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.

We propose to develop a low-cost Nipple Shield Delivery System (NSDS) to administer drugs or nutrients to breastfeeding infants via easily disintegrating tablets within a modified nipple shield. A wide-range of active pharmaceutical ingredients (APIs) could be delivered to infants using the NSDS such as antibiotics, antimalarials, antiretrovirals, vitamins, nutrients, and probiotics. Use of the NSDS would empower a breastfeeding mother during the early postnatal period by allowing her to personally administer medicines in a natural setting. This system can provide a novel method for accurately administering drugs and nutrients to breastfeeding infants.

Guatemala has one of the highest national maternal mortality ratios in Latin America at 149 per 100,000 live births, and up to 260 per 100,000 in some northern departments. Only 31% of deliveries are attended by a skilled birth attendant. We propose to scale up an already tested innovative strategy, combining technology, service delivery, and demand creation approaches. Our collaborative effort integrates: 1) a low cost, simulation-based training program (PRONTO) using a low-tech birth simulator (PartoPants) to teach provider teams emergency management during childbirth, 2) a research-driven social marketing campaign encouraging women in the target communities to give birth in clinics rather than at home, and 3) professional midwife liaisons charged with connecting traditional birth attendants to the formal health care system. We expect that this effort will catalyze critical practice changes in maternity care, increase the proportion of births attended in clinics, improve maternal outcomes, and decrease perinatal death in indigenous Guatemalan communities.

Rodolfo de Carvalho Pacagnella from the Universidade Estadual de Campinas in Brazil will perform two randomized clinical trials across 15 obstetric clinics in Brazil to evaluate treatment with progesterone in the presence or absence of a cervical pessary for preventing spontaneous preterm birth. Both cervical pessary and progesterone are individually considered to be effective preventative treatments for preterm birth, which is one of the most common complications seen in pregnancy and can cause severe complications for the premature infant. The causes of preterm birth are mostly unknown, although incidence does increase with cervical shortening during the mid stages of pregnancy. They will also analyze the prevalence of a short cervix in Brazilian pregnant women, and determine how well it predicts preterm birth. Their approach to screen for cervix length and then treat high-risk individuals with the combination therapy will also be evaluated for cost-effectiveness.