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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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"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

"Just-Add-Water" Nucleic Acid Amplification

Apostolos AlissandratosThe Australian National UniversityActon, Australian Capital Territory, Australia
Grand Challenges Explorations
Diagnostics Systems
1 May 2018

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.

"Krik Krak": Mental Health for Pregnant Haitian Teens

Guitele RahillUniversity of South FloridaTampa, Florida, United States
Grand Challenges Explorations
Maternal Mental Health
1 May 2018

Guitele Rahill and Manisha Joshi of the University of South Florida in the U.S. will harness the Haitian tradition of storytelling to produce online videos, brochures, and posters that support pregnant teenagers in Haiti who are at high risk of depression. There has been an increase in unplanned teenage pregnancies since the 2010 earthquake, due in part to the loss of parents, and a rise in transactional sex and sexual assaults facilitated by very limited resources. Pregnancy places a substantial additional stress on these children, which in turn causes long-term difficulties for their children. In Haiti, to tell a story you announce "Krik?", and to hear it you respond "Krak!" They will use this familiar story-telling framework and actors who resemble the target group to teach pregnant teenagers about childbirth, motherhood, and how to cope with depression. They will conduct two focus groups of six pregnant teens to identify the specific challenges they face, and use their feedback to help ensure the approach will work.

10+10+30 Infant Vaccines Communication via Radio in Ethiopia

Bernard AppiahTexas A&M School of Public HealthCollege Station, Texas, United States
Grand Challenges Explorations
Immunization Delivery
1 May 2018

Bernard Appiah of Texas A&M School of Public Health in the U.S. will produce a one-hour community radio program to be aired twice per week comprising a 10-minute radio drama serial on infant vaccines, a 10-minute panel discussion by community health workers, and a 30-minute phone-in by listeners, to improve on-time childhood vaccinations in Ethiopia. In 2016, on-time and full immunization coverage in Ethiopia was only achieved for 39% of children between one and two years of age, despite long-term efforts to improve it. One of the main reasons for this was lack of communication with mothers about immunizations. To address this, they will harness the popularity of community radio in Ethiopia. They will engage mothers, community health workers, and radio actors to help design a radio drama incorporating relevant topics on childhood immunizations, and train 20 health workers to be part of radio panel discussions. They will air the radio program for six months in two districts, and determine its impact on timely immunization coverage in a selected cohort of mothers with infants.

A Blended Intervention: Digital Mental Health Game and Mentoring for Treatment of Common Perinatal Mental Disorders in Adolescent Refugee Mothers

Rebecca DempsterHIASSilver Spring, Maryland, United States
Grand Challenges Explorations
Maternal Mental Health
1 May 2018

Rebecca Dempster of HIAS in the U.S. will develop an online game- and mentorship-based intervention to improve the mental health of refugee adolescent mothers in Kenya that integrates into their daily lives and helps them develop new skills. Digital games can help treat mental health disorders such as depression particularly in young people because they have a natural appeal and are easy to access from home. They will recruit ten young mothers, a psychologist, and software programmers to design a mental health game so that it can be used to identify those with mental health disorders and connect them with counselors, and provides interactive challenges to help treat and protect against those disorders as well as build relevant life skills. They will then train these young mothers to act as mentors to support the online game, and pilot test their approach on a sample of 15 refugee adolescent mothers over three months to evaluate feasibility, acceptability, and effect on maternal depression.

A Crowd-Sourcing Approach to Large-Scale Monitoring of Pests by Smallholder Farmers

Menale KassieInternational Centre of Insect Physiology and EcologyNairobi, Kenya
Grand Challenges Explorations
Crop Disease Surveillance
1 Nov 2018

Menale Kassie of the International Centre of Insect Physiology and Ecology in Kenya along with Ram Fishman and Opher Mendelsohn from Tel Aviv University in Israel will take a community-based crowdsourcing approach to crop protection of smallholder farms in low-resource settings by developing a simple software platform for basic feature phones to monitor pest incidence. Human-based monitoring of crops is the most accurate way to identify pests, but there are too few public monitoring agents in low-resource settings, leaving the majority of farms unprotected. Engaging the smallholder farmers to monitor their own crops is a promising solution, but most of them lack sophisticated equipment like smart phones and have low technical knowledge, so simpler solutions are needed. Therefore, they will adapt commercially-available software that collates and analyzes pest incidence data for basic feature phones and, together with smallholder farmers, design simple interfaces for SMS communication. They will test their approach by performing a pilot study to monitor wheat and maize, covering one to two counties in Kenya, and teach smallholder farmers and government agents how to use the monitoring system and compare the data with that collected by expert field agents.

A Developing Story: HIV Resistance Among African Populations May be Linked to Genotypic Traits of Type 2 Diabetes

Elijah SongokKenya Medical Research InstituteNairobi, Kenya
Grand Challenges Explorations
HIV Infection
1 Oct 2008

Elijah Songok at the Kenya Medical Research Institute hopes to better understand preliminary findings from studies of sex workers that natural resistance to HIV may be linked to genetic markers for type 2 diabetes.

A Digital Platform for 21st Century Education

Saurabh AgarwalDeeper Learning Innovations Private LimitedLucknow, Uttar Pradesh, India
Grand Challenges
Teaching and School Leadership
1 Nov 2018

Saurabh Agarwal of Deeper Learning Innovations Private Limited in India will build an interactive, digital teaching platform using advanced data analytics and artificial intelligence algorithms to enable teachers across the globe to more effectively teach life skills to every child. Teaching standards in developing countries suffer from limited access to quality content, restricted teaching methods for teachers, and a lack of ways to transfer knowledge and skills to other teachers and parents. Life skills such as problem solving and communication that are needed to address 21st century challenges such as health, wellness, and gender equality are far better learned by experience and reflection, rather than reading and lectures. They will build the platform and incorporate life skills modules designed by learning experts and teachers containing multi-lingual and contextualized content for global access, a teacher's discussion forum, and a module designed by teachers to help parents support their child's education. The goal is to make the platform freely available and accessible to all teachers across the globe.

A Mobile-Based Training Platform for ASHA workers

Pushpendra SinghIIIT-DelhiNew Delhi, Delhi, India
Grand Challenges Explorations
Immunization Delivery
1 May 2018

Pushpendra Singh of IIIT Delhi in India will develop interactive training and mentoring sessions for community health workers in India (ASHAs) using mobile phones and interactive voice response systems so they can provide better public healthcare in rural communities. Current training programs are run by medical professionals and require the workers to visit a health center, which may be inconvenient. The lack of medical experts has also reduced the frequency of these programs. These limitations could be overcome with online sessions whereby one expert trains multiple health workers remotely. They have already developed the format of the sessions, which involves an expert delivering a defined curriculum to groups of health workers followed by a question and answer session, and shown that it improved the knowledge and confidence of the health workers in a pilot test. They will now scale up the testing to 500 health workers, and also evaluate the platform as a peer-to-peer learning mechanism for health workers to share their experiences and learn from each other without the need for an expert.

A Mutable Vaccine for HIV

Marilia CascalhoUniversity of MichiganAnn Arbor, Michigan, United States
Grand Challenges Explorations
HIV Infection
1 Oct 2008

Marilia Cascalho of the University of Michigan will test whether a “mutable”DNA vaccine in which the gene coding for the antigen mutates a million times more frequently than a typical gene will trigger immune response that anticipates the production of new viral variants and produces broadly neutralizing antibodies against HIV.

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