceptive Insertion Device: Increasing Access to Long-Term Contraception in Rural Low- and Middle-Income Countries

Kathleen SienkoUniversity of MichiganAnn Arbor, Michigan, United States
Grand Challenges for Development
Saving Lives at Birth
15 Feb 2016

In this proposal, we describe an assistive medical device that dramatically reduces the training required to administer subcutaneous contraceptive implants (a long-term form of contraception). The device ensures accurate insertion of the contraceptive implant and minimizes the risk of incorrect placement (a major concern during implant removal). Through use of this device, community healthcare workers (prevalent in rural areas of LMICs) would be enabled to administer a crucial form of long-term contraception and increase access to an underserved population.

Testing and Implementation of Low-cost Breathing Aid for Infants in Tigray, Ethiopia

Anjelica GonzalezYale UniversityNew Haven, Connecticut, United States
Grand Challenges for Development
Saving Lives at Birth
29 Nov 2016

PremieBreathe has built a functional infant breathing aid for $450, one tenth the price of commercial models. The device, a humidified high flow nasal cannula (HHFNC), is the gold standard of non-invasive neonatal respiratory care in high-income countries. With the support of Saving Lives at Birth, PremieBreathe will conduct initial trials at Ayder Referral Hospital in the Tigray region of Ethiopia, and identify design, manufacturing, and distribution partners to prepare for scaled production and dissemination.

Smart Sclera Screening of Jaundiced Newborns in Ghana

Terence LeungUniversity College LondonLondon, United Kingdom
Grand Challenges for Development
Saving Lives at Birth
1 Mar 2018

Smart Sclera Screening of Jaundiced Newborns in Ghana

Scaling Up the Lucky Iron Fish: A Low-Cost, Innovative Solution to Iron Deficiency Saving Lives of Women and Children in Urban Cambodia

Gavin ArmstrongLucky Iron FishGuelph, Ontario, Canada
Grand Challenges for Development
Saving Lives at Birth
1 Jan 2016

The project will scale-up distribution of the Lucky Iron Fish: an innovative, affordable, and clinically-proven solution to iron deficiency. The fish have a compliance rate of 90% and reduce the prevalence of iron deficiency by ~50%. We will integrate business, health care and university-based expertise to create a different service delivery and carry out research into the impact of the fish on iron status in women with HIV. We will promote an integrated approach that will change service delivery to some of the poorest people in urban areas including HIV positive women.

Scaling Up Simprints: Mobile Biometrics for MNCH Care in Bangladesh

Dan Storisteanu SimPrints Technology Ltd.Cambridge, United Kingdom
Grand Challenges for Development
Saving Lives at Birth
1 Mar 2018

Scaling up Simprints: Mobile Biometrics for MNCH Care in Bangladesh

Scaling the BEMPU Hypothermia Alert Device Across Indian and International Markets

Ratul NarainBEMPU TechnologiesBengaluru, Karnataka, India
Grand Challenges for Development
Saving Lives at Birth
1 Mar 2018

Scaling the BEMPU hypothermia alert device across Indian and international markets

Safer Deliveries Using Point-of-Care Decision Support and Monitoring

Marc MitchellD-Tree InternationalWeston, Massachusetts, United States
Grand Challenges for Development
Saving Lives at Birth
29 Nov 2016

The Safer Deliveries project will improve the ability of nurses and midwives to identify danger signs for a woman and her baby during the critical period of labor and delivery and link these measures to specific decision support rules that guide the health worker in taking corrective action. Using ultra-low-cost disposable ECG leads, D-tree International will build a phone based device that provides continuous tracking of fetal and maternal heart rate and uterine contractions during labor and delivery leading to more timely and effective interventions to save the life of the mother and infant.

Reduction of Maternal Death Through Postpartum Hemorrhage: A Highly Heat-Resistant Form of Oxytocin that Does Not Require Injection

Robert OffordThe Mintaka Foundation for Medical ResearchGeneva, Switzerland
Grand Challenges for Development
Saving Lives at Birth
4 Jan 2016

We will seek to demonstrate measurable levels of the first inhalable formulation of oxytocin in blood and measurable biological effects of inhalation, all this with no seriously adverse side effects. Success will provide the essential platform for the further steps required to move into a first clinical trial. Our ultimate goal is licensure and distribution in affected areas: providing every mother on the planet with access to a life-saving drug when in labor.

Rapid Diagnostic Test for Urinary Adipsin Biomarker-Based Test for Improving PE Screening in Low-Resource Settings

Nicole AdvaniProgram for Appropriate Technology in Health (PATH)Seattle, Washington, United States
Grand Challenges for Development
Saving Lives at Birth
1 Mar 2018

Rapid diagnostic test for urinary adipsin biomarker-based test for improving PE screening in low resource settings

Quadruple Fortified Salt: An Efficient and Scalable Vehicle for Simultaneous Delivery of Iron, Folic Acid, Vitamin B 12 and Iodine in Low-Resource Settings

Levente DiosadyUniversity of TorontoToronto, Ontario, Canada
Grand Challenges for Development
Saving Lives at Birth
1 Jan 2016

Salt is universally consumed at a constant, predictable level independently of social status. Our approach is to develop innovative technology for incorporating these micronutrients into salt at levels that can have a significant beneficial health effect. Our objective is to develop a stable premix in the laboratory, test its long-term stability in salt, and scale up the process for premix production in pilot scale tests in India.

Outpatient Treatment of Neonatal Sepsis by the Rectal Administration of Gentamicin

David McAdamsProgram for Appropriate Technology in Health (PATH)Seattle, Washington, United States
Grand Challenges for Development
Saving Lives at Birth
6 Dec 2016

We propose to investigate the feasibility of a needle-free method of administration for the antibiotic gentamicin via the rectal route. Under this project we would conduct laboratory release studies, preclinical rectal bioavailability studies and stakeholder interviews to assess the feasibility of novel concept. This delivery method would improve access to outpatient treatment of neonatal sepsis in areas serviced by low level healthcare providers and would remove the inherent risks associated with parenteral delivery.

NIFTY: A Neonatal Intuitive Feeding Technology for preterm infants who have difficulty breastfeeding

Trish CoffeyProgram for Appropriate Technology in Health (PATH)Seattle, Washington, United States
Grand Challenges for Development
Saving Lives at Birth
1 May 2016

The NIFTY cup's extended reservoir off the cup lip optimizes efficient milk delivery, and mothers can directly express into the 60-ml cup. The NIFTY cup's soft silicone material protects the infant's mouth from injury. The cup has embossed volume measurements to track intake; is designed to enhance finger and wrist control over milk flow; and is made with quick-drying, UV- and heat-resistant, durable, affordable silicone that can be boiled for sterilization. Our project aims to 1) generate an evidence base by validating the NIFTY cup in a hospital in Ethiopia and 2) shape the sub-Saharan Africa market by identifying a commercialization partner and developing a go-to market strategy and global advocacy plan.

Newborn Heart Rate as a Catalyst for Improved Survival

Casey LowmanAmerican Academy of PediatricsItasca, Illinois, United States
Grand Challenges for Development
Saving Lives at Birth
1 Mar 2018

Newborn Heart Rate as a catalyst for improved survival

Neonate Biometric Scanner for Frontline Health Workers

Dan Storisteanu SimPrints Technology Ltd.Cambridge, United Kingdom
Grand Challenges for Development
Saving Lives at Birth
1 Mar 2018

Neonate Biometric Scanner for Frontline Health Workers

Mobile WACh NEO: Communication Empowering Mothers and Newborns

Jennifer UngerUniversity of WashingtonSeattle, Washington, United States
Grand Challenges for Development
Saving Lives at Birth
1 Jan 2016

We will adapt and scale the existing Mobile WACh - a human-computer hybrid communication system, connects women and newborns to care during the most at-risk period, bringing a virtual provider into the home - platform, which has demonstrated efficacy for maternal and child outcomes, to target the problems of neonatal mortality and unmet need for family planning. We will utilize the strengths of our collaborative research partners to evaluate this intervention with plans to scale into electronic medical records (EMR) country-wide. Mobile WACh offers benefits over existing SMS messaging because it provides personalized support.

Microarray Patch for Delivery of a Combination of Antibiotics for the Treatment of Neonatal Sepsis

Mary KearneyQueen's University BelfastBelfast, United Kingdom
Grand Challenges for Development
Saving Lives at Birth
30 Nov 2016

This team proposes to develop and test an innovative microarray patch to deliver a combination of antibiotics for the treatment of neonatal sepsis. An easy-to-use, less-invasive, affordable delivery method for amoxicillin and gentamicin could expand access to lifesaving outpatient antibiotic treatment for infants with severe infection during the neonatal period.

Measurement of Impact of Hemafuse, An Autologous Blood Transfusion Device

Katie KirschSisu Global HealthTroy, Michigan, United States
Grand Challenges for Development
Saving Lives at Birth
1 Jun 2018

Measurement of Impact of Hemafuse, an autologous blood transfusion device

Low-Cost Technology to assess the Risk of Obstructed Labor in Ethiopia

Rudolph GleasonGeorgia Tech Research CorporationAtlanta, Georgia, United States
Grand Challenges for Development
Saving Lives at Birth
15 Mar 2016

A reliable, low-cost screening tool to identify high-risk cephalopelvic disproportion (CPD) patients is of paramount importance especially in resource-limited areas where a timely referral to a medical facility for assisted delivery or cesarean section would make the difference between saving the life of mother and child and potential loss of both patients. To address this pressing need we propose to develop and test a simple, ultra-low cost portable technology using off-the-shelf Microsoft Kinect sensor to quantify an obstructive score to identify women at high risk for CPD. The technology will create very high precision 3D patient models from which a plethora of traditional and novel anthropometric and volume measures can be extracted and used in conjunction with machine learning algorithms to establish a clinical score identifying high risk for CPD. This novel technology has the potential to establish a better risk assessment for obstruction than currently available clinical practice in low-resource setting, thus providing a low-cost avenue to save lives at birth.

Life-saving Instruction for Emergencies (LIFE) Delivered Using Serious Games and mHealth Technologies

Mike EnglishUniversity of OxfordOxford, United Kingdom
Grand Challenges for Development
Saving Lives at Birth
29 Nov 2016

Drawing on 10 years of experience developing and delivering essential newborn care training, this project will develop 3D games using an iterative co-design process in UK and Kenya so it excites users and addresses needs and preferences. This project will explore incentives for learning and develop data capture tools to understand who is playing as well as where and when they are playing. This project will also design a test of the effectiveness of our training in Kenya, explore how to extend the approach to maternal care and plan for dissemination and testing.

Inhaled Oxytocin: Bringing Gold Standard Postpartum Hemorrhage Prevention to Women in Greatest Need

Victoria OliverMonash UniversityClayton, Victoria, Australia
Grand Challenges for Development
Saving Lives at Birth
19 Dec 2016

This project seeks to substantially expand access to oxytocin through the development of an affordable, simple to administer inhaled oxytocin delivery system. Using innovative technology, inhaled oxytocin is formulated as a fine powder that can withstand the climatic conditions common in tropical regions without the need for refrigeration. The product therefore removes the requirement for cold chain supply and storage, potentially allows task-shifting to lower tier healthcare and community workers and has the potential to save 146,000 lives over 8 years.

FREo2 Solar: Battery-Free Solar-Powered Oxygen System for Small Health Facilities

Bryn SobottFRE02 FoundationMelbourne, Victoria, Australia
Grand Challenges for Development
Saving Lives at Birth
1 Mar 2018

FREO2 Solar: Battery-free solar-powered oxygen system for small health facilities

Field Validation of a New Protein-To-Creatinine (PrCr) Strip Test: An Impactful New Tool to Improve Diagnosis of Preeclampsia at the Front Lines of Antenatal Care in Low-Resource Settings

Nicole AdvaniProgram for Appropriate Technology in Health (PATH)Seattle, Washington, United States
Grand Challenges for Development
Saving Lives at Birth
1 Dec 2016

PATH seeks to improve access to improved preeclampsia screening in routine antenatal care (ANC) by addressing the need for a low-cost, accurate proteinuria screening tool to replace the protein-only dipstick as the standard used in routine ANC in LRS. PATH is working in collaboration with LifeAssay Diagnostics, Ltd. (South Africa) to develop and support validation of a simple, low-cost protein-to-creatinine ratiometric urine dipstick test and is seeking to demonstrate the feasibility for implementation and use of the test within routine ANC.

Evaluation of an Infusion Monitoring Device as a Cost-Effective Way to Increase Safe Access to Oxytocin and Magesium Sulfate

Beth KolkoShift Labs, IncSeattle, Washington, United States
Grand Challenges for Development
Saving Lives at Birth
1 Mar 2018

Evaluation of an Infusion Monitoring Device as a cost-effective way to increase safe access to oxytocin and magesium sulfate

Evaluating the Approach to Administration and Dose of Bovine Lactoferrin to Prevent Neonatal Infections in Low Birthweight Newborns in Pakistan

Michael DibleyThe University of SydneySydney, New South Wales, Australia
Grand Challenges for Development
Saving Lives at Birth
19 Dec 2016

The goal of this project is to improve newborn survival among low birth weight (LBW) infants through a daily prophylactic dose of bovine lactoferrin (bLF). A two-stage project will be conducted with formative research followed by randomized controlled trial (RCT) to evaluate the appropriate daily dose of bLF and its efficacy in preventing neonatal infections.

Development of a Model for National Scale-up of the Pratt Pouch to Expand Infant Nevirapine Prophylaxis in Uganda, Prevent Mother-to-child Transmission of HIV, and Save Infant Lives

Edward BitarakwateElizabeth Glaser Pediatric AIDS Foundation (EGPAF)Washington, District of Columbia, United States
Grand Challenges for Development
Saving Lives at Birth
16 Mar 2016

The Pratt Pouch, a foilized, polyethylene pouch (similar to a ketchup pouch) designed and proven to safely store NVP doses, offers an innovative way to expand NVP coverage. The Elizabeth Glaser Pediatric AIDS Foundation and its partners propose to introduce and scale up the Pratt Pouch in antenatal care, delivery, and postnatal care services in Uganda. Integrating this technology into existing services will simplify dosing and ensure all HIV-positive women have access to infant NVP. The easy-to-use pouches will empower women to immediately initiate NVP after delivery and encourage them to deliver in a health facility or bring their infants for postnatal care within 14 days.

Development and Evaluation of the RELI Delivery System - An Innovative, Simplified, Low-Cost Infusion Pump for Obstetric and Newborn Emergencies

Mike EisensteinProgram for Appropriate Technology in Health (PATH)Seattle, Washington, United States
Grand Challenges for Development
Saving Lives at Birth
6 Dec 2016

PATH's novel infusion pump, the RELI Delivery System, was designed to address many of the barriers surrounding access to infusion pumps in LRS: it does not require electricity or a battery, is inexpensive to manufacture and operate, does not require expensive consumables, and has a simple user interface. We will develop a functional prototype and related job aids to share with stakeholders.

Chamas for Change: Validating an integrated community-based strategy of peer support in pregnancy and infancy

Astrid Christoffersen-DebMoi University College of Health SciencesEldoret, Kenya
Grand Challenges for Development
Saving Lives at Birth
1 Jan 2016

Often faced with financial, nutritional and political insecurities, the majority of women struggle to care for their own and their children's health. To address this, we developed a peer-support model that groups pregnant women together in the same community to receive maternal and child health services, called Chama cha MamaToto (chamas). Central to our approach is the integration of health, social and financial literacy education with a savings/loans program. Having demonstrated feasibility and sustainability of the program through an earlier Saving Lives at Birth grant, we now aim to validate the success of this intervention in a new site. Implementing chamas in a population of 800,000 over 2 years, we aim to decrease maternal (MMR), perinatal (PNR), and newborn (NMR) mortality rates by 30%.

Augmented Infant Resuscitator: Transitioning a Novel Behavior Change Innovation to Drive Newborn Ventilation Enhancement to Improve Newborn Health Outcomes At Birth

Data SantorinoMbarara University of Science and TechnologyMbarara, Uganda
Grand Challenges for Development
Saving Lives at Birth
1 Mar 2018

Augmented infant resuscitator: transitioning a novel behavior change innovation to drive newborn ventilation enhancement to improve newborn health outcomes at birth

An Affordable and Robust Diagnostic Platform for Neonates and Young Children in Low-Resource Settings

Rashed ShahSave the Children Federation, IncWestport, Connecticut, United States
Grand Challenges for Development
Saving Lives at Birth
15 Nov 2016

Save the Children proposes an affordable and exclusive point-of-care diagnostic device for accurate measurement and interpretation of key vital signs (oxygen saturation, respiratory rate and temperature) among young infants (0-59 days) and children (2-59 months). It is equipped with a unique universal pulse oximeter sensor. The device will improve the quality of pneumonia case management and possible serious bacterial infections at community and health facility levels in low-resource settings.

An Accurate, Rugged and Low-Power Syringe Pump for Maternity and Neonatal Care in Resource Limited Settings

Maria OdenRice UniversityHouston, Texas, United States
Grand Challenges for Development
Saving Lives at Birth
9 Nov 2016

There is international consensus that syringe pumps are an essential medical device to support care of mothers and newborns at district hospitals. Yet, they are often unavailable in low-resource settings because of high cost, technical complexity, and lack of brand name consumables. The project's idea is to scale AutoSyp, a low cost, low power, syringe pump in maternity and neonatal wards of hospitals in Malawi.

All Babies Count (ABC): Eliminating Preventable Neonatal Deaths in Rwanda

Catherine KirkPartners in HealthBoston, Massachusetts, United States
Grand Challenges for Development
Saving Lives at Birth
1 Jun 2016

To increase health-system capacity to prevent newborn deaths using evidence-based measures, Partners In Health has developed the All Babies Count (ABC) model, an intensive 18-month change acceleration process. The ABC model - instead of focusing on a single change strategy - creates sustainable impact by re-orienting the culture of the health system to continuous quality improvement (QI). The ABC model: (i) equips health workers with essential supplies; (ii) provides on-site, regular clinical mentorship to improve delivery of evidence-based interventions; and (iii) launches learning collaboratives to promote data utilization for continuous improvement.

A Loyalty Program to Mobilize and Sustain Maternal and Neonatal Health

Benson WamalwaUniversity of NairobiNairobi, Kenya
Grand Challenges for Development
Saving Lives at Birth
15 Jan 2016

We have developed a sustainable barcode-based incentive system that encourages "loyal health visits". Pilot proof was undertaken for child and mother vaccinations with strong evidence that our Barcode Mother and Child Wellness Card innovation could very quickly elicit a positive behavioral response for immunization adherence in low resource smallholder settings. Our project's goal is to validate this novel approach to mobilize and sustain maternal and neonatal health visits with special emphasis on around the time of birth but all the while tracking the pregnant mother along the continuum of antenatal care. We specifically address the problem of few (no) antenatal care visits and skilled attendant deliveries with the goal of reaching every pregnant mother and/or neonates. The Mother and Child Wellness Loyalty Card will apply quick response (QR) codes to track ANC attendance and reward mothers with discounts on essential livelihood items thereby creating demand for both health and livelihood services.

"Help, the Mother Is Bleeding!" An Interactive Voice-Controlled Virtual Mentor to Support Birth Attendants in Resource-Constrained Settings

Tiffany LundeenPreterm Birth Initiative East AfricaSan Francisco, California, United States
Grand Challenges for Development
Saving Lives at Birth
1 Mar 2018

"Help, the Mother is Bleeding!" An interactive voice-controlled virtual mentor to support birth attendants in resource-constrained settings

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